Akhtar Waqas, Chung Yooyun
St Bartholomew's Hospital.
BMJ Qual Improv Rep. 2014 Feb 21;2(2). doi: 10.1136/bmjquality.u204012.w1749. eCollection 2014.
As a team of junior doctors our aim has been to save costs in day to day work so that money can be reallocated to improving nursing staff levels on our wards. Stem cell units have regular blood collection schedules in order to monitor organ response to chemotherapy and to look for complications in immunocompromised patients. We set out to reduce the number of biochemical investigations to a minimum that would be clinically indicated. We designed a new blood collection proforma for nursing staff to follow and audited all blood tests taken during a 2 week period before and after its introduction. The number of inappropriate blood tests were recorded as those that were not clinically indicated or not present on the collection schedule. After the introduction of the change the number of inappropriate tests were reduced by 937 over the 2 week period, with a cost saving of £1,478.42. Similar strategies for reducing unnecessary investigations and focusing on tests that will change management could help the NHS cope with a difficult financial future and provide continued safe staffing levels and quality care.
作为一个初级医生团队，我们的目标是在日常工作中节省成本，以便能够重新分配资金来提高病房护理人员的数量。干细胞科室有定期的采血计划，以便监测器官对化疗的反应，并寻找免疫功能低下患者的并发症。我们着手将生化检查的数量减少到临床所需的最低限度。我们为护理人员设计了一种新的采血表格供其遵循，并对引入该表格前后两周内进行的所有血液检查进行了审核。不适当的血液检查被记录为那些没有临床指征或不在采血计划中的检查。实施这一改变后，在两周内不适当检查的数量减少了937次，节省了1478.42英镑的成本。类似的减少不必要检查并专注于能改变治疗管理的检查的策略，有助于英国国家医疗服务体系应对艰难的财政前景，并提供持续安全的人员配置水平和优质护理。
