Thoughtful Requesting for Rheumatology

Primary & Secondary Care Guidance to Improve Efficiency

Overview of the Project

The current economic climate creates an imperative for clinicians to improve efficiency. A culture change is needed to encourage clinicians to request only those tests which will impact on patient management Thoughtful Requesting. We introduced guidance for clinicians requesting tests for Rheumatology patients, aiming to reduce the number of unnecessary tests performed. Collaboration between Rheumatologists, Immunologists and Pathology Laboratory Managers led to the creation of new primary care guidance and approval of existing secondary care guidance. It was vital to engage effectively with requestors to encourage them to utilise the guidance and to emphasize the importance of this approach.

Learning to collaborate more effectively Maintaining resilience whilst balancing the project with Specialist Training in Rheumatology and General Internal Medicine, on call commitments including nights and long days, the Postgraduate Certificate in Leadership and Service Improvement and the Kings Fund Experiential Learning

Results
Project: Consensus guidelines formally approved Excellent relations with primary care; online survey, liaison via GP leads Integration of primary care guidance into online requesting system Hospital guidance online and in clinics Education sessions performed Planned analysis of the impact on requesting rates The Trust:
Guidance anticipated to reduce unnecessary tests, save money and

Leadership Challenges
Project: Forming a consensus on guideline creation Engaging stakeholders including specialist nurses, primary and secondary care physicians, pathology laboratory management, IT team, junior clinicians Gaining formal approval for the guidelines despite organisational change occurring Making guidance easily accessible Promoting the guidance Educating clinicians Personal: Understanding stakeholder analysis Appreciating the importance of personality preferences

reduce venepuncture for patients

Promotion of Thoughtful Requesting in other specialties Sponsor inspired to initiate further Quality Improvement Projects

Personal:
Learnt to identify and engage with stakeholders Understood the impact of organisational change Consolidated commitment to improving quality and promoting clinical

leadership Formed fantastic friendships

Contact Information
Dr. Charlotte Sharp ST4 Rheumatology and General Internal Medicine charlotte.a.sharp@gmail.com 07813893012