We’ve often discussed the issue of test results pending at discharge (see our March 1, 2011 Patient Safety Tip of the Week “Tests Pending at Discharge” and the list of other columns below). In our August 21, 2012 Patient Safety Tip of the Week “More on Missed Followup of Tests in Hospital” we discussed barriers to using computer technology to alert physicians to test results pending at discharge. One barrier was that the physician had to remember to log into a site to see if any test results had come back. A second barrier was that the list of pending tests was often long, including many results that were not deemed important. That, of course, led to alert fatigue when we attempted to alert physicians they had results when they logged on to CPOE.
In that column we noted a potential solution developed by Dalal and colleagues (Dalal 2012) that utilized automated email alerts as pending test results came in after discharge. Their preliminary results were encouraging. That group now reports on longer term results (Dalal 2013). Their methodology was a cluster randomized controlled trial. Intervention attending physicians and PCPs were significantly more aware of results of tests that were pending at discharge (76% vs 38% for attending physicians and 57% vs 33% for PCP’s). Attending physicians tended to be more aware when the test results were actionable TPAD results. Satisfaction with the system was high for both attendings and PCP’s.
This is an excellent and practical intervention for helping to avoid significant test results from falling through the cracks at a key transition of care.
See also our other columns on communicating significant results:
Dalal AK, Schnipper JL, Poon EG, et al. Design and implementation of an automated email notification system for results of tests pending at discharge. J Am Med Inform Assoc 2012; 19(4): 523-528
Dalal AK, Roy CL, Poon EG, et al. Impact of an automated email notification system for results of tests pending at discharge: a cluster-randomized controlled trial. J Am Med Inform Assoc 2013; Published Online First: 23 October 2013
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