In message <[log in to unmask]>, Mike Bosomworth
<[log in to unmask]> writes
>There has to be an argument for stopping the more obviously ill-thought out
>repeat requests. CRP 2 - 3 times in the same day. LFTs 4 times in the same
>day! We have been heavily criticised for not controlling workload. Whilst I and
>others argue that we do not make the request (and yes I agree it is a request
>not an order) we are still seen as being the gatekeepers and surely we are. We
>are supposed to be experts in our field and ought to be able to agree logical
>time periods within which to request repeat tests with our users. If we can use
>modern technology to enforce those protocols so much the better. If we can
>link that technology to on-line teaching aids even better still. Yes there is a cost
>in terms of time to agreeing those protocols, but once in place the rest, with
>the right technology,
But therein is the rub - most of us are working with legacy technology
which is incapable of this sophistication. I have absolutely no faith
that the new IT strategy will put such refinements very high on their
list of requirements. In any case, you always have to have a let out of
allowing the test for clinical change - which is usually just a few more
keystrokes so the requester has their way!
As several people have already indicated, by the time the patient
demographics have been input, the tests are done and it would be unwise
to delete them simply to enforce a no-repeat rule.
I believe that educating (shaming) the consultants with examples of
flagrant abuse of the system can work - it has done so locally in
containing (but not preventing) abuse of troponins and TFT.
Trevor
--
Trevor Gray
Dept. of Clinical Chemistry,
Northern General Hospital,
Sheffield S5 7AU
0114 271 4309
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