Abstract Aims To provide optimal patient care and experience by reducing the number of inappropriate blood test requests across an acute surgical receiving ward and minimise risk of needle stick injury, infections, cost and waste. Methods Retrospective figures collated from laboratory statistics provided baseline data. Feedback from residents highlighted lack of guidance prompting multidisciplinary discussion and the production of succinct guidelines depicting specific requests for different patient groups. Laboratory data identified an unusually high proportion of non-indicated Liver Function Test (LFT) testing leading to the creation of a new “order set”. The guidelines and order set were implemented in a staggered timeframe with all interventions active by August 2024. Results Using two periods (January-March and April-December) the mean number of venepunctures decreased by 10% from 634 to 557 per month, while the mean percentage of venepunctures including LFT analysis decreased from 97% to 59%; a 38% decrease. Similarly, the mean number of LFT requests per month decreased by 50% from 616 to 318. There were no adverse events during the analysis period attributable to reduced LFT testing. Conclusions These data support the implementation of guidance concurrent to a new order excluding LFT analysis. The comparatively modest reduction in venepunctures is likely the result of a conscious effort to rationalise blood sampling. Whilst patient experience may not be significantly changed since venepuncture may be required for other analyses, the reduction in LFT sampling reduces the risk of “care cascades” secondary to incidental findings and has systemic benefits through assay cost saving.
SMITH et al. (Fri,) studied this question.