No Unnecessary Tests (NUTS)
NUTS is Bendigo ED’s initiative that supports the Choosing Wisely Australia campaign.
There are various pathology and radiology tests that are over-ordered and low-yield, so we have created algorithms and flow charts to help decision making for ordering these tests and reduce unnecessary tests! A list of all the current NUTS projects can be seen below.
The goal of Choosing Wisely is to promote a dialogue on unnecessary tests, treatments and procedures, and support people to choose health care that is:
- Supported by evidence
- Not duplicative of other tests or procedures already received
- Free from harm
- Truly necessary
Choosing Wisely encourages the thought process that “more is not always better.” It encourages clinicians to have better conversations about what care is truly needed, which practices are helpful, improve patient management and which do not.
The core principles that govern Choosing Wisely are:
- Health professional-led
- Clear emphasis on improving quality of care and on harm prevention
- Consumer-focused communication
- Transparency in process and supporting evidence
There are currently many Choosing Wisely initiatives across multiple speciality health professional colleges and societies. These draw on expert opinion, developing lists of recommendations for tests, treatments, and procedures to question. ACEM has given recommendations that have helped guide some of our NUTS projects.
Please review the NUTS project recommendations for guidance before ordering these tests- VBGs, Coags, Urine MC+S, CT Brain, CT C-Spine, CTPA, CXR, CTKUB. While not strictly a test, we have also produced guidance on which patients require a cannula versus venepuncture.