Document Detail


Management of test results in family medicine offices.
MedLine Citation:
PMID:  19597172     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We wanted to explore test results management systems in family medicine offices and to delineate the components of quality in results management. METHODS: Using a multimethod protocol, we intensively studied 4 purposefully chosen family medicine offices using observations, interviews, and surveys. Data analysis consisted of iterative qualitative analysis, descriptive frequencies, and individual case studies, followed by a comparative case analysis. We assessed the quality of results management at each practice by both the presence of and adherence to systemwide practices for each results management step, as well as outcomes from chart reviews, patient surveys, and interview and observation notes. RESULTS: We found variability between offices in how they performed the tasks for each of the specific steps of results management. No office consistently had or adhered to office-wide results management practices, and only 2 offices had written protocols or procedures for any results management steps. Whereas most patients surveyed acknowledged receiving their test results (87% to 100%), a far smaller proportion of patient charts documented patient notification (58% to 85%), clinician response to the result (47% to 84%), and follow-up for abnormal results (28% to 55%). We found 2 themes that emerged as factors of importance in assessing test results management quality: safety awareness-a leadership focus and communication that occurs around quality and safety, teamwork in the office, and the presence of appropriate policies and procedures; and technological adoption-the presence of an electronic health record, digital connections between the office and testing facilities, use of technology to facilitate patient communication, and the presence of forcing functions (built-in safeguards and requirements). CONCLUSION: Understanding the components of safety awareness and technological adoption can assist family medicine offices in evaluating their own results management processes and help them design systems that can lead to higher quality care.
Authors:
Nancy C Elder; Timothy R McEwen; John M Flach; Jennie J Gallimore
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of family medicine     Volume:  7     ISSN:  1544-1717     ISO Abbreviation:  Ann Fam Med     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-07-14     Completed Date:  2009-11-03     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  101167762     Medline TA:  Ann Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  343-51     Citation Subset:  IM    
Affiliation:
Department of Family Medicine, University of Cincinnati, Cincinnati, Ohio, USA. eldernc@fammed.uc.edu
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MeSH Terms
Descriptor/Qualifier:
Communication
Family Practice / methods*,  organization & administration,  standards
Female
Humans
Information Management / methods,  standards
Laboratory Techniques and Procedures
Male
Medical Errors / prevention & control
Medical Records / standards*
Middle Aged
Patient Care Management / methods,  standards
Physician's Practice Patterns
Qualitative Research
Quality Assurance, Health Care
Safety Management / methods
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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