10 Summary

This module has introduced you to the concept of diagnostic stewardship. At the heart of this is the timely and clear communication between the clinicians and clinical microbiology laboratory personnel, both at the point of taking a correct sample and choosing an appropriate diagnostic test, and in interpreting the results of those diagnostic tests to inform the appropriate treatment for the individual patient.

Diagnostic stewardship encompasses understanding how important it is to submit correct and appropriate specimens in a timely manner, and generating results of the highest quality by the laboratory that are provided to clinicians in a timely and proactive manner.

Depending on the country and local healthcare facility, there will be differences in the initial priorities in setting up diagnostic stewardship; but whatever the baseline level in a particular hospital, patient outcomes can be improved by implementing aspects of diagnostic stewardship, with the additional benefits of providing surveillance data to inform local prescribing practices and reducing the costs of long hospital stays and ineffective treatment.

Diagnostic stewardship is essential for collecting reliable surveillance data locally, nationally and (as capacity increases) internationally for the WHO’s GLASS.

You should now be able to:

• describe the roles in a diagnostic stewardship programme
• understand the principles of taking appropriate clinical samples
• appreciate the range of laboratory techniques available for bacterial isolation, pathogen identification and AST
• understand how microbiology can be appropriately reported to clinicians
• understand factors affecting bacteriology laboratory turnaround times and reporting
• promote good working relationships between laboratories and clinicians for effective diagnostic stewardship
• understand diagnostic stewardship in surveillance at national and international levels
• understand how to introduce a diagnostic stewardship programme.

Now that you have completed this module, consider the following questions:

• What is the single most important lesson that you have taken away from this module?
• How relevant is it to your work?
• Can you suggest ways in which this new knowledge can benefit your practice?

When you have reflected on these, go to your reflective blog [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]   and note down your thoughts.