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- Title
Evaluation of Inappropriate COVID-19 RT–PCR Test Utilization at an Academic Medical Center.
- Authors
Hardy, Naomi L; Luethy, Paul M
- Abstract
Background: An evolving COVID-19 testing landscape and issues with test supply allocation, especially in the current pandemic, has made it challenging for ordering providers. We audited orders of the Xpert® Xpress SARS-CoV-2 PCR with reverse transcription (RT–PCR) platform—the fastest of several other testing modalities available—to illuminate these challenges utilizing a multidisciplinary laboratory professional team consisting of a pathology resident and microbiology laboratory director. Methods: Retrospective review of the first 5 hundred Xpert Xpress SARS-CoV-2 RT–PCR test orders from a 2-week period to determine test appropriateness based on the following indications: emergency surgery, emergent obstetric procedures, initial behavioral health admission, and later including discharge to skilled care facilities and pediatric admissions. Our hypothesis was that a significant proportion of orders for this testing platform were inappropriate. Results: On review, a significant proportion of orders were incorrect, with 69.8% (n = 349, P < 0.0001) not meeting indications for rapid testing. Of all orders, 249 designated as emergency surgery were inappropriate, with 49.0% of those orders never proceeding with any surgical intervention; most of these were trauma related (64.6% were orders associated with a trauma unit). Conclusions: Significant, pervasive inappropriate ordering practices were identified at this center. A laboratory professional team can be key to identifying problems in testing and play a significant role in combating inappropriate test utilization.
- Subjects
COVID-19 testing; NURSING care facilities; TESTING laboratories; TRAUMA centers; SURGICAL emergencies; ACADEMIC medical centers
- Publication
Journal of Applied Laboratory Medicine, 2021, Vol 6, Issue 6, p1484
- ISSN
2475-7241
- Publication type
Article
- DOI
10.1093/jalm/jfab081