About: Audit and feedback to improve laboratory test and transfusion ordering in critical care: a systematic review

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About: Audit and feedback to improve laboratory test and transfusion ordering in critical care: a systematic review Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Audit and feedback to improve laboratory test and transfusion ordering in critical care: a systematic review
Creator	Brehaut, Jamie Carroll, Kelly Foster, Madison Hutton, Brian Presseau, Justin Mcintyre, Lauralyn Mccleary, Nicola
Source	Medline; PMC
abstract	BACKGROUND: Laboratory tests and transfusions are sometimes ordered inappropriately, particularly in the critical care setting, which sees frequent use of both. Audit and Feedback (A&F) is a potentially useful intervention for modifying healthcare provider behaviors, but its application to the complex, team-based environment of critical care is not well understood. We conducted a systematic review of the literature on A&F interventions for improving test or transfusion ordering in the critical care setting. METHODS: Five databases, two registries, and the bibliographies of relevant articles were searched. We included critical care studies that assessed the use of A&F targeting healthcare provider behaviors, alone or in combination with other interventions to improve test and transfusion ordering, as compared to historical practice, no intervention, or another healthcare behaviour change intervention. Studies were included only if they reported laboratory test or transfusion orders, or the appropriateness of orders, as outcomes. There were no restrictions based on study design, date of publication, or follow-up time. Intervention characteristics and absolute differences in outcomes were summarized. The quality of individual studies was assessed using a modified version of the Effective Practice and Organisation of Care Cochrane Review Group’s criteria. RESULTS: We identified 16 studies, including 13 uncontrolled before-after studies, one randomized controlled trial, one controlled before-after study, and one controlled clinical trial (quasi-experimental). These studies described 17 interventions, mostly (88%) multifaceted interventions with an A&F component. Feedback was most often provided in a written format only (41%), more than once (53%), and most often only provided data aggregated to the group-level (41%). Most studies saw a change in the hypothesized direction, but not all studies provided statistical analyses to formally test improvement. Overall study quality was low, with studies often lacking a concurrent control group. CONCLUSIONS: Our review summarizes characteristics of A&F interventions implemented in the critical care context, points to some mechanisms by which A&F might be made more effective in this setting, and provides an overview of how the appropriateness of orders was reported. Our findings suggest that A&F can be effective in the context of critical care; however, further research is required to characterize approaches that optimize the effectiveness in this setting alongside more rigorous evaluation methods. TRIAL REGISTRATION: PROSPERO CRD42016051941.
has issue date	2020-06-19(xsd:dateTime)
bibo:doi	10.1186/s13012-020-00981-5
bibo:pmid	32560666
has license	cc-by
sha1sum (hex)	5e75896574b66c4a0eb3e3cf61a1260457631343
schema:url	https://doi.org/10.1186/s13012-020-00981-5
resource representing a document's title	Audit and feedback to improve laboratory test and transfusion ordering in critical care: a systematic review
has PubMed Central identifier	PMC7303577
has PubMed identifier	32560666
schema:publication	Implement Sci
resource representing a document's body	covid:5e75896574b66c4a0eb3e3cf61a1260457631343#body_text
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