eMJA: Isouard, Box 3

3: Changes in the use of clinically indicated tests for the experimental confirmed acute myocardial infarction group
	Pre-TQM intervention period			TQM intervention period			Percentage point increase
	Number of tests			Number of tests			in indicated tests
	Requested*	Indicated†	Ratio A‡	Requested*	Indicated†	Ratio B§	requested (B-A)	P
Sodium, potassium, chloride	2193	3394	64.6%	2631	3180	82.7%	18.1	<0.01
Urea	0	0	--	0	0	--	--	--
Creatinine	175	329	53.2%	281	294	95.6%	42.4	<0.01
Glucose	310	529	58.6%	375	522	71.8%	13.2	<0.01
Calcium, magnesium, phosphate	75	81	92.6%	24	28	85.7%	-6.9	<0.01
Cardiac enzyme profile§§	1860	2016	92.3%	1962	2024	96.9%	4.7	0.18
Liver function tests#	147	154	95.5%	77	84	91.7%	-3.8	<0.01
Cholesterol/triglyceride	479	504	95.0%	438	506	86.6%	-8.5	<0.01
Free thryoxine, thyrotropin	30	42	71.4%	20	26	76.9%	5.5	<0.01
Miscellaneous clinical chemical tests	116	116	100.0%	86	86	100.0%	0	--
All clinical chemical tests	5385	7165	75.2%	5894	6750	87.3%	12.2	<0.01
Automated blood count**	1136	1304	87.1%	1028	1148	89.6%	2.4	0.20
Prothrombin index	252	252	100.0%	253	253	100.0%	0	--
Miscellaneous haematology tests	24	24	100.0%	45	45	100.0%	0	--
All haematology tests	1412	1580	89.4%	1326	1446	91.7%	2.3	0.15
Urine microexamination	11	11	100.0%	14	14	100.0%	0	--
Miscellaneous microbiology tests	16	16	100.0%	28	28	100.0%	0	--
All microbiology tests	27	27	100.0%	42	42	100.0%	0	--
All tests	6800	8772	77.5%	7262	8238	88.2%	10.6	<0.01
TQM=total quality management. Clinically indicated tests that were requested. †Total number of tests that were clinically indicated but not necessarily requested. ‡Pre-TQM tests requested/pre-TQM tests indicated. §TQM tests requested/TQM tests indicated. §§Creatine kinase and creatine kinase-MB. #Total bilirubin, aspartate aminotransferase, alanine aminotransferase, gamma glutamyltransferase, alkaline phosphatase, protein, albumin. *Haemoglobin, white cell count, red cell count, platelets.

©MJA 1998

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