ORDERING ACCURACY - A COLLEGE-OF-AMERICAN-PATHOLOGISTS Q-PROBES STUDYOF 577 INSTITUTIONS

Five hundred seventy-seven institutions examined how accurately physic ians' test orders on inpatients were transmitted to the laboratory. Wr itten orders could be found on laboratory requisitions or the medical record for 97.5% of 224431 completed tests (median institution = 99.3% ). Participants indicated that entry of extra tests into a hospital co mputer was the most common reason for completing unordered tests. In a multivariate analysis, factors associated with completing unordered t ests were the lack of a policy requiring nursing staff to recheck comp uter orders against the medical record, average census of 301-450 pati ents, College of American Pathologists accreditation, and the use of p reprinted ''checkoff'' order forms. Overall, 97.1% of 225457 test orde rs were completed by the laboratories (median institution = 98.1%). Fa ctors associated with not completing ordered tests were the lack of a policy requiring staff to check computer orders, teaching hospital sta tus, and urban hospital location. Several interventions commonly thoug ht to improve communication of orders were not found to affect perform ance. These results indicate that many institutions have a problem acc urately transmitting test orders to their clinical laboratories.