Effect of Decreasing Numbers of Blood Cultures on Patient Quality Outcomes
Project Description: Between 2014 and 2016, there has been approximately a decrease in the number of blood culture sets sent to the microbiology laboratory, from about 3500 - 3800/month in the first half of 2014 to 2800 - 3000 in 2016. While reducing unnecessary testing is a highly important goal for UFHealth Shands as an institution, such improvements in utilization must not result in patient harm. This process was spearheaded in the Adult ED and these efforts have been particularly successful there, with blood cultures dropping from about 1300 sets/month at its peak in the 1st quarter of 2014 to approximately 780 sets/month in the 4th quarter of 2016. In the case of the entire hospital, the rate of positive cultures has risen as the number of blood culture sets has fallen, and this is what one would expect if clinical judgment resulted in cultures not being sent on patients who would have no growth anyway. However, there were almost 200 more patients with positive blood cultures in 2014 than in 2016, while hospital occupancy increased by 10,000 patient days in this time frame.
QPI: Kenneth, Rand, (email@example.com)
Collaborators: (firstname.lastname@example.org); (email@example.com); (firstname.lastname@example.org)
UF Health Big Aims: Zero Harm None
MeSH Keywords: Bacteremia, Blood Culture, Sepsis, Bloodstream infection, hospital mortality, length of stay