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Appropriate use criteria (AUC) for transthoracic echocardiography (TTE) were developed in response to concerns about inappropriate utilization of TTE. We aimed to prospectively study the impact of an AUC–based educational intervention on TTE ordering among housestaff on an inpatient General Internal Medicine service.
We conducted a prospective, time series analysis of an educational intervention designed to reduce inappropriate TTE ordering from February 23–June 24, 2012, which was compared to TTE ordering on the same medical service during a control period (January 1 – November 30, 2011). The intervention consisted of: 1) a lecture to housestaff on the 2011 AUC for TTE, 2) a pocketcard that applies the AUC to common clinical scenarios and, 3) bimonthly feedback on ordering behavior via email. The primary outcome was the proportion of inappropriate TTEs ordered during the intervention period.
99% and 98% of all TTEs ordered in the control and study periods were classifiable using the 2011 AUC, respectively. During the study period, there was a 26% reduction in the number of TTEs ordered per day compared to the control period (2.9 vs. 3.9 TTEs, p<0.001). During the study period, the proportion of inappropriate TTEs was significantly lower (5% vs. 13%, p<0.001) and the proportion of appropriate TTEs was significantly higher (93% vs. 84%, p<0.001).
A simple educational intervention produced a significant reduction in the proportion of inappropriate TTEs ordered.
Special Session North, Room 120
Monday, March 11, 2013, 10:45 a.m.–11:00 a.m.
Session Title: Young Investigator Awards Competition: Cardiovascular Health Outcomes and Population Genetics
Abstract Category: Cardiovascular Health Outcomes and Population Genetics
Presentation Number: 409–4
- 2013 American College of Cardiology Foundation