In reply: An interventional program for diagnostic testing in the emergency department

Peter J Stuart
Med J Aust 2003; 178 (1): .
Published online: 6 January 2003

In reply: Our intervention1 was developed following concerns with the quality of test ordering in our department, and resulted in a significant improvement in the checking and documentation of test results. Quality of care is also influenced by test over- and underutilisation. The study demonstrated a marked reduction in test ordering and accorded with the current estimates for test overutilisation.2 Test underutilisation was monitored using established mechanisms for reporting critical incidents (including missed or incorrect diagnoses) and patient complaints, as well as feedback from staff, general practitioners and other departments and hospitals. Patient outcome factors (eg, readmission rates, length of stay) were confounded by the dramatic onset of access block during the intervention period, making retrospective comparisons unreliable.


  • 1. Stuart PJ, Crooks S, Porton M. An interventional program for diagnostic testing in the emergency department. Med J Aust 2002; 177: 131-134.
  • 2. Van Walraven C, Naylor CD. Do we know what inappropriate laboratory utilisation is? A systemic review of laboratory clinical audits. JAMA 1998; 280: 550-558.
  • 3. Kelly AM. Clinical impact of blood cultures taken in the emergency department. J Accident Emerg Med 1998; 15: 254-256.
  • 4. Bates DW, Goldman L, Lee T. Contaminant blood cultures and resource utilisation: the true consequences of false positive results. JAMA 1991; 265: 365-369.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.