Demand optimisation in laboratory medicine: phase two report

8 Recommendations

There is a need to maintain the momentum from the initial successful phases of the national Demand Optimisation programme and implement improvement strategies locally and nationally, embedding the values and tools of DO into operational practice.

To enable this, the following recommendations are made: -

1. Pilot the Atlas with referring clinicians: -

• to obtain feedback on the utility and identify improvements 
• to widely promote its capabilities in highlighting variation for demand management at individual, group and board level
• to provide full access to all to enable new and sustained improvements 

2. Focus on sustaining the current quality improvement initiatives, as well as delivering and monitoring new QI proposals and progressing implementation of the ongoing proposals. This should be supported by the production of a quality improvement package to instigate interventions in specific areas of unwarranted test requesting. 

3. Ensure alignment with the values of the Realistic Medicine and contribution to the Scottish Government’s vision for the future of primary care services. 

In order to enable the progression of these recommendations, the following objectives have been agreed for Phase III: -

• Engaging with referring clinicians to continue to improve the Atlas of Variation and promoting its capabilities within the GP community
• Data collection for the calendar year of 2018 to build upon the existing data collected in phase II
• Exploring alternative options to streamline data collection for populating the Atlas
• Where applicable, undertaking internal demand optimisation within laboratories to review and standardise methodologies 
• Monitoring and reporting on QI programmes being delivered
• Expanding stakeholder engagement by coordinating quality improvement champions at a local level to support change 
• Engaging with referring clinicians to promote a cultural shift in managing requesting patterns
• Implementing interventions where unwarranted variation can be identified
• Continuation of clinical networks engagement at a national, regional and local level around specific conditions to develop and implement requesting guidelines which could be referenced at a board level
• Promoting the demand optimisation and the realistic medicine agenda at conferences, in reports to professional bodies and in newsletters