357 A Novel Protocol for Post-Operative Bloods Following Elective Colorectal Cancer Resections - a Re-Audit of a Closed Loop

Abstract

Abstract Aim Indications for blood tests are often poorly considered. Appropriate blood requests reduce trauma for patients, improve laboratory workflow and reduce costs. We therefore created a novel protocol for bloods requested in the post-operative period for patients undergoing elective colorectal cancer resections. We performed two audit cycle loops to assess protocol adherence and evaluate financial savings. Method The protocol was agreed locally by consultant consensus, presented locally in February 2021, and displayed on surgical wards in May 2021. Bloods requested were reviewed retrospectively for patients undergoing elective colonic resection with an uncomplicated post-operative course. Data was collected prior to the local meeting between September-November 2020 (audit 1, cycle 1), after the meeting between March-April 2021 (audit 2, cycle 1), then after distribution of the protocol to wards between July-August 2021 (cycle 2). Results The locally agreed protocol was post-op day 1,5,7 FBC, U&E, CRP; day 3 FBC, U&E, CRP, LFT; day 2,4,6 no bloods. In audit 1 (cycle 1) 100% protocol adherence would have saved £15.96 per patient (n = 20). In audit 2 (cycle 1) the protocol was followed on 21.4% of days with further savings of £14.21 per patient (n = 23) had there been 100% adherence. In cycle 2, there was 40.74% protocol adherence with £6.62 further potential savings per patient (n = 15). Conclusions Following the post-elective colorectal resection bloods protocol may save our hospital £1700 per annum. Protocol adherence improved when displayed on surgical wards. With these exciting results, we are working with Medway EPR to create an order set containing this protocol.