Why the study?
NICE updated guidelines on preoperative blood tests for elective surgery in 2016, but the extent of local compliance and financial implications of inappropriate testing remained to be evaluated.
Does staff education and a guidance poster reduce inappropriate preoperative blood tests and financial expenditure in patients undergoing elective breast surgery?
Observational (n=1,370)
No
Does staff education and a guidance poster reduce inappropriate preoperative blood tests and financial expenditure in patients undergoing elective breast surgery?
Effect estimate: 71% reduction in financial expenditure
Staff education and visual aids significantly reduce inappropriate preoperative blood testing and associated costs in elective breast surgery without compromising patient care.
Non-adherence to NICE preoperative testing guidelines drives excess costs in breast surgery; leaves open targeted local interventions to improve compliance.
In 2016, the National Institute for Health and Care Excellence updated guidelines on preoperative blood tests for elective surgery; with failure of adherence having implications for both patients and healthcare providers. A local audit was performed on 919 patients undergoing elective breast surgery that determined compliance and the financial implications of performing inappropriate preoperative blood tests against the National Institute for Health and Care Excellence guideline. Initial findings of an unacceptable quantity of inappropriate blood tests led to the education of the pre-assessment clinic staff regarding the guidelines along with the development of a poster to guide the ordering of appropriate tests. A re-audit of 451 patients assessed impact of interventions which resulted in a significant reduction in the number of blood tests requested with a 71% reduction in financial expenditure. The blood tests considered inappropriate in both the initial and re-audit did not add any relevant clinical information and abnormal results did not alter the clinical course of the patient.
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Jones et al. (2020) conducted an observational in Elective breast surgery (n=1,370). Staff education and poster guidance vs. Pre-intervention practice was evaluated on Number of blood tests requested and financial expenditure (71% reduction in financial expenditure). Staff education and a guiding poster significantly reduced the number of inappropriate preoperative blood tests requested, resulting in a 71% reduction in financial expenditure.
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