TABLE 3

Major Reasons Described by Providers for Not Obtaining RVT

ThemesRepresentative Quotes
Medical management
 RVT does not change medical management• “I just find a lot of the time it doesn’t really help me with my clinical decision-making” (hospitalist 4).
• “The test may be negative, and it still wouldn’t change what we do because we’d just assume it was a different virus that we don’t know the name of” (hospitalist 7).
Educational
 The decision not to test is used as an educational opportunity for trainees• “We like to educate them not to obtain the screen unless it’s going to change their management” (hospitalist 11).
• “I see the decision used as teaching tool often. We’ve made this clinical diagnosis; this is not likely to change what we’re doing” (resident 12).
Cost
 RVT is expensive• “Cost is 1 thing I definitely take into mind when I’m thinking about obtaining RVT. I’d say that it’s inhibitive” (hospitalist 5).
• “The respiratory viral panel’s not without its costs. It’s an expensive test” (ED physician 5).
Patient risks
 Obtaining the specimen can be uncomfortable• “It’s not really beneficial to the patient and…to have your nose swabbed…it’s not really comfortable” (hospitalist 4).
 Test results can lead to premature closure on a diagnosis• “One risk of the test is—let’s say it comes back positive—we tend to sort of narrow down our differential diagnoses based off of our testing, and I can imagine some cases where having a positive test may lead you down the wrong direction” (ED physician 8).
 Negative results could decrease families’ trust in providers• “It’s only going to test for those handful of things, and if it’s negative, then you have parents’ trust issues” (hospitalist 1).