Paperless Reporting of Routine Dialysis Haematology and Biochemistry Results

Key learning point: Digitalisation of pathology reporting results in significant social as well as environmental and financial savings.

Setting/Patient Group: Dialysis unit patient cohort

Issue to be addressed: Routine monthly haemodialysis blood tests generate a large amount of paper results (at least 20,000 sheets of A4 paper/year for the dialysis program). This creates a significant clinical and administrative workload and a high risk of relevant reports being missed. All such results are reviewed electronically in the monthly dialysis MDT meetings. Given the costs and lack of utility of paper reports it was agreed with the Trust's medical director that paper reports for routine haemodialysis results could be switched off.

Intervention:

1. Attain Trust Medical Director’s approval to stop paper results, evidencing no risk to patient safety or potential medico-legal problem.
2. Inform Medical Records department to ensure that a record is kept of which notes are affected and what results are not being filed on paper.
3. The pathology IT manager assigned location codes to each dialysis unit and then set the pathology system to paperless reporting of haematology and biochemistry reports for these locations.
4. Staff in the haemodialysis units and pathology specimen reception were informed of the relevant codes to ensure samples are booked in correctly.

Outcomes:

Clinical

• No adverse events reported.

Social

• Freeing up administrative and clinical time
• Reducing the size and weight of notes (with resulting reduction in the costs of transport and storage and improvements in readability of the notes files).
• Improved patient safety as reduction in unnecessary paper reports reduces risk of important results being lost

Environmental

• Estimated carbon savings a 380kgCO₂e/year

Economic

• Estimated financial savings £120/year