Diagnostic Services Utilization Improvement Process

The Diagnostic Services Improvement Project uses three interventions targeting physicians ordering practices: Distribution of information on the cost of testing; evidence-based test ordering guidelines; and test ordering data for the top 50 per cent of ordering physicians as directed by the Hospital Medical Advisory Committee (MAC) and the Chief Executive Officer (CEO). This approach has resulted in a reduction in testing for 11 out of 13 tests targeted three months post intervention, for an overall reduction in testing of 18.5 per cent or 22,500 tests annually. The largest percentage of the change is a result of change in practice of the top 50 per cent of ordering physicians. The results of these reductions have improved up to 12 months post intervention for Erythrocyte Sedimentation Rate (ESR), Prostate Specific Antigen (PSA) and Lumbar Spine, and for Carcinoembryonic Antigen (CEA) after six months. The results of Chest X-Ray and Portable Chest X-Ray remain stable 9 months post intervention. This suggests that the changes in ordering practices are sustainable over time.