Judicious utilization of healthcare resources: reducing unindicated pediatric anaerobic blood cultures in a pediatric hospital

J Healthc Qual. 2015 May-Jun;37(3):199-204; quiz 204-5. doi: 10.1097/01.JHQ.0000462897.11646.61.

Abstract

The decline in anaerobic infections in the past 15 years has resulted in healthcare professionals questioning the need for routine anaerobic blood cultures. In this study, we extracted baseline aerobic and anaerobic blood culture rates over the past 10 years (2001-2010) from our pediatric wards. A questionnaire survey of doctors was conducted to gather their views regarding anaerobic blood cultures. Interventions such as physician education were introduced over 6 months to reduce unindicated anaerobic blood cultures. Furthermore, the rates of blood cultures were tracked over time after intervention. Before intervention, 85% of doctors surveyed routinely ordered anaerobic blood cultures, 90% were unaware of any guidelines for anaerobic blood cultures, and 100% were unaware of the costs. The combination of physician education and restrictive interventions resulted in an 80% reduction in the number of anaerobic blood cultures performed and processed, which translated into savings of USD $2,883 per week, with projected savings of USD $145,560 annually.

MeSH terms

  • Adolescent
  • Bacteremia / diagnosis
  • Bacteremia / epidemiology
  • Bacteremia / microbiology*
  • Bacteria, Anaerobic / isolation & purification*
  • Blood / microbiology*
  • Child
  • Child, Preschool
  • Diagnostic Tests, Routine / economics*
  • Diagnostic Tests, Routine / statistics & numerical data*
  • Hospitals, Pediatric / economics*
  • Hospitals, Pediatric / organization & administration
  • Humans
  • Infant
  • Practice Patterns, Physicians'*
  • Quality Improvement
  • Retrospective Studies
  • Singapore
  • Surveys and Questionnaires