• D S Groopman and R D Powers.
• Department of Medicine, University of Virginia, Health Sciences Center, Charlottesville.
• Ann Emerg Med. 1992 May 1;21(5):524-7.

Study ObjectivesTo determine whether the test ordering of physicians working in a teaching hospital emergency department could be influenced by modification of automated laboratory order sets.DesignProspective, using data from the same ED before and after intervention.SettingA 58,000-visit public university hospital ED.Type Of ParticipantsEmergency physicians caring for adult patients admitted from the ED to the ward medical services.InterventionBeginning July 1, 1989, coagulation studies were deleted from the automated admission order sets used in the study hospital ED.Measurements And Main ResultsPatient charts were examined to assess the effect of coagulation study deletion on the frequency and appropriateness of coagulation test ordering. A tripling of the percentage of patients who did not receive coagulation parameter testing was noted (P less than .0001, chi 2). In no case were the tests omitted when a high-yield indication for their use was present. This resulted in an estimated reduction of $20,000 per year in patient charges.ConclusionModification of ED "standard orders" can result in reduction of laboratory use without an adverse effect on patient care.

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