Abstract
Introduction and Aims
The Older People’s Same Day Emergency Care (OSDEC) unit at Portsmouth Hospitals University NHS Trust accepts admissions for older patients referred by South Central Ambulance Services (SCAS), aiming to deliver early patient reviews and reduce emergency department (ED) waits. Timely blood test results are critical for decision-making and early discharge. NHS England SDEC protocols recommend pathology access comparable to ED processes, though no national standards exist for pathology turnaround times.
This quality improvement project aimed to implement targeted interventions to improve patient admission processes in OSDEC and to assess the sustainability and long-term impact of these improvements.
Methods
Data were collected for 88 SCAS direct attendances to OSDEC from February to September 2024. Patient arrival times, time of pathology request, laboratory receipt and blood results availability were recorded. Analysis focused on the average times from arrival on OSDEC to blood sample collection and laboratory receipt.
Results
Baseline data showed an average sample receipt time of 91 minutes and time to first results of 147 minutes. Improvement interventions were introduced to include printing of blood forms on receipt of referral and identification of staff to obtain blood sample on patient arrival. In May, sample receipt times were reduced by 7 minutes (8%), and time to results improved by 26 minutes (18%). By July, sample receipt times decreased further by 35 minutes (38%), and time to results improved by 35 minutes (24%) from baseline.
Although times increased in July and September (to 124–165 minutes), consistency improved, with fewer delays. Additional interventions included daily checklists to ensure stock levels for phlebotomy supplies and enabling senior nurses to request appropriate pathology investigations based on common frailty presentations.
Conclusion
Implementation of several interventions using a Plan-Do-Study-Act method improved availability of blood tests results that is important to enable prompt decision-making.