title: The effect of a gold coin fine on C-reactive protein test ordering in a tertiary referral emergency department.
abstract: OBJECTIVE
  To examine the effect of an education campaign based around a gold coin fine on ordering of C-reactive protein (CRP) tests.
  
  
  METHODS
  A retrospective analysis of CRP test ordering before and after the intervention in the emergency department (ED) of a tertiary referral hospital in metropolitan Sydney that sees about 60,000 patients per annum. The date of the intervention - 2 August 2013 - corresponded with Jeans for Genes Day.
  
  
  METHODS
  Number of CRP tests ordered in the ED.
  
  
  RESULTS
  1290 CRP tests were ordered before the intervention (1-31 July), and 394 were ordered after the intervention (2-31 August). This decrease in CRP test ordering was despite an increased number of ED presentations in August compared with July (5219 v 5497 presentations). This represented an absolute reduction in the rate of CRP test ordering of 17.6% (95% CI, 16.2%-18.9%; P < 0.001).
  
  
  CONCLUSIONS
  The threat of a gold coin fine for ordering a CRP test, as part of a broader education campaign, significantly reduced the number of CRP tests ordered in a tertiary referral ED.
authors: Emergency Department, Nepean Hospital, Sydney, NSW, Australia. james.mallows@health.nsw.gov.au.
authors: James L
authors: JL
authors: Mallows
mesh_terms: D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D004502:Education, Medical, Continuing; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D006046:Gold; D006801:Humans; D008485:Medical Audit; D009517:New South Wales; D009717:Numismatics; D011678:Punishment; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement / Q000706:statistics & numerical data; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000592:standards / Q000706:statistics & numerical data*; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*
chemical_list: D015415:Biomarkers; D006046:Gold; D002097:C-Reactive Protein