Managing demand for laboratory tests: a laboratory toolkit

Fryer, Anthony A.; Smellie, W. Stuart A.

Abstract

Healthcare budgets worldwide are facing increasing pressure to reduce costs and improve efficiency, while maintaining quality. Laboratory testing has not escaped this pressure, particularly since pathology investigations cost the National Health Service £2.5 billion per year. Indeed, the Carter Review, a UK Department of Health-commissioned review of pathology services in England, estimated that 20% of this could be saved by improving pathology services, despite an average annual increase of 8%-10% in workload. One area of increasing importance is managing the demands for pathology tests and reducing inappropriate requesting. The Carter Review estimated that 25% of pathology tests were unnecessary, representing a huge potential waste. Certainly, the large variability in levels of requesting between general practitioners suggests that inappropriate requesting is widespread. Unlocking the key to this variation and implementing measures to reduce inappropriate requesting would have major implications for patients and healthcare resources alike. This article reviews the approaches to demand management. Specifically, it aims to (a) define demand management and inappropriate requesting, (b) assess the drivers for demand management, (c) examine the various approaches used, illustrating the potential of electronic requesting and (d) provide a wider context. It will cover issues, such as educational approaches, information technology opportunities and challenges, vetting, duplicate request identification and management, the role of key performance indicators, profile composition and assessment of downstream impact of inappropriate requesting. Currently, many laboratories are exploring demand management using a plethora of disparate approaches. Hence, this review seeks to provide a 'toolkit' with the view to allowing laboratories to develop a standardised demand management strategy.

Citation

Fryer, A. A., & Smellie, W. S. A. (2013). Managing demand for laboratory tests: a laboratory toolkit. Journal of Clinical Pathology, 66(1), 62-72. https://doi.org/10.1136/jclinpath-2011-200524

• Journal Article Type: Article
• Acceptance Date: Sep 4, 2012
• Online Publication Date: Sep 26, 2012
• Publication Date: 2013-01
• Deposit Date: Aug 24, 2023
• Journal: JOURNAL OF CLINICAL PATHOLOGY
• Print ISSN: 0021-9746
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 66
• Issue: 1
• Pages: 62-72
• DOI: https://doi.org/10.1136/jclinpath-2011-200524
• PMID: 23015659