Evidence-Based Practice Screening for Coagulation Testing Could Save Jackson Money

Dr. David Woolsey

Local 1991 Trustee Dr. David Woolsey has been working on an efficiency project that involves implementing an evidence-based screening tool for ordering coagulation testing that would improve quality care while saving Jackson hundreds of thousands of dollars!

Coagulation testing is often part of routine preoperative or pre-procedure testing, but evidence-based studies have found that lab screening is not as effective as conducting a careful patient history and physical.  The $3 test is administered about 5,000 times a week at Jackson, costing about $780,000 each year. Cutting the amount of coagulation testing in half would save our public hospital almost $400,000 a year.

The Efficiency Task Force will be educating clinicians about using this new screening tool (See box below). “Our screening tool allows clinicians to use patient history and physical findings to determine which patients would benefit from the lab test,” Dr. Woolsey said. “We think that with this approach, we will considerably reduce the amount of unnecessary testing, which will save Jackson a significant amount of money while improving quality care.”

“Many healthcare providers order coagulation studies because it’s routine,” Dr. Woolsey said. “This tool addresses the challenge of bringing evidence-based practices to the point of care. Ultimately, we’re serving patients better and saving money for Jackson.”

Evidence-Based Indications for Preop/Preprocedure Coagulation Testing

1.) Personal or family history of bleeding disorder (such as hemophilia)

2.) Personal history of excessive bleeding after minor trauma or prior to surgery/dental procedure

3.) History or clinical suspicion of liver disease, malnutrition, use of medication affecting coagulation (such as heparin, warfarin)

4.) Reliable history is unobtainable

5.) Baseline values necessary for planned anticoagulation