Rationalising blood tests in a resource-limited emergency unit: A quality improvement project

Abstract

Background: In resource-limited emergency settings, blood testing is crucial for diagnostics but can lead to financial strain and diagnostic challenges if used indiscriminately. This quality improvement project (QIP) aimed to identify commonly requested blood tests in an emergency department (ED), assess their appropriateness, and establish evidence-based guidelines for judicious use. This project was conducted during the family medicine rotation of interns at a tertiary hospital in a semi-urban area.

Methods: The Plan-Do-Study-Act (PDSA) method was employed. Pre- and post-intervention data were collected. An educational intervention, featuring informative visual aids was implemented to help guide the medical practitioners in the unit on appropriate blood test ordering.

Results: The intervention led to a significant 48.7% reduction in total daily blood tests ordered, with a notable decrease in full-panel requests and an increase in individual test ordering.

Conclusion: Educational interventions, aimed at guiding blood test requests, can significantly reduce unnecessary testing. Long-term data collection is necessary to confirm sustained changes in practice.

Contribution: Our findings indicate that clear, evidence-based guidelines for the judicious use of blood tests can positively impact test ordering, particularly in resource-limited settings, and suggest opportunities for further long-term studies.