Considerable Lack of Test Result Follow-Up in Hospitals

Wide variation in the proportion of test result follow-up in emergency departments

MONDAY, Feb. 21 (HealthDay News) -- Failure to follow up on test results is a considerable problem, which can negatively impact patient health, according to a review published in the February issue of BMJ Quality & Safety.

Joanne Callen, Ph.D., from the University of New South Wales in Sydney, Australia, and colleagues examined 12 published articles from 1990 to 2010, which quantified the proportion of diagnostic tests that were not followed up for hospital patients. The impact of failure to follow up on patient outcomes was evaluated.

The investigators found a wide variation in the extent of the problem and impact on patient outcomes. The lack of test result follow-up varied from 20.04 to 61.6 percent, and for patients treated in the emergency department, the proportion of tests not followed up varied from 1.0 to 75 percent. Follow-up failure was particularly evident in critical test results and results for patients who were moving across health care settings. Serious patient outcomes included misuse, or inappropriate use, of antibiotics, neglected cancer diagnoses, and death. Follow-up of test results included paper-based, electronic, and hybrid paper-and-electronic systems; there was limited evidence of effectiveness of electronic management systems.

"The existing evidence suggests that the problem of missed test results is considerable, and reported negative impacts on patients warrant the exploration of solutions. Further studies are urgently needed to test the effectiveness of interventions such as online endorsement of results," the authors write.

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