| Primary care providers |
••“Sometimes the BPA* fires even when the patient obviously doesn’t qualify.”
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••“The BPA comes up for anyone who has a fever and a sore throat. Some people do not have muscle aches or other concerns for the flu and have a low pretest probability of a positive test. It would be a waste of resources to swab the unlikely people . . . .”
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••“The threshold for firing the influenza BPA is very low.”
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••“We need to get the results back in a more timely fashion in order for them to be clinically useful, especially for treatment decisions.”
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••“BPAs are repetitive.”
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••“Tweak the indications so that the BPA fires appropriately. Make sure that doing the test causes the BPA to go away!”
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••“[A]uthorizing nursing [staff] to swab anyone with given criteria could facilitate larger enrollment if there is no limitation on the number of tests.”
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| Nursing staff |
••“Patient symptoms are not indicative to ordering test such as no fever or sore throat.”
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••“Fever seems to prompt the BPA for flu testing. Patients will present with fever due to other reasons — sometimes with urinary problems — and an influenza swab is not needed. We can use our judgment, as nurses, to consult and communicate with doctors when BPAs are not needed. If it is a strict rule, then there will be some problems.”
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••“More help — staff.”
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BPA = best-practice alert (clinical decision support alert).