A 5-step root cause analysis model for test overutilization a study on its application to plasma transferrin testing
Issued Date
2024-08-01
Resource Type
ISSN
00029173
eISSN
19437722
Scopus ID
2-s2.0-85200213575
Pubmed ID
38447167
Journal Title
American Journal of Clinical Pathology
Volume
162
Issue
2
Start Page
160
End Page
166
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Clinical Pathology Vol.162 No.2 (2024) , 160-166
Suggested Citation
Jittapranerat J., Chinswangwatanakul W. A 5-step root cause analysis model for test overutilization a study on its application to plasma transferrin testing. American Journal of Clinical Pathology Vol.162 No.2 (2024) , 160-166. 166. doi:10.1093/AJCP/AQAE015 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/100441
Title
A 5-step root cause analysis model for test overutilization a study on its application to plasma transferrin testing
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Author's Affiliation
Corresponding Author(s)
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Abstract
Objectives: This study aimed to develop a root cause analysis (RCA) model for test overutilization, applying it to transferrin overordering at our institution. Methods: A comprehensive review was undertaken to establish a systematic RCA model. Upon implementation, the questionnaire identifying the root causes of transferrin overordering with infographic intervention was distributed to clinicians and nurses. Results: The RCA model comprises 5 steps: (1) problem identification, (2) causal factor determination, (3) data collection, (4) significant factor identification, and (5) corrective action development and outcome measurement. The major causes of transferrin overutilization were confusion between transferrin and transferrin saturation, as well as unfamiliarity with the laboratory handbook. An infographic reduced postintervention transferrin ordering among clinicians (84.9%, P < .001) and nurses (46.8%, P < .001). Conclusions: This study presents a 5-step RCA model that offers a customized method to identify the causes of test overutilization. Applying this model to transferrin at our institution revealed 22 leading root causes. Laboratories are encouraged to adopt this RCA model as it can contribute to optimized patient care and more efficient resource allocation.