Endocrine Diagnostic Tests: A smoother, more legal diagnostic journey for the patient travelling through the Endocrine Test Care
Morag Zelisko, Clair Price, Janet Sear & Moghah Elsheikh
Endocrine diagnostic tests have long taken place in centres both with and without dedicated endocrine units. Problems with reliability have however been encountered, including difficulty in interpretation, the need for repeat tests with an inevitable delay of diagnosis, poor cost effectiveness and added stress to the patient. With the advent of the Endocrine Nurse post at the Royal Berkshire Hospital, the endocrine diagnostic tests were reviewed. To optimise the quality of the tests, various potential points for improvement were identified here and in other units. These included inadequate preparation of the patient psychologically and physically. Medicines required earlier review and other areas for consideration included unnecessary fasting pre test and overnight stay, poorly timed test, inefficient blood transport to biochemist and cancellation of tests due to bed shortages. To address these, a process from referral to the next outpatient appointment (or discharge back to the GP) was encapsulated in a test specific Care Pathway. This patient journey was evaluated in respect to correct adherence to agreed protocols and procedures, legal issues pertaining to adequate documentation, informed consent, unlicensed drug use for tests and ultimately quality of patient care. A standardisation of tests was achieved resulting in reliable information to assist diagnosis and treatment. The patient received improved, individualised care. The introduction of the endocrine care pathways was successful and with periodic update is considered a useful tool in ensuring optimal care.