What’s New in the Patient Safety World
January 2014
Email Alerts for Pending Test Results
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:
- Patient Safety Tip of the Week May 1, 2007 “The Missed Cancer”
- Patient Safety Tip of the Week February 12, 2008 “More on Tracking Test Results”
- Patient Safety Tip of the Week October 13, 2009 “Slipping Through the Cracks”
- What’s New in the Patient Safety World July 2009 “Failure to Inform Patients of Clinically Significant Outpatient Test Results
- Patient Safety Tip of the Week March 9, 2010 “Communication of Urgent or Unexpected Radiology Findings”
- Patient
Safety Tip of the Week March 1,
2011 “Tests
Pending at Discharge”
- Patient
Safety Tip of the Week August 21,
2012 “More
on Missed Followup of Tests in Hospital”
- What’s
New in the Patient Safety World
October 2013 “New
AHRQ Toolkit: Improving Your Office Testing Process”
References:
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
http://jamia.bmj.com/content/19/4/523.full
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
http://jamia.bmj.com/content/early/2013/10/23/amiajnl-2013-002030.abstract
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