Indiscriminate coagulation screening of acute medical admissions: national cost ramifications

M A Hughes, A D Duckworth, I Edmond, L L Tan, D P Ripley, J Tucker, P J Leslie

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND: Routine coagulation screening constitutes poor medical practice and is wasteful of resources. We aimed to determine the extent of inappropriate coagulopathy screening of acute medical admissions in a Scottish general hospital.

METHODS: One hundred consecutive medical admissions were prospectively analysed, assessing whether or not a coagulation screen had been conducted on admission and whether or not this was indicated according to current hospital guidelines. Following targeted dissemination of guidelines to appropriate front door medical and nursing staff the audit was repeated.

RESULTS: Pre-education, 58% of those for whom coagulation screening was not indicated were being tested. After targeted education, this figure was reduced to 32%. Preeducation, 81% of all patients in whom coagulation screening was indicated were tested. After targeted education, this figure was 86%.

CONCLUSION: Indiscriminate coagulation screening is widespread amongst medical admissions to our unit. With simple targeted education, we reduced the rate of inappropriate testing by 26% without reducing the rate of appropriate testing. In a small district general hospital (where the mean local cost for processing a haematology specimen is 8.59 pounds) this translates into a saving of 21,000 pounds per annum. Extrapolated nationwide this represents a cost saving of 1.15 million pounds per annum in Scotland.

Original languageEnglish
Pages (from-to)32-4
Number of pages3
JournalScottish Medical Journal
Volume54
Issue number4
Publication statusPublished - Nov 2009

Keywords / Materials (for Non-textual outputs)

  • Acute Disease
  • Blood Coagulation Tests
  • Diagnostic Tests, Routine
  • Humans
  • Management Audit
  • Practice Guidelines as Topic
  • Prospective Studies
  • Scotland

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