Cost-analysis project: Daily CBC

Slides:

Advertisements

Similar presentations

Diagnostic Work-up. There is no specific laboratory or imaging test to diagnose irritable bowel syndrome. Currently the diagnosis of IBS relies on meeting.

Advertisements

Cost analysis project : Ordering Magnesium and Phosphorus Pouneh Nasseri R2 12/17/12.

Chart Review Duplicate testing of Hemoglobin A1c in patients admitted to UCI under medicine team D Samantha Harris UCI Internal Medicine Residency October.

B USINESS IN M EDICINE H OW ARE WE USING T ELEMETRY ? Asad Qasim MD, MPH – PGY2.

COST CONCIOUSNESS PROJECT FECAL OCCULT BLOOD TEST (FOBT) – APPROPRIATE OR NOT APPROPRIATE? by Kelvin Nguyen 05/10/2013.

Cost-Conscious Care Presentation Follow-up Chest X-Ray in Patients Admitted for Community Acquired Pneumonia Huy Tran, PGY-2 12/12/2013.

Gastro Intestinal Bleeding By: Abdulrahman Sindi ED Resident.

OBJECTIVES NOT TO BE A NEPHROLOGIST

IST-3 – an imaging substudy Dr Ingrid Kane Clinical research fellow.

Duplicate HgA1c Testing

Iatrogenic Anemia in the ICU Anh Nguyen, MD, MPH, PGY2.

ACOVE 4: Continuity and Coordination of Care in Vulnerable Elders Continuity is ‘‘care over time by a single individual or team of healthcare professionals’’

Objectives  Identify appropriate usage of BMP  Evaluate UCI Medicine Ward teams on usage of daily BMP and determining how often residents over-order.

Improving Patient Safety at the RD&E Council of Governors January 2010, Item 9 Respond, Deliver & Enable.

Wrexham South Locality Health & Well-Being Pilot Results and Findings to date Wrexham South Locality Health & Well-Being Pilot Appendix 4.

MORTALITY AUDIT Dr S Callin SpR Palliative Medicine Dr L Russon Consultant Palliative Medicine BRI Palliative Care Team.

Appropriateness of PE workup at UCI based on Well’s Criteria Amy Ni, MD Cost Consciousness Project: March 2015.

Copenhagen University Hospital Rigshospitalet, Denmark

THE USE OF CARDIAC MONITORING FOR NON-ICU MEDICINE PATIENTS AT UCI: A FOLLOW UP Jerry Yu DSR2.

Post-implementation study on appropriate GI prophylaxis in the Inpatient Setting David Nguyen 5/14/12.

Ordering CT Heads on the inpatient setting An Update of the Original Project from January 2012 Cost Containment Project DSR II June 2016 Thi Mai, PGY-2.

The Southampton Mobility Volunteer programme to increase physical activity levels of older inpatients: a feasibility study (SoMoVe) Dr Stephen Lim Specialist.

THE USE OF CARDIAC MONITORING FOR NON-ICU MEDICINE PATIENTS AT UCI: A FOLLOW UP OF A FOLLOW UP Michelle Le – PGY2 DSR2 Cost Conscious Project.

What the Diff? (Cost Analysis Project)

PROTON PUMP INHIBITORS (PPI)

Cost conscious project: Microcytic anemia

Ruchi Kapoor, MD, PhD DSR 2 Cost Consciousness Project

Warfarin in primary care

Thrombocytopenia Allen Chang, PGY2 5/18/15.

CTC Clinical Strategy and Cost Committee

GI Inpatient Services post AAU

Copenhagen University Hospital Rigshospitalet, Denmark

Not Wanting to Miss a Beat – Is it Costing Us?

Cost Effective Use of Troponin to Rule Out Acute Coronary Syndrome

Dynamic Discharging in Medicine

Major case presentation Dimorphic anemia

Cerebral sinus and venous thrombosis in postpartum women

NHSI - Criteria Led Discharge Case study: Oxleas NHS Foundation Trust

MAJOR CASE PRESENTATION ON SEVERE ANEMIA

Overuse of INR and PT Testing in Medical Inpatients

UCI internal medicine mini-lecture series By Julia Kao

Trap B and Hansen EH Euro Health Group, Denmark &

Relative Adrenal Insufficiency

Antimicrobial Stewardship in Long Term Care Facilities

Study Skills Checklist for Students

Symptom Management: Terminal Agitation J28 & J29

The three components of patient self-care

OUT-PATIENT IN A BED (OIB) PROCESS.

BMP Ordering Practice Among UCI Wards Teams

Jennifer S. Albrecht, PhD, Jessina C. McGregor, PhD, Erik K

PRBC Transfusions Medicine Floors Internal Medicine, PGY-3

Goals of Care and End-of-Life Decision Making for Hospitalized Patients at a Canadian Tertiary Care Cancer Center David Hui, MD, MSc, FRCPC, Andrea Con,

Gregory P. Samsa, PhD, Steven Wolf, MB, Thomas W

Clostridium difficile Update

QAPI HOW WE IMPROVE.

New Tool to Help Prevent Readmissions Modified LACE Tool

GHS Outpatient Enoxaparin Program

Evaluation Pleural Effusions

VOD/SOS: Aligned Education for Patients and the Interprofessional Team

Antimicrobial ward round

Appropriateness of Potassium Repletion on UCI Wards

Safe Staffing Reports / NQB

Ward Redesign Pilot Data Cycle 2

Calculate Well’s score for PE (BOX1)

The use of telemetry cardiac monitoring on inpatient wards at UCI

Easily available adjustment criteria for the comparison of antibiotic consumption in a hospital setting: experience in France B. Amadeo, C. Dumartin,

CAMBODIA EXPERIENCES ON MTP (MONITORING-TRAINING-PLANNING) TO REDUCE INAPPROPRIATE MEDICINE USE IN HOSPITAL Prepared by Dr. Sok Srun and Dr. Chroeng Sokhan.

Patient Outcomes when Housestaff Exceed 80 Hours per Week

Mean BP by visit - all patients

Mindfulness based Laboratory ordering: a new quality control project

Presentation transcript:

Cost-analysis project: Daily CBC Hoa Nguyen, MD PGY2 April 2017

Background Daily CBCs are often ordered to monitor patients though at times not necessarily indicated

The Plan Define indications for CBC (with and without differentials) Identify cost of CBC at UCI Monitor the CBC ordering practices of one UCI ward team over one week Calculate the number of inappropriately ordered CBC and associated costs

Indications for CBC On admission New signs or symptoms of infection New signs of symptoms of anemia Active GI bleeding Monitoring thrombocytopenia Contraindications: Patient without above criteria and daily monitoring in hemodynamically stable patients

Costs CBC $54 CBC with differential: $65

The Results Day Number of CBC/CBC with diffs ordered Number not indicated Excess cost 1 16 5 ~$300 2 14 6 ~$360 3 18 4 ~$240 15 10 7 17 ~$420

The Results Total excess cost in 1 week: ~$2004 Projected excess cost in 1 year for 1 team:~$104,208 Projected excess cost in 1 year for all medicine teams: ~$625,248

Conclusions There is a large amount of excess ordering of CBCs This results in high excess cost especially if projected to a year and even more when considering all medicine teams There should be more care in ordering CBCs and only ordering for indicated reasons.