Altering a computerized laboratory test order form rationalizes ordering of laboratory tests in primary care physicians

Peer reviewe

Assessment of the effectiveness of electronic gatekeeping as a utilization management tool at Groote Schuur Hospital

BACKGROUND: Utilization management ensures the appropriateness of laboratory testing by reducing the performance of tests which can be reasonably avoided with no adverse effects for the patient. Electronic gatekeeping, a utilization management tool, was introduced at Groote Schuur in 2010. Criteria were based on the minimum retesting interval, healthcare location, level of experience and discipline of the requesting clinician and specific ICD-10 codes. METHODS: A retrospective observational study assessing the effectiveness of electronic gatekeeping at Groote Schuur Hospital (Cape Town, South Africa), by comparing the test request volumes by using absolute test numbers and pre-defined ratios in the year prior to gatekeeping, to the two years following implementation. A secondary aim is to apply selected ratios to the other national academic hospitals to determine the potential for cost saving. RESULTS: At the medical wards of Groote Schuur Hospital there was an overall decrease in number and cost of tests of 24% per inpatient day for 2011. The most dramatic difference in cost is seen for chloride (91%) followed by HbA1c (90%), FT3 (89%) and CRP (82%). The application of ratios to Groote Schuur Hospital show a decrease in 2011 in all ratios apart from PCT: FBC+WCC (0.003 vs 0.002) and Mg: Ca (0.86 vs 0.84). AST: ALT remained the same at 0.55. This suggests overall effectiveness of the eGK rules although there is ongoing panel requesting. If the GSH eGK rules were to be applied at all other national academic hospitals, it could translate into a potential cost saving of $13 411 873.96 (R103 196 838.80) per annum. CONCLUSIONS: Electronic gatekeeping is an effective utilization management tool at Groote Schuur Hospital. It is relatively easy to implement and manage, and when combined with additional tools has the potential to result in larger reductions of unnecessary tests, cost savings and improved patient outcome

The competing discourses of workplace health

"This study provides a postcritical analysis of the discourses on workplace health, using data gathered with information technology company Labyrinth Computing."Doctor of Philosoph

Auditing Symposium XIII: Proceedings of the 1996 Deloitte & Touche/University of Kansas Symposium on Auditing Problems

Meeting the challenge of technological change -- A standard setter\u27s perspective / James M. Sylph, Gregory P. Shields; Technological change -- A glass half empty or a glass half full: Discussion of Meeting the challenge of technological change, and Business and auditing impacts of new technologies / Urton Anderson; Opportunities for assurance services in the 21st century: A progress report of the Special Committee on Assurance Services / Richard Lea; Model of errors and irregularities as a general framework for risk-based audit planning / Jere R. Francis, Richard A. Grimlund; Discussion of A Model of errors and irregularities as a general framework for risk-based audit planning / Timothy B. Bell; Framing effects and output interference in a concurring partner review context: Theory and exploratory analysis / Karla M. Johnstone, Stanley F. Biggs, Jean C. Bedard; Discussant\u27s comments on Framing effects and output interference in a concurring partner review context: Theory and exploratory analysis / David Plumlee; Implementation and acceptance of expert systems by auditors / Maureen McGowan; Discussion of Opportunities for assurance services in the 21st century: A progress report of the Special Committee on Assurance Services / Katherine Schipper; CPAS/CCM experiences: Perspectives for AI/ES research in accounting / Miklos A. Vasarhelyi; Discussant comments on The CPAS/CCM experiences: Perspectives for AI/ES research in accounting / Eric Denna; Digital analysis and the reduction of auditor litigation risk / Mark Nigrini; Discussion of Digital analysis and the reduction of auditor litigation risk / James E. Searing; Institute of Internal Auditors: Business and auditing impacts of new technologies / Charles H. Le Grandhttps://egrove.olemiss.edu/dl_proceedings/1012/thumbnail.jp

Organizational Response to Perceptual Risk: Managing Substantial Response to Unsubstantiated Events

Analysis and perceived severity of risk influences organizational decisions to anticipated threats. As economic development and technology improve our standards of living, they also create new challenges to conceptualizing concrete and abstract threats. Organizations that face new threats, along with agencies that oversee these organizations, produce tightly coupled systems that increase risks for direct, indirect, and future stakeholders (Perrow, 1999). Natural disasters, political misbehavior, organizational corruption, financial collapse, food and water contaminations, chemical or nuclear accidents, international tension, to name a few, all present risks and challenges. Unfortunately, many of these situations endanger the lives and well-being of persons. The ability of individuals to conceptualize, prioritize, and respond to myriad threats ultimately determines their risk perception and intention to act accordingly. Individuals often exaggerate some risks, while failing to acknowledge the severity of others (Sandman, 1989; Lachlan & Spence, 2007). This study will contribute to the understanding of subjectively constructed threats by examining three specific perceptual crises: A hoax, near miss, and risk misconstrual event. Each of these cases relies on robust newspaper descriptions, content analysis of media, and confirmatory organizational interviews. They are documented through a level of legislative action to determine real and structural changes incurred from perceptual crises. From these investigations this dissertation articulates how perceptual crises challenge organizations and governments, ascertains the viability of actional legitimacy theory, and observes variance in communication challenges between differing crisis contexts. These expectations encompass both applied and theoretical contributions