XYZ Formula (Diagnostic Stewardship)
Definition
Requesting investigations only when the result has the potential to influence diagnosis, management or disposition. The importance of considering how a positive & negative test result would alter clinical decision making.
How to Apply
This is another of my favourites and an extremely important framework in today’s grey world where decision making is becoming more nuanced and the pressures require resource stewardship.
XYZ formula – I am doing ‘X’ which will show me ‘Y’ and I will do ‘Z’ about it. As a rule of thumb if you can’t get to the ‘Z’ then consider whether you need to do the ‘X’?
This allows for pragmatic & holistic decision making with clinical thinking which is robust and retrospectively justifiable. Again, this approach will become more evident in the clinical cases section.
The Acute Mind 