Establishment of indicators to improve clinical analysis prescribing patterns.

An appropriate medical analysis prescribing pattern is part of the medical biologists' work as it enhances patient care and reduces costs. In this study, we use four indicators to aim to evaluate the relevance of clinical analysis prescription. We confronted clinical data and medical analysis prescribed in June 2013 in the emergency department (ED) and found that prescriptions were justified in 73% of TnT prescriptions but only in less than 50% of NTproBNP (27%), APTT (37%), PR (33%) or INR (23%) prescriptions. We noted that staff training, an improved communication between biologists and clinical physicians, and better computing devices, have led to better prescribing patterns. From 2013 to 2015, inappropriate associations of PR and APTT have significantly declined in the intensive care unit. At the same period, amounts of medical analysis as well as department spendings decreased in the ED. The use of indicators is essential to evaluate and monitor the relevance of medical analysis patterns. In this work, we propose to combine a global indicator (cost/day of hospitalization or medical analysis amount/month) with a regular follow up on inadequate prescribed analysis associations. These indicators will need to be adjusted to each clinical department.