Clinical need-directed blood tests: a step in saving the NHS?
Zahir Mughal1, Aravindan Narayanan2, Vivek Gupta2
1Department of General Surgery, Lister Hospital, East & North Hertfordshire NHS Trust, Stevenage, UK zahir5019@gmail.com.
Annals of Clinical Biochemistry
|January 10, 2016
Summary
Implementing clinical need-focused blood tests reduced unnecessary requests by 33%, saving £2406 in three months. This approach did not adversely affect patient outcomes or hospital stays.
Area of Science:
- Healthcare Management
- Clinical Pathology
- Health Economics
Background:
- Unnecessary blood tests contribute significantly to healthcare waste.
- Estimates suggest 25% of National Health Service wastage stems from superfluous laboratory investigations.
Purpose of the Study:
- To evaluate the financial impact of clinical need-based blood test ordering.
- To assess the effectiveness of senior clinician guidance in reducing unnecessary blood tests in a hospital setting.
Main Methods:
- An observational longitudinal study was conducted over six months.
- A vetting intervention was implemented in one colorectal firm (Team A), requiring senior clinician discussion for blood test requests.
- A control colorectal firm (Team B) was used for comparison.
Main Results:
- The vetting intervention led to a 33% reduction in blood test requests.
- This resulted in a cost saving of £2406 over three months.
- Significant reductions were observed in daily requests for C-reactive protein, full blood counts, liver function tests, and urea and electrolytes.
Conclusions:
- Directing blood test requests by junior doctors based on clinical need, under senior clinician guidance, reduces inappropriate testing.
- This strategy leads to a reduction in laboratory costs without negatively impacting patient care or hospital stay duration.
Related Concept Videos
01:26Therapeutic Drug Monitoring: Drug Analysis Methods
289
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood or body tissues to tailor drug therapy effectively. This monitoring is critical for managing drugs with narrow therapeutic indices like digoxin and phenytoin, ensuring they are both safe and effective. For instance, monitoring theophylline levels in asthma patients involves precision and sensitivity to adjust doses according to individual responses to therapy, ensuring efficacy and...
289
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
256
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
256
01:16Therapeutic Drug Monitoring: Overview and Classification
510
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
510
01:30Serum Laboratory Studies, Stool Test, Breath Test
1.1K
Gastrointestinal (GI) diagnostic studies are pivotal in confirming, ruling out, diagnosing, or staging various diseases, including cancers. Following diagnosis, allocating time for discussions with the patient and providing informational resources is crucial. Diagnostic assessments of the GI tract often occur in outpatient settings like endoscopy suites or GI labs. Preparation for these tests may include dietary restrictions, fasting, liquid bowel preparations, laxatives, enemas, and the...
1.1K
01:26Blood Studies I: ABG and VBG
1.6K
Blood studies are critical in the medical field, enabling healthcare professionals to assess a patient's health status accurately. This page will focus on two significant blood studies: Arterial Blood Gas (ABG) and Venous Blood Gas (VBG).
Arterial Blood Gas (ABG)
Arterial Blood Gas (ABG) studies are crucial for assessing the lungs' ability to supply oxygen and remove carbon dioxide, reflecting the patient's ventilation status. They also help understand the kidneys' capacity to...
Arterial Blood Gas (ABG)
Arterial Blood Gas (ABG) studies are crucial for assessing the lungs' ability to supply oxygen and remove carbon dioxide, reflecting the patient's ventilation status. They also help understand the kidneys' capacity to...
1.6K