Pulmonary function test ordering practices in the COVID-19 era – a clinical audit at Beaumont Hospital

Title: Pulmonary function test ordering practices in the COVID-19 era – a clinical audit at Beaumont Hospital
Author(s): S Garvey, E Mullen, L Clarke, ME O’Brien
Institution: Beaumont Hospital
Poster: Click to view poster
Category: Miscellaneous
Abstract: The PFT ordering process at Beaumont Hospital involves a paper-based referral and filing system. The paucity of clinical information required on the card precludes triaging of requests. We audited a random selection of PFT orders in 2020 to identify areas for quality improvement.
2751 PFT studies were performed during the audit period in 2020, compared to 4658 studies in 2019; a 41% reduction in activity. 281 (10.2%) were reviewed. 55 (19.6%) referrals did not request a specific test or detail a specific indication, leading to suboptimal testing. These incomplete requests were more likely to come from non-respiratory referrers than from within the respiratory department (40% vs 11%). We also found that there was significant repetition of PFTs. Of those patients who previously had PFTs, 83.2% were returning within 2 years of their prior study. A significant proportion (49.8%) of tests were normal, comprising 33% of respiratory requests vs 55.4% of non-respiratory requests.
The impact of the COVID-19 pandemic has led to reduced capacity for PFTs, increased demand for testing, and significant growth in waiting times. The implementation of an electronic ordering system will permit triaging of requests, facilitate online access to results, and improve the efficiency of the PFT service.