Methodology: 2.5/5
Usefulness: 2/5

Mathura P, et al. CJEM. 2022 Sep;24(6):636-640.

Editorial: When evidence-based medicine and quality improvement collide.

Question and Methods: Can we decrease physician ordering of the BUN (blood urea nitrogen) test, using an evidence-based multicomponent quality improvement intervention?
Findings: Monthly average BUN ordering declined from 1905 to 448, and BUN test to Emergency Department visit proportion reduced from 0.46 to 0.1.
Limitations: Unclear which facet of the three interventions helped most. Benefits/drawbacks of BUN bloodwork not clearly delineated. Covid pandemic led to baseline heteroskedasticity.

Interpretation: The study reported a significant reduction in emergency department BUN ordering using a multifaceted approach of education, order set changes and audit feedbacks.

Dr. Ellias Horner

JC Supervisor: Dr. Venkatesh Thiruganasambandamoorthy