Website spotlight: Avoiding overuse of tests to prevent harm, eliminate waste, and reduce costs

Staff Development Weekly: Insight on Evidence-Based Practice in Education, May 4, 2012

The Joint Commission recently proposed a new National Patient Safety Goal (NPSG) to take effect January 1, 2013, addressing overuse of treatments, tests, and procedures in order to reduce the risk of patient harm. The idea is that if evidence shows no benefit to an unnecessary test, treatment, or procedure, you are exposing a patient only to potential harm by performing it.

The proposed goal would require hospitals to implement a program to address the issue by selecting a test or treatment to focus on, evaluating and monitoring it, and implementing methods to decrease any overuse found along the way.

Hospitals may select a treatment, procedure, or test based on a risk assessment of their clinical services using evidence-based literature on the potential harm of a specific test to patients; or they may select a treatment, procedure, or test from a list in the proposed NPSG that is relevant to their services.

The list provided by The Joint Commission reflects growing attention to the safety and quality problems that unnecessary use of certain tests, treatments, or procedures can cause, and research has documented that overuse occurs with significant frequency in the United States. Should hospitals choose to select a test from the list provided by The Joint Commission, they will have to choose one of the following, relevant to the hospital's services:

  • Early induction of labor in women at less than 39 weeks of gestation
  • Insertion of tympanostomy tubes in children with otitis media and bilateral effusions of less than 60 days and without other symptoms
  • Packed red blood cell transfusions in patients with hemoglobin of 12 grams or more
  • Coronary stenting or balloon angioplasty for coronary stenosis of 40% or less
  • CT scans for emergency department patients complaining of abdominal pain

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