EP 031 Quality Improvement Project: The Use of Routine Blood Testing in General Surgery; Are we Testing too Much and is it of Clinical Significance?
Shivani Kalair, Jaideep Rat, Ankur Shah, Roy Yan, Tharun SubramaniyamAbstract
Aim
Each year, the National Health Service (NHS) spends approximately £2.2 billion on blood tests and evidence suggests that 25% are unnecessary repeats placing a burden on a financially stretched organisation. This paves the way to analyse patterns, outcomes and cost effectiveness of routine blood testing with the aim to improve current practices and enhance resource utilisation in the NHS.
Method
Collected initial data over 3 weeks to assess baseline frequency of bloods tests for 6 conditions: gallstone pancreatitis, cholecystitis, diverticulitis, colorectal resection with anastomosis, post laparoscopic appendicectomy, complex hernia repair. After analysis a poster was generated highlighting a call for reduction of blood tests in the department. The second intervention included a condition specific guideline poster using feedback from departmental consultant surgeons. Data was collected again to assess for improvement.
Results
Overall, there was a majority decrease of blood tests performed and the average cost of blood tests per patient decreased by 24% by the end of Cycle 2. There was no statistically significant difference between the mean blood test numbers of the cycles (p = 0.12). Furthermore, there was a discrepancy between the frequency of blood tests performed and suggested from expert opinion across all conditions.
Conclusion
There was an initial reduction in the frequency of blood tests thus reducing cost and highlighting the issue. Whilst the project had limited statistical power and a small sample size, it paves the way for further investigation beyond a single centre study to improve and enhance resource utilisation in the NHS.