Background

The growing number of laboratory investigation requests is placing an increased burden upon NHS resources. Around a quarter of all tests are unnecessary repeats, and almost a third have no impact on patient management. Doctors recognise that tests should only be performed when clinically indicated, but a culture persists of undertaking unnecessary repeat investigations.

Methods

A cohort study was undertaken at a district general hospital to observe the impact of introducing educational interventions in the form of a poster and a series of educational lectures, encouraging clinicians to consider whether an investigation was clinically indicated. Data was collected from nine different sites across the hospital run by different medical teams regarding the number of tests undertaken and the impact on patient care.

Results

Data from over 13,000 tests and over 2000 patients was analysed from nine different sites across the hospital. There was a significant reduction (33%, p = 0.0001) in the number of blood tests performed. This reduction in testing saved £7006 over the course of 1 month, in addition to other benefits. There was a reduction in testing in eight out of the nine sites in which the study was undertaken, demonstrating good generalisability of results. There was no significant increase in length of admission or mortality.

Conclusion

Educational interventions to doctors have a significant and safe impact in reducing the number of unnecessary investigations, providing cost saving benefits to the NHS.

中文翻译：

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通过使用教育干预措施减少医院内不必要的实验室检查次数

背景

越来越多的实验室调查请求增加了 NHS 资源的负担。大约四分之一的测试是不必要的重复，几乎三分之一对患者管理没有影响。医生认识到只有在有临床指征时才应进行测试，但一种文化仍然存在，即进行不必要的重复调查。

方法

在地区综合医院进行了一项队列研究，以观察以海报和一系列教育讲座的形式引入教育干预的影响，鼓励临床医生考虑是否有临床指征。数据是从医院内由不同医疗团队运营的九个不同地点收集的，涉及所进行的测试数量和对患者护理的影响。

结果

对来自医院 9 个不同地点的 13,000 多项测试和 2000 多名患者的数据进行了分析。进行的血液检查次数显着减少（33%，p = 0.0001）。除了其他好处外，测试的减少在 1 个月内节省了 7006 英镑。在进行研究的 9 个地点中，有 8 个地点的测试减少了，这表明结果具有良好的普遍性。入院时间或死亡率没有显着增加。

结论

对医生的教育干预在减少不必要的调查数量方面具有显着且安全的影响，为 NHS 提供节省成本的好处。