ABSTRACT
OBJECTIVE: The objective of this study was to determine if variation in compliance to standards listed in Ancillary (Bedside) Blood Glucose Testing in Acute and Chronic Care Facilities (ABBGT) was linked to variation in patient outcomes. DESIGN AND SETTING: A retrospective analysis examined 450 hospitalized patients with a diagnosis of diabetes from three hospitals with high, medium, and low assessment scores for compliance with ABBGT guidelines. Patients with a diagnosis of diabetes without surgical interventions or intensive care unit stays were selected for the study. MAIN OUTCOMES MEASURED: percent bedside glucose tests that were out of normal range and length of stay. RESULTS: Compliance with ABBGT guidelines explained the variation for out of range bedside glucose tests---1.4% and length CONCLUSION: Within a narrow range and high level of compliance with ABBGT guidelines, the compliance scores had a small effect upon the selected outcomes. The hypothesis that following ABBGT guidelines improves patient outcomes was neither proven nor disproven with this study.
Subject(s)
Blood Glucose/analysis , Guideline Adherence , Outcome and Process Assessment, Health Care , Point-of-Care Systems , Practice Guidelines as Topic , Aged , Diabetes Mellitus/diagnosis , Female , Humans , Intensive Care Units , Male , Middle Aged , Practice Patterns, Physicians'/statistics & numerical data , Treatment OutcomeABSTRACT
Screening for disease prior to the manifestation of clinical symptoms is a secondary method of disease prevention. Its use in clinical laboratory testing is based on disease prevalence, etiology, and physiology and on characteristics of the screening tests, including sensitivity, specificity, and positive and negative predictive values. An overview of the principles of screening is presented. Analytic evaluation methods, such as cost-effectiveness analysis, use data relevant to screening programs to examine new protocols. Results of studies reported in the literature are included in the discussion of screening with clinical laboratory tests for three diseases affecting women. Development of effective and appropriate screening protocols for specific diseases incorporate scientific data from randomized controlled trials and economic analytical evaluation methods in conjunction with societal perspectives and desires.
Subject(s)
Mass Screening/methods , Bias , Clinical Laboratory Techniques , Colorectal Neoplasms/diagnosis , Female , Hemochromatosis/diagnosis , Hemochromatosis/genetics , Humans , Mass Screening/economics , Mass Screening/statistics & numerical data , Outcome Assessment, Health Care , Predictive Value of Tests , Thyroid Diseases/diagnosisABSTRACT
The present assessment of laboratory quality is primarily a qualitative summary process. The objective of our study is to convert a qualitative standards document into a quantitative, weighted scoring system. We selected a laboratory testing standards document, Ancillary (Bedside) Blood Glucose Testing in Acute and Chronic Care Facilities, C30, developed by the National Committee for Clinical Laboratory Standards (NCCLS), as our prototype and used a two-stage, modified delphi technique. Sixty-nine criteria were identified from the C30 document. Using a two-stage, modified delphi technique, members of the NCCLS committee that developed the guideline weighted the relative importance of each criteria. This weighting system then was used to evaluate the quality of bedside glucose testing at the 14 general hospitals located within the city limits of Boston.
