Emergency Unit Slashes Paper-Based Lab Requests

Paper-based requests for laboratory tests made by Cardiff and Vale University Health Board’s Emergency Unit have been cut by 97% in less than one month.

The department shifted almost all requests for blood science and microbiology tests into the Electronic Test Request (ETR) system in just four weeks.

Across the NHS in Wales, pathology services process more than 34 million requests every year through the Laboratory Information Management System (LIMS).

Requests made through ETR automatically populate into LIMS, boosting efficiency, improving turnaround times for results, and reducing the potential for manual error. Providing accurate results reporting and notifications to the test requesters, the system is creating an improved experience for patients, requesting clinicians, and pathology staff.

Across Cardiff and Vale University Health Board, requests made for blood science and microbiology testing in ETR have increased from 15 per cent in March 2018 to 84 per cent by February 2022.

Among those services that have adopted the system are the Paediatric Emergency unit at the University Hospital of Wales. Treating more than 35,000 patients per year, the ETR system has become part of a robust process for ensuring that results are identified and actioned.

Dr David Hanna, Consultant in A&E at the University Hospital of Wales, said: “Since adopting ETR and Result Notifications our team has been able to deliver significant improvements in quality of care to our patients. The information going to lab in the ETR is accurate and legible. We no longer have to take phone calls from the lab asking for more information as these fields are now mandatory on the e-form.

"Result Notifications now provides us with a robust system for signing off all our results. Keeping track of outstanding results can be difficult in a large team with junior and senior clinicians working around the clock on a shift basis. We benefit from using the Team Preferences functionality in WCP, which means that our patients’ results are pooled and available for all clinicians to action and sign-off.

"Signing off results on WCP has become part of our daily workflow in the department. Our team have really got behind it because of the significant improvements in patient safety and clinical governance it has delivered."

A dedicated ETR team within the Health Board is working to deliver further uptake of the system across the organisation, towards a target of at least 90 per cent of all pathology requests being made through ETR by December 2022.

Dr Fiona Jenkins, Executive Director of Therapies and Health Science, said: “the Implementation of the ETR system is streamlining and enhancing the accuracy of our processes for requesting blood science and microbiology tests, and accessing the results, which has clear benefits in the quality of care that we provide to our patients.

“The collaborative work of teams who have contributed to the initial success of embedding ETR into our processes has been commendable, and with the excellent ongoing support of our digital team I look forward to seeing the system being further pushed out across the organisation."

The implementation of the ETR system by Cardiff and Vale University Health Board across Primary and Secondary is supported by Welsh Government funding through Laboratory Information Network Cymru Programme (LINC).