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Singh HK, Claeys KC, Advani SD, Ballam YJ, Penney J, Schutte KM, Baliga C, Milstone AM, Hayden MK, Morgan DJ, Diekema DJ. Diagnostic stewardship to improve patient outcomes and healthcare-associated infection (HAI) metrics. Infect Control Hosp Epidemiol 2024; 45:405-411. [PMID: 38204365 PMCID: PMC11007360 DOI: 10.1017/ice.2023.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 01/12/2024]
Abstract
Diagnostic stewardship seeks to improve ordering, collection, performance, and reporting of tests. Test results play an important role in reportable HAIs. The inclusion of HAIs in public reporting and pay for performance programs has highlighted the value of diagnostic stewardship as part of infection prevention initiatives. Inappropriate testing should be discouraged, and approaches that seek to alter testing solely to impact a reportable metric should be avoided. HAI definitions should be further adapted to new testing technologies, with focus on actionable and clinically relevant test results that will improve patient care.
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Affiliation(s)
- Harjot K. Singh
- Division of Infectious Diseases, Weill Cornell Medicine, New York City, New York
| | - Kimberly C. Claeys
- Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Sonali D. Advani
- Department of Medicine–Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Yolanda J. Ballam
- Infection Prevention and Control, Children’s Mercy Kansas City, Missouri
| | - Jessica Penney
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts
| | - Kirsten M. Schutte
- Medical Director, Infectious Disease, eviCore Healthcare, Bluffton, South Carolina
| | - Christopher Baliga
- Section of Infectious Diseases, Department of Medicine, Virginia Mason Hospital and Seattle Medical Center, Seattle, Washington
| | - Aaron M. Milstone
- Division of Pediatric Infectious Diseases, Johns Hopkins Medicine, Baltimore, Maryland
| | - Mary K. Hayden
- Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois
| | - Daniel J. Morgan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
- Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland
| | - Daniel J. Diekema
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Division of Infectious Diseases, Department of Medicine, Maine Medical Center, Portland, Maine
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