BLOOD CULTURE QUALITY IMPROVEMENT - A COLLEGE-OF-AMERICAN-PATHOLOGISTS Q-PROBES STUDY INVOLVING 909 INSTITUTIONS AND 289,572 BLOOD CULTURE SETS

Objective.-To evaluate solitary blood culture (SEC) collections as a p reanalytic quality indicator of blood culture practice. Design and Set ting-Two College of American Pathologists Q-Probes laboratory quality improvement studies involving prospective evaluation of the proportion of and reasons for SEC collections in 909 institutions. Outcome.-Redu ction in the proportion of SBCs. Results.-Of 289 572 blood culture set s studied, the median proportion of SBCs per institution was 10.1% and 12.1% among adult inpatients, 25.4% and 33.3% among adult outpatients , and 89.0% and 100% among pediatric/infant patients in the first and second (follow-up) studies, respectively. The two most common reasons for not performing a second culture in adults were (1) test not indica ted and (2) physician believed one was sufficient. When compared with inpatient cultures, a significantly higher proportion of outpatient SB Cs were classified as not indicated (P < .0001). Among 198 institution s participating in both studies, a significant decline in SEC rates wa s observed in the subgroup (n = 50) that continued to monitor SBCs (P = .004). Conclusions.-Interinstitutional evaluation of solitary blood cultures provides a benchmark for quality assessment and an opportunit y for performance improvement in blood culture specimen collections.