Presentation Description
Institution: Royal Adelaide Hospital - SA, Australia
Purpose
Blood and serum testing form a vital part of vascular surgical practice. Deranged and elevated blood tests, such as cholesterol and blood sugar levels are established risk for many vascular pathologies, including stroke, myocardial infarction and peripheral vascular disease. Accordingly, ordering these blood tests is an essential component of the initial vascular outpatient consultation and in some cases, may delay timely intervention and risk factor modification.
Methodology
This study was conducted in the Northern and Central Adelaide Local Health Networks. Clinical programmers developed a rule-based computerised system that identifies patients scheduled to attend an outpatient vascular surgery appointment in the next 1-5 weeks and generates auto-completed Lipid and HbA1c pathology requests if the patients has not undergone testing in the prior six months. A four-week historical control period prior to implementation of the intervention was compared to a four-week post-intervention period.
Results
A total of 1165 patients were included, with a mean age of 68.4 years (SD: 15.0) and 35.9% of patients were female. During the pre-intervention period, 38.0% (246/647) of patients had HbA1c and 17.9% (116/647) had lipid studies in the preceding six months. Post-intervention the proportion of patients with HbA1c and lipid studies requested increased to 100% (518/518). It is estimated that in total 15% of patients had at least one test duplicated post-intervention.
Conclusion
Our study demonstrates the feasibility of implementing a simple computerised pathology request protocol, which may help enhance outpatient efficiency and streamline routine pathology testing. Further studies examining the benefit on clinical endpoints in associated vascular pathology are required to truly demonstrate the effectiveness of this system. Similar protocols may be easily adapted to other specialty outpatient departments.
Speakers
Authors
Authors
Mr Lewis Hains - , Dr Benjamin Thurston - , Dr Shrirajh Satheakeerthy - , Dr Andrew Booth - , Ms Christina Gao - , Dr Jamie Bellinge - , Dr Brandon Stretton - , Prof Peter Psaltis - , A/Prof Stephen Bacchi -