On this page
The benefits of this project
Benefits for Your Patients
- Saves time and travel as fewer appointments to provide samples
- Quicker results
Benefits for Your Practice
- Fewer phlebotomy appointments needed
- Financial savings from reduced need for appointments & sample collection consumables
Benefits for The Planet
- Carbon savings from reduced journeys and equipment for repeat blood tests. (1.06 kgCO2e per average return patient journey to GP practice).
Opportunity for improvement
- Investigations cost money and produce emissions, both through the procedures themselves and the travel patients undertake to have them done.
- The main carbon emissions from general practice investigations are likely to be from patient and sample transport and sample collection consumables (blood-taking equipment, gloves, sample bags etc).
- Having the ability to ‘add-on’ tests to samples already in the laboratory is highly beneficial, saving patient and practice time, reducing travel and reducing other emissions from repeat sample collection. For example, if a patient has blood taken for an FBC and U+Es and their result shows anaemia, it is possible to ‘add-on’ haematinics testing to the U+Es sample to investigate the cause of the anaemia without taking a repeat blood sample. The haematinics only need to be requested if the FBC is abnormal, reducing unnecessary testing.
- This QIP outlines how to create a robust ‘add-on’ culture in your practice (see disclaimers).
- You might like to make a SMART goal for this project, e.g. reduce repeat blood tests by 30% within 6 months by promoting add-on testing, measured via lab request audits and patient transport data.
How to carry out this project
-
Contact the lab
Contact your local laboratory to discuss their ‘add-on’ process and see how to make it work at your practice.
-
Create a guide
Check if the laboratory has a guide to what tests can be added on and, if not, work with them to adapt this one:
-
Track add-on requests
Ask the laboratory if they track ‘add-on’ requests from your practice and, if not, ask them to start doing so to be able to measure any changes from this intervention. If this isn’t possible you will need to show change in another way e.g. a staff survey to assess staff awareness and use of ‘add-ons’ prior to and then after the intervention.
-
Collect the baseline data
Look at the number of ‘add-on’ requests for a 3-month period prior to QIP intervention.
-
Make the intervention
Advertise the ‘add-on’ process and guide to all clinicians at the practice e.g. clinical meeting, F2F conversations, email, staff newsletter.
Include the ‘add-on’ process and guide in any staff handbooks and induction so all staff aware of the process.
-
Re-measure the data
Review the results, summarise learning, share with practice team + decide if any changes are needed to improve the process.
Decide when to re-audit again to ensure the change has lasted e.g. 2-3 months and use the Project Monitoring form to keep track.
Top tip
Work closely with your local laboratory team to make sure the process works well for them and the practice.
How to scale this project up or down
Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership—access must not be shared with non-members.
We found it helpful to chat directly to the clinicians who kept prescribing multiple doses to change prescribing practice across the board.
Share your project with your PCN, Federation, ICB (England) or Cluster, Health Board (Scotland or Wales) or GP federation, Health Trust (Northern Ireland), so the learning can be shared and the project easily implemented by other practices too.
Ask your laboratory to advertise the ‘add-on’ process to all their GP practices.
Have you completed this QIP?
Tell us a little about your project and enter your data in order to generate a certificate showing the probable benefits. This project may help with CQC evidence submission (see disclaimers).
More project guides
-
Extreme Cold Weather Alert QIP
Carbon saving potential: Solid
<10 hours
-
Bath & Shower Emollient Deprescribing
Carbon saving potential: High
<10 hours
-
Reducing Emissions Associated with Banking
Carbon saving potential: Very high
20-40 hours
-
Switching Energy Provider
Carbon saving potential: Very high
<10 hours