New study targets overuse of blood tests and imaging in Intensive Care
One in three blood tests and imaging requests in Australian intensive care units (ICUs) are considered potentially unnecessary.
With these low-value tests a potential contributor to patient harm, increased hospital costs and a misuse of clinician’s time, a new $2.7 million grant from Australia’s Medical Research Future Fund aims to evaluate the implementation of new strategies to reduce these forms of diagnostic testing in ICUs.
As part of a 12-month trial involving NSW public hospital ICUs, researchers will assess strategies focused on quality improvement, behavioural change, audits and feedback to ascertain the effectiveness in reducing low-value diagnostic testing.
Senior Staff Specialist at Nepean Hospital’s Intensive Care Unit, and one of the lead researchers of the project, Dr Nhi Nguyen says the trial will contribute definitive evidence on ways to reduce low value diagnostic testing at scale.
“We know that sometimes performing diagnostic tests which are done routinely rather than matched to clinical need can contribute to hospital acquired anaemia and unnecessary follow up interventions or tests,” says Nhi, who is also the Clinical Director of Intensive Care for NSW Agency for Clinical Innovation.
“With this research project we are hoping to improve patient safety, reduce health system waste, and inform national policy on sustainable care delivery.”
To help measure success of the research, the team will examine numerous factors including the number of blood tests ordered per patient, imaging frequency, ICU and hospital length of stay, readmissions and complications, cost of care as well as staff and patient feedback to see how sustainable the strategies are.
“Through the development of educational materials, implemented at staff orientation and departmental meetings, along with point-of-care decision supports and benchmarking dashboards we hope to see real positive outcomes generated from the trial,” explains Nhi.
“This project builds on a quality improvement initiative piloted in the Nepean Hospital ICU more than 5 years ago. It is very exciting to be involved in this project at a much larger scale.”
The project is co-led between the University of Sydney and NSW Agency for Clinical Innovation, in collaboration with NSW Health Pathology, eHealth NSW, NSW Ministry of Health, NSW Behavioural Insights Unit, Clinical Excellence Commission, University of New South Wales, University of Newcastle, and three NHMRC-accredited Research Translation Centres.