Abstract
Background: Delays and failure to follow-up abnormal test results after a patient leaves hospital are critical patient safety issues which have not been comprehensively studied.
Aim: To explore the non-endorsement of test results in a metropolitan teaching hospital Emergency Department
Research questions:
1) What is the average time between microbiology and radiology test ordering and clinician endorsement?
2) What proportions of microbiology and radiology test results were not endorsed?
Methods: The study was conducted in the Emergency Department (ED) of a 400-bed hospital which has used a computerised provider order entry (CPOE) system to order and view diagnostic and radiology tests for all inpatients since 1992. Data relating to microbiology (n=126) and radiology tests (n=240) ordered by ED physicians were collected for a five day period (13th-17th August 2007). Comparisons were made between the CPOE generated list of tests ordered and the endorsement of test results on hard copy reports printed to the ED. The medical records of patients where the microbiology or radiology test appeared on the test order list but were missing from the test results printed to the ED were reviewed.
Results: The average duration between the time a specimen was collected or an examination was performed and a result report was printed to the ED was 2.5 days for microbiology and 1.5 days for radiology with the majority (64% and 93% respectively) endorsed on the same day the result was printed. The majority of microbiology and radiology results were printed within two days of specimen collection or examination (68%; n=163 and 68%; n=85 respectively). Two microbiology results and seven radiology reports appeared not to have been
endorsed. The patients’ medical records for these 9 results were reviewed by an ED clinician (RP). After review there was no evidence that the two microbiology results were endorsed (1.6%) nor that two of the radiology reports were endorsed (0.8%) either prior or post patient discharge.
Conclusion: This study highlighted the need for the test endorsement function to be utilized in the existing CPOE system to assist clinicians in following up all test results for their patients.
Aim: To explore the non-endorsement of test results in a metropolitan teaching hospital Emergency Department
Research questions:
1) What is the average time between microbiology and radiology test ordering and clinician endorsement?
2) What proportions of microbiology and radiology test results were not endorsed?
Methods: The study was conducted in the Emergency Department (ED) of a 400-bed hospital which has used a computerised provider order entry (CPOE) system to order and view diagnostic and radiology tests for all inpatients since 1992. Data relating to microbiology (n=126) and radiology tests (n=240) ordered by ED physicians were collected for a five day period (13th-17th August 2007). Comparisons were made between the CPOE generated list of tests ordered and the endorsement of test results on hard copy reports printed to the ED. The medical records of patients where the microbiology or radiology test appeared on the test order list but were missing from the test results printed to the ED were reviewed.
Results: The average duration between the time a specimen was collected or an examination was performed and a result report was printed to the ED was 2.5 days for microbiology and 1.5 days for radiology with the majority (64% and 93% respectively) endorsed on the same day the result was printed. The majority of microbiology and radiology results were printed within two days of specimen collection or examination (68%; n=163 and 68%; n=85 respectively). Two microbiology results and seven radiology reports appeared not to have been
endorsed. The patients’ medical records for these 9 results were reviewed by an ED clinician (RP). After review there was no evidence that the two microbiology results were endorsed (1.6%) nor that two of the radiology reports were endorsed (0.8%) either prior or post patient discharge.
Conclusion: This study highlighted the need for the test endorsement function to be utilized in the existing CPOE system to assist clinicians in following up all test results for their patients.
| Original language | English |
|---|---|
| Title of host publication | HIC 2008 Conference |
| Subtitle of host publication | Australias Health Informatics Conference; The Person in the Centre |
| Editors | Heather Grain |
| Publisher | Health Informatics Society of Australia (HISA) |
| Pages | 66-71 |
| Number of pages | 6 |
| ISBN (Print) | 9780980552003 |
| Publication status | Published - 2008 |
| Externally published | Yes |
| Event | HIC 2008 Conference: Australias Health Informatics Conference; The Person in the Centre - Melbourne, Australia Duration: 31 Aug 2008 → 2 Sept 2008 |
Conference
| Conference | HIC 2008 Conference |
|---|---|
| Country/Territory | Australia |
| City | Melbourne |
| Period | 31/08/08 → 2/09/08 |
Keywords
- Diagnostic tests
- computerized physician order entry systems
- CPOE
- safety
- hospital information systems