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Wu KY, Beaulieu É, Daigle P. Interdisciplinary quality improvement in oculoplastic surgery: transforming biopsy follow-up through PDSA cycles. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00217-5. [PMID: 39153736 DOI: 10.1016/j.jcjo.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 06/06/2024] [Accepted: 07/02/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVE To evaluate and improve the quality of periocular biopsy follow-up by determining the absolute compliance rate, examining delays between stages, identifying obstacles to high-quality follow-up, and offering recommendations for improvement. METHODS Phase 1: A retrospective, observational, and descriptive study was conducted using chart reviews of adult patients who underwent periocular biopsies at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) from January 2019 to October 2022. Phase 2: Three simultaneous Plan-Do-Study-Act (PDSA) cycles were implemented, focusing on enhancing communication channels between clinicians and pathologists, introducing a priority system for urgent cases, and establishing an automatic reminder system for pathologists. RESULTS Phase 1: Among the 103 patients analyzed, 29 had malignant lesions, while 74 had nonmalignant lesions. The absolute compliance rate was 37.9% for malignant lesions. All of these noncompliances were due to excessive turnaround time (TT) to issue the pathology report. The percentage of cases that had adequate pathology TT (≤ 7 days) were 37.9% for malignant lesions, much lower than the Quebec Ministry of Health's target (80% at ≤7 days). Phase 2: The implemented PDSA cycles led to significant increases in absolute compliance rates and pathology TT compliance rates for malignant lesions. Primary outcomes showed that the absolute compliance rate increased to 93.3%. Secondary outcomes indicated that the pathology TT compliance rate also reached 93.3%. CONCLUSIONS Delayed pathology reporting was identified as the primary cause of suboptimal follow-up. The successful implementation of targeted PDSA cycles improved communication, prioritization, and reminder systems, resulting in considerable improvements in primary and secondary outcomes.
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Affiliation(s)
- Kevin Y Wu
- Department of Surgery - Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC, Canada
| | | | - Patrick Daigle
- Department of Surgery - Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC, Canada.
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2
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Scally E, Watts CG, Nugent C, Houghton R. A nurse-led approach to urgent results management at Sydney Sexual Health Centre demonstrates benefits to client outcomes and cost savings: a time efficiency and health system cost analysis. Sex Health 2024; 21:NULL. [PMID: 38071757 DOI: 10.1071/sh22200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/20/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND The timely provision of test results to facilitate early access to treatment is an essential component of sexually transmissible infection (STI) control and contributes to a significant proportion of the workload at sexual health services. We aimed to estimate the time to deliver client results and treatment as well as the health system costs of the nurse-led urgent results management model at the Sydney Sexual Health Centre (SSHC) compared to an alternative 'ordering clinician' model. METHODS We conducted a retrospective analysis of urgent results managed by the results nurse over 2weeks in 2019 and an observational study over 2weeks in 2021, where 10 clinicians managed five of their own urgent results. Additional activity data were gathered to determine the annual health system costs for both models. RESULTS In the nurse-led model 211 of 280 clients required notification; 156 (73.9%) were notified on the day their results became available, and the median time to treatment (n =137) was 1day. The annual health system cost for the nurse-led model was A$3922143. In the ordering clinician model, 17 (42.5%) clients were notified on the same day, and of the 27 clients treated at SSHC, the median time to treatment increased to 4days. The annual health system cost for the ordering clinician model was A$4043667.28 compared with the nurse-led model, and an additional 33.3h per week of clinician time was required for the same level of service provision. CONCLUSIONS This study highlights the strengths of the nurse-led results model at SSHC, demonstrating improved client outcomes for STI notification and treatment times and health systems savings.
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Affiliation(s)
- E Scally
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - C G Watts
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - C Nugent
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - R Houghton
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia
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3
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Sayegh CS, Im D, Moss IK, Urquiza R, Patel S, Thomas D. Randomized pilot trial of praise text messages to improve medication adherence among adolescents and young adults with liver transplants. Pediatr Transplant 2022; 26:e14361. [PMID: 35854423 PMCID: PMC9560958 DOI: 10.1111/petr.14361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/27/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AYA who have undergone liver transplantations often struggle to adhere to their post-transplant immunosuppressant medications, which can lead to serious health complications. The objective of this pilot study is to examine the acceptability and feasibility of a brief mobile health (mHealth) intervention and its impact on medication adherence among AYA liver transplant recipients. METHODS Thirty-five AYAs (13-21 years old) were randomized to either (1) receive praise text messages whenever laboratory results indicated immunosuppressant medications within the expected range or (2) usual care. Motivation for adherence and adherence were assessed via self-report, and a MLVI was calculated based on values abstracted from the electronic health record. RESULTS Multilevel, multivariate models showed significant associations between group assignment and some self-reported motivation and adherence outcomes but not MLVI. Specifically, AYA receiving the praise text messages were significantly more likely to report taking their prescribed doses (OR = 2.49, p = .03), taking their medicine according to the directions (OR = 2.39, p = .04), and being highly confident in taking their medication (OR = 2.46, p = .04), compared with the usual services group. Qualitative responses indicated praise texts were mostly helpful but could be improved. CONCLUSIONS The results suggest texting patients about positive health indicators was acceptable and, with refinement, might promote AYA illness self-management.
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Affiliation(s)
- Caitlin S. Sayegh
- Children’s Hospital Los Angeles, Division of Adolescent and Young Adult Medicine
- Children’s Hospital Los Angeles, USC University Center for Excellence in Developmental Disabilities
- University of Southern California Keck School of Medicine
| | - Deborah Im
- University of Southern California Keck School of Medicine
| | - Ilana K. Moss
- Children’s Hospital Los Angeles, Division of Gastroenterology, Hepatology, and Nutrition
| | - Ruby Urquiza
- Children’s Hospital Los Angeles, Division of Gastroenterology, Hepatology, and Nutrition
| | - Shreena Patel
- University of Southern California Keck School of Medicine
- Children’s Hospital Los Angeles, Division of Gastroenterology, Hepatology, and Nutrition
| | - Daniel Thomas
- University of Southern California Keck School of Medicine
- Children’s Hospital Los Angeles, Division of Gastroenterology, Hepatology, and Nutrition
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Thomas J, Dahm MR, Li J, Georgiou A. Can patients contribute to enhancing the safety and effectiveness of test-result follow-up? Qualitative outcomes from a health consumer workshop. Health Expect 2020; 24:222-233. [PMID: 33283413 PMCID: PMC8077113 DOI: 10.1111/hex.13150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/21/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022] Open
Abstract
Background Missed test‐results and failure to follow‐up test‐results are major patient safety concerns. Strategies to improve test‐results management have predominantly focused on clinician‐based interventions, with patients principally involved in studies of test‐result communication preferences, the impact of patient portals or experiences with reporting processes in primary care. Objective To identify consumer perspectives and experiences of the challenges they have faced with test‐results management, through consumer participation in qualitative data analysis. Design and participants Volunteers (n = 10) were recruited to participate in a health consumer reference group workshop on test‐results management. Prior to the workshop, consumers selected topics for discussion using a preference poll. During the workshop, consumers participated in qualitative data analysis of de‐identified excerpts of previously collected interview data discussing hospital test‐results management. Researchers (n = 5) guided consumers through the analytical process and discussion of themes. Discussions were audio‐recorded and transcribed for qualitative analysis. Results Consumer‐selected topics for discussion were ‘Transitions of Care’ and ‘Access’. Consumer data analysis prompted broader discussion including lived experiences. Following the workshop, a second level of content analysis pinpointed issues with implications for patient safety highlighting that consumers were astutely aware of macrolevel ‘Systems Factors’ relating to ‘Emergency Departments’ and the health system, as well as microlevel ‘Patient Factors’ (eg patient preferences and circumstances) which impact a patient's understanding during the ‘Communication’ (clinician to patient/between clinicians) of test‐results ‘Information’ (or lack thereof). Conclusions Consumers identified the challenges patients experience with test‐results management, and our findings highlight areas for potential improvement in patient safety. Patient or public contribution Ten health consumer volunteers actively participated in the test‐results management data analysis workshop conducted in this study. Two health consumers also volunteered to read and comment on the draft manuscript.
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Affiliation(s)
- Judith Thomas
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia
| | - Maria R Dahm
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.,Institute for Communication in Health Care (ICH), College of Arts and Social Sciences, Australian National University, Canberra, ACT, Australia
| | - Julie Li
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia
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Shah SGS, Hannan A, Elliott B, Brindle I, Fitton R. The view of a general practitioner on immediate access for patients to their laboratory test results. Clin Chem Lab Med 2019; 57:375-382. [PMID: 30375343 DOI: 10.1515/cclm-2018-0743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/04/2018] [Indexed: 11/15/2022]
Abstract
This position paper presents the role of laboratory test results in traditional general practice and provides a recommendation for responsible sharing of results with patients for improved safety, efficiency and outcomes. This paper looks at the relationship between the laboratory, the general practitioner consultation, the patient, safety and general practice capacity. We suggest changes in the traditional practice of communicating laboratory test results whereby normal or abnormal results are made available to patients as soon as they become available. We also endorse the opinion that using online tools such as email or text messages could enhance the provision of rapid access to laboratory test results for patients.
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Affiliation(s)
- Syed Ghulam Sarwar Shah
- Department of Occupational Health, Guy's and St Thomas' NHS Foundation Trust, The Education Centre, St Thomas Hospital, Westminster Bridge Road, London SE1 7EH, UK
| | - Amir Hannan
- Haughton Thornley Medical Centres, Hyde, Cheshire, UK
| | - Bruce Elliott
- Type 1 Diabetic and Diabetes UK Member, Darlington, Co Durham, UK
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Smith MW, Hughes AM, Brown C, Russo E, Giardina TD, Mehta P, Singh H. Test results management and distributed cognition in electronic health record-enabled primary care. Health Informatics J 2018; 25:1549-1562. [PMID: 29905084 DOI: 10.1177/1460458218779114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Managing abnormal test results in primary care involves coordination across various settings. This study identifies how primary care teams manage test results in a large, computerized healthcare system in order to inform health information technology requirements for test results management and other distributed healthcare services. At five US Veterans Health Administration facilities, we interviewed 37 primary care team members, including 16 primary care providers, 12 registered nurses, and 9 licensed practical nurses. We performed content analysis using a distributed cognition approach, identifying patterns of information transmission across people and artifacts (e.g. electronic health records). Results illustrate challenges (e.g. information overload) as well as strategies used to overcome challenges. Various communication paths were used. Some team members served as intermediaries, processing information before relaying it. Artifacts were used as memory aids. Health information technology should address the risks of distributed work by supporting awareness of team and task status for reliable management of results.
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Affiliation(s)
| | | | | | | | - Traber D Giardina
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, and Baylor College of Medicine, USA
| | - Praveen Mehta
- VA Great Lakes Health Care System, USA; Loyola University Chicago Stritch School of Medicine, USA
| | - Hardeep Singh
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, and Baylor College of Medicine, USA
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O'Connor SD, Khorasani R, Pochebit SM, Lacson R, Andriole KP, Dalal AK. Semiautomated System for Nonurgent, Clinically Significant Pathology Results. Appl Clin Inform 2018; 9:411-421. [PMID: 29874687 DOI: 10.1055/s-0038-1654700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND Failure of timely test result follow-up has consequences including delayed diagnosis and treatment, added costs, and potential patient harm. Closed-loop communication is key to ensure clinically significant test results (CSTRs) are acknowledged and acted upon appropriately. A previous implementation of the Alert Notification of Critical Results (ANCR) system to facilitate closed-loop communication of imaging CSTRs yielded improved communication of critical radiology results and enhanced adherence to institutional CSTR policies. OBJECTIVE This article extends the ANCR application to pathology and evaluates its impact on closed-loop communication of new malignancies, a common and important type of pathology CSTR. MATERIALS AND METHODS This Institutional Review Board-approved study was performed at a 150-bed community, academically affiliated hospital. ANCR was adapted for pathology CSTRs. Natural language processing was used on 30,774 pathology reports 13 months pre- and 13 months postintervention, identifying 5,595 reports with malignancies. Electronic health records were reviewed for documented acknowledgment for a random sample of reports. Percent of reports with documented acknowledgment within 15 days assessed institutional policy adherence. Time to acknowledgment was compared pre- versus postintervention and postintervention with and without ANCR alerts. Pathologists were surveyed regarding ANCR use and satisfaction. RESULTS Acknowledgment within 15 days was documented for 98 of 107 (91.6%) pre- and 89 of 103 (86.4%) postintervention reports (p = 0.2294). Median time to acknowledgment was 7 days (interquartile range [IQR], 3, 11) preintervention and 6 days (IQR, 2, 10) postintervention (p = 0.5083). Postintervention, median time to acknowledgment was 2 days (IQR, 1, 6) for reports with ANCR alerts versus 6 days (IQR, 2.75, 9) for reports without alerts (p = 0.0351). ANCR alerts were sent on 15 of 103 (15%) postintervention reports. All pathologists reported that the ANCR system positively impacted their workflow; 75% (three-fourths) felt that the ANCR system improved efficiency of communicating CSTRs. CONCLUSION ANCR expansion to facilitate closed-loop communication of pathology CSTRs was favorably perceived and associated with significant improved time to documented acknowledgment for new malignancies. The rate of adherence to institutional policy did not improve.
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Affiliation(s)
- Stacy D O'Connor
- Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Ramin Khorasani
- Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Stephen M Pochebit
- Department of Pathology, Brigham and Women's Faulkner Hospital, Boston, Massachusetts, United States
| | - Ronilda Lacson
- Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Katherine P Andriole
- Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Anuj K Dalal
- Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
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Nicholson BD, Goyder CR, Bankhead CR, Toftegaard BS, Rose PW, Thulesius H, Vedsted P, Perera R. Responsibility for follow-up during the diagnostic process in primary care: a secondary analysis of International Cancer Benchmarking Partnership data. Br J Gen Pract 2018; 68:e323-e332. [PMID: 29686134 PMCID: PMC5916079 DOI: 10.3399/bjgp18x695813] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/05/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND It is unclear to what extent primary care practitioners (PCPs) should retain responsibility for follow-up to ensure that patients are monitored until their symptoms or signs are explained. AIM To explore the extent to which PCPs retain responsibility for diagnostic follow-up actions across 11 international jurisdictions. DESIGN AND SETTING A secondary analysis of survey data from the International Cancer Benchmarking Partnership. METHOD The authors counted the proportion of 2879 PCPs who retained responsibility for each area of follow-up (appointments, test results, and non-attenders). Proportions were weighted by the sample size of each jurisdiction. Pooled estimates were obtained using a random-effects model, and UK estimates were compared with non-UK ones. Free-text responses were analysed to contextualise quantitative findings using a modified grounded theory approach. RESULTS PCPs varied in their retention of responsibility for follow-up from 19% to 97% across jurisdictions and area of follow-up. Test reconciliation was inadequate in most jurisdictions. Significantly fewer UK PCPs retained responsibility for test result communication (73% versus 85%, P = 0.04) and non-attender follow-up (78% versus 93%, P<0.01) compared with non-UK PCPs. PCPs have developed bespoke, inconsistent solutions to follow-up. In cases of greatest concern, 'double safety netting' is described, where both patient and PCP retain responsibility. CONCLUSION The degree to which PCPs retain responsibility for follow-up is dependent on their level of concern about the patient and their primary care system's properties. Integrated systems to support follow-up are at present underutilised, and research into their development, uptake, and effectiveness seems warranted.
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Affiliation(s)
- Brian D Nicholson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Clare R Goyder
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Clare R Bankhead
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Peter W Rose
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hans Thulesius
- Department of Clinical Sciences, Lund University, Växjö, Sweden
| | - Peter Vedsted
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Macrae C. When no news is bad news: communication failures and the hidden assumptions that threaten safety. J R Soc Med 2017; 111:5-7. [PMID: 29182882 DOI: 10.1177/0141076817738503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Carl Macrae
- Department of Experimental Psychology, University of Oxford, Oxford OX1 3UD, UK
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Bowen ME, Merchant Z, Abdullah K, Bhat D, Fish J, Halm EA. Patient, Provider, and System Factors Associated With Failure to Follow-Up Elevated Glucose Results in Patients Without Diagnosed Diabetes. Health Serv Res Manag Epidemiol 2017; 4:2333392817721647. [PMID: 28890909 PMCID: PMC5580845 DOI: 10.1177/2333392817721647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 06/19/2017] [Indexed: 01/23/2023] Open
Abstract
Background: Although elevated glucose values are strongly associated with undiagnosed diabetes, they are frequently overlooked. Patient, provider, and system factors associated with failure to follow-up elevated glucose values in electronic medical records (EMRs) are not well described. Methods: We conducted a chart review in a comprehensive EMR with a patient portal and results management features. Established primary care patients with no known diagnosis of diabetes and ≥ 1 glucose value >125 mg/dL were included. Follow-up failure was defined as (1) no documented comment on the glucose value or result communication to the patient within 30 days or (2) no hemoglobin A1c (HbA1c) ordered within 30 days or resulted within 12 months. Associations were examined using Wilcoxon and χ2 tests. Results: Of 150 charts reviewed, 97 met inclusion criteria. The median glucose was 133 mg/dL, and 20% of patients had multiple values >125 mg/dL. Only 36% of elevated glucose values were followed up. No associations were observed between patient characteristics, diabetes risk factors, or provider characteristics and follow-up failures. Automated flagging of glucose values ≥140 mg/dL by highlighting them red in the EMR was not associated with improved follow-up (46% vs 32%; P = .19). Even when follow-up occurred (n = 35), only 31% completed gold standard diabetes testing (HbA1c) within 12 months. Of the resulted HbA1c tests (n = 11), 55% were in the prediabetes range (5.7%-6.4%). Conclusions: Two-thirds of elevated glucose values were not followed up, despite EMR features facilitating results management. Greater understanding of the results management process and improved EMR functionalities to support results management are needed.
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Affiliation(s)
- Michael E Bowen
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Zahra Merchant
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kazeen Abdullah
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Deepa Bhat
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jason Fish
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ethan A Halm
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Abstract
Failure to follow-up on test results represents a serious breakdown point in the diagnostic process which can lead to missed or delayed diagnoses and patient harm. Amidst discussions to ensure fail-safe test result follow-up, an important, yet under-discussed question emerges: how do we determine who is ultimately responsible for initiating follow-up action on the tests that are ordered? This seemingly simple question belies its true complexity. Although many of these complexities are also applicable to other diagnostic specialities, the field of medical imaging provides an ideal context to discuss the challenges of attributing responsibility of test result follow-up. In this review, we summarize several key concepts and challenges in the context of critical results, wet reads, and incidental findings to stimulate further discussion on responsibility issues in radiology. These discussions could help establish reliable closed-loop communication to ensure that every test result is sent, received, acknowledged and acted upon without failure.
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Affiliation(s)
- Janice L Kwan
- Department of Medicine, Division of General Internal Medicine, University of Toronto, Mount Sinai Hospital, 427-600 University Avenue, Toronto, Ontario M5G 1X5, Canada
| | - Hardeep Singh
- Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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Murphy DR, Meyer AN, Bhise V, Russo E, Sittig DF, Wei L, Wu L, Singh H. Computerized Triggers of Big Data to Detect Delays in Follow-up of Chest Imaging Results. Chest 2016; 150:613-20. [PMID: 27178786 DOI: 10.1016/j.chest.2016.05.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/14/2016] [Accepted: 05/02/2016] [Indexed: 02/08/2023] Open
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