Patient Safety and Quality

Safety awareness and technological adoption are keys to managing test results in family medicine offices

After finding great variation in how family medical practices receive and share patient test results, the authors of a new study recommend that guidelines and best practices be developed to assist office staff in providing quality care. Nancy C. Elder, M.D., of the University of Cincinnati, and colleagues interviewed and surveyed staff members and patients at four southwest Ohio family medicine offices. None of the four offices excelled at reporting patient test results. Although 87 to 100 percent of patients said they received their test results, just 58 to 85 percent of charts indicated that patient notification actually occurred. Just two of the offices had written procedures for managing test results, and none routinely adhered to results management practices. Most of the offices' standardized steps entailed communicating with the testing facility and getting results to the physician. However, the standards tended to skip the crucial step of notifying the patient.Two factors that researchers deemed important in managing test results were safety awareness and technological adoption.

The former involves having leaders who are focused on quality and safety, stress communication and teamwork, and institute policies and procedures for staff to follow. The latter involves incorporating technology, such as electronic health records (EHRs) and communication links between the medical office and testing sites, to eliminate staff having to manually track results. Although offices without EHRs had to spend more time tracking, following up, and documenting test results, the presence of EHRs did not guarantee high-quality, safe care, the authors note. In fact, one office that had an EHR did not use it to track test orders. This study was funded in part by the Agency for Healthcare Research and Quality (HS13914). See “Management of test results in family medicine offices,” by Dr. Elder, Timothy R. McEwen, M.S., John M. Flach, Ph.D., and Jennie J. Gallimore, Ph.D., in the July/August 2009 Annals of Family Medicine 7(4), pp. 343-351.

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