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BackgroundUnnecessary testing is a problem-facing healthcare systems around the world striving to achieve sustainable care. Despite knowing this problem exists, clinicians continue to order tests that do not contribute to patient care. Using behavioural and implementation science can help address this problem. Locally, audit and feedback are used to provide information to clinicians about their performance on relevant metrics. However, this is often done without evidence-based methods to optimise uptake. Our objective was to improve the appropriate use of laboratory tests in the ED using evidence-based audit and feedback and behaviour change techniques.MethodsUsing the behaviour change wheel, we implemented an audit and feedback tool that provided information to ED physicians about their use of laboratory tests; specifically, we focused on education and review of the appropriate use of urine drug screen tests. The report was designed in collaboration with end users to help maximise engagement. Following development of the report, audit and feedback sessions were delivered over an 18-month period.ResultsData on urine drug screen testing were collected continually throughout the intervention period and showed a sustained decrease among ED physicians. Test use dropped from a monthly departmental average of 26 urine drug screen tests per 1000 patient visits to only eight tests per 1000 patient visits following the initiation of the audit and feedback intervention.ConclusionAudit and feedback reduced unnecessary urine drug screen testing in the ED. Regular feedback sessions continuously engaged physicians in the audit and feedback intervention and allowed the implementation team to react to changing priorities and feedback from the clinical group. It was important to include the end users in the design of audit and feedback tools to maximise physician engagement. Inclusion in this process can help ensure physicians adopt a sense of ownership regarding which metrics to review and provides a key component for the motivation aspect of behaviour change. Departmental leadership is also critical to the process of implementing a successful audit and feedback initiative and achieving sustained behaviour change.

Catch the Sun Anne Johnson, author Shawn McCann, illustrator Beaver's Pond Press 7108 Ohms Lane Edina, MN 55439 9781592989836 $11.50 www.BeaversPondPress.com Created as a nonprofit effort in conjunction with the [...]

The Sick Bug Goes to School Susie Bazil, author Shawn McCann, illustrator Beaver's Pond Press 7104 Ohms Lane, Suite 101, Edina, MN 55439 9781592983469, $16.95, www.beaverspondpress.com 'The Sick Bug Goes [...]

Staarabu was Wise, Anana was Gentle Dan Haugen, author Shawn McCann, illustrator Beaver's Pond Press 7104 Ohms Lane, Suite 101, Edina, MN 55439 9781592983353, $16.95, www.beaverspondpress.com 'Staarabu was Wise, Anana [...]

The article offers tips for librarians on accessibility in digital and physical spaces that are useful for creating guides, posting handouts in Learning Management System (LMS), building online tutorials, or similar activities, while upholding the Americans with Disabilities Act (ADA). Details about the tips which include on being the leader in linking, being boss of browser extensions, and being the officiate of Office documents, are provided.

The article discusses how the Australia-based Chris Wright transforms his Ford's Falcon. Topics discussed include modification made by Murray in the factory installed column shift; use of fabricated alloy tank to increase boot space; installation of stainless independent front; and the car's participation in different racing events.

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An index of the winners of the 2012 Advertising and Interactive Awards is presented.

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