Eliminating the second group and save prior to laparoscopic cholecystectomies

Project completed as part of the 2021 Green Surgery Challenge

Setting/Patient Group: Trust-wide

Issue to be addressed:

To eliminate the second group and save (G&S) blood test in the preoperative pathway for laparoscopic cholecystectomies (LC).

Intervention:

1. 1. Stakeholder engagement through staff and patient survey
2. 2. Safety assessment through patient safety audit and literature review to identify studies reporting transfusion or bleeding rates post-LC

Outcome:

Clinical

• Evidence supported the hypothesis that eliminating the second G&S is likely to be safe..

Social

• Reduced inconvenience and travel costs to patients
• Reduced concerns of low value or over-investigation of patients,
• Lower clinical pressures on staff

Environmental

• Estimated savings of up to 2.5 tonnes CO2e/year

Economic

• Estimated saving >£3000,based on a conservative estimate of 250 cases.

Key learning point

We demonstrated that eliminating the second G&S in the preoperative workup for LC procedures is a safe intervention. The reduction of unnecessary testing adds environmental, financial and social benefits such as increased convenience to patients, and reduced workload for staff.