Narrow Results Clear All
- Communication Improvement 2
- Logistical Approaches
- Quality Improvement Strategies 2
- Technologic Approaches
Search results for "Logistical Approaches"
Cases & Commentaries
- Web M&M
Jonathan R. Genzen, MD, PhD, and Heather N. Signorelli, DO; March 2015
After presenting to the emergency department, a woman with chest pain was given nitroglycerine and a so-called GI cocktail. Her electrocardiogram was unremarkable, and she was scheduled for a stress test the next morning. A few minutes into the stress test, the patient collapsed and went into cardiac arrest.
Journal Article > Review
Impact of health information technology interventions to improve medication laboratory monitoring for ambulatory patients: a systematic review.
Fischer SH, Tjia J, Field TS. J Am Med Inform Assoc. 2010;17:631-636.
Failure to follow up on test results has been linked to missed and delayed diagnoses in the ambulatory setting. Although electronic health records (EHR) hold great promise for addressing this issue, this systematic review found only modest published evidence linking EHR use to improved laboratory test monitoring. This finding corroborates other studies documenting persistent failure to comprehensively follow up abnormal lab tests and radiologic studies despite use of an EHR. The authors conclude that further research will be required to develop optimal test management systems within electronic medical records.
Journal Article > Study
Notification of abnormal lab test results in an electronic medical record: do any safety concerns remain?
Singh H, Thomas EJ, Sittig DF, et al. Am J Med. 2010;123:238-244.
Unreliable test result management systems are a common problem in ambulatory care, and failure (or inability) to promptly follow up abnormal test results may lead to diagnostic errors and other safety problems. Automated alerts within electronic health records should minimize such problems. However, this study conducted in Veterans Affairs clinics found that 1 in 10 alerts for abnormal laboratory test results went unread by providers, and a large proportion of those patients did not receive timely clinical follow-up. The investigators found similar results when analyzing follow-up of alerts for abnormal imaging results. "Alert fatigue" is one possible explanation for these findings.
Journal Article > Study
Casalino LP, Dunham D, Chin MH, et al. Arch Intern Med. 2009;169:1123-1129.
Failure to adequately follow up on test results is a known problem after hospital discharge, in primary care settings, and within computerized systems. This study reviewed more than 5400 patient medical records from 19 community-based and 4 academic primary care practices and discovered a 7.1% rate of failure to inform (or document informing). Interestingly, investigators found that partial electronic health records (EHRs), with a mix of paper and electronic systems, were associated with higher failure rates than those practices without an EHR or with a complete EHR. Variations in failure rates among practices, ranging from 0% to 26%, suggest that best practices can make a significant difference. A past AHRQ WebM&M commentary discussed the impact of delayed notification for a test result following hospital discharge.
Weiss GG. Med Econ. May 19, 2006; 83:47-49.
This article provides suggestions for physicians to ensure reliable follow-up on test results, including tracking forms, computerization, and staff compliance with processes.