The article can be downloaded free from AHRQ here: http://psnet.ahrq.gov/public/Singh-JCJQPS-2010_PSNetID18026.pdf
The eight recommendations are:
- Policies should be introduced with clear definitions of key terms.
- Policies should clearly outline provider responsibilities.
- Policies should specify procedures for fail-safe communication of abnormal test results.
- Policies must define verbal and/or electronic reporting procedures for both critical and significantly abnormal laboratory, imaging, and other test values.
- Policies should specify "Critical Tests" and acceptable length of time between their ordering and reporting.
- Policies should define time lines between the availability of test results and patient notification, and institutions should specify preferred mechanisms for patient notification.
- Policies must be of "real world" value and written with feedback from key stakeholders.
- Policies should establish responsibilities for monitoring and evaluating communication procedures.
Background: Health care organizations continue to struggle to ensure that critical findings are communicated and acted on in a timely and appropriate manner. Recent research highlights the risks of communication breakdowns along the entire spectrum of test-result abnormality, including
significantly abnormal but nonemergent findings. Evidence-based and practical institutional policies must uphold effective processes to guide communication of abnormal test results. Eight recommendations for effective policies on communication of abnormal diagnostic test results were developed based on policy refinement at the Michael E. DeBakey Veterans Affairs Medical Center
(Houston), institutional experience with test result management, and findings from research performed locally and elsewhere.
Key Facets of Effective Policies: Research findings on vulnerabilities in existing policies and procedures were taken into consideration. The eight recommendations are based on important refinements to the policy which clarified staff roles and responsibilities for test ordering, follow-up, and communication; defined categories of abnormal test results to guide appropriate follow-up action; and elaborated procedures for monitoring the effectiveness of test result communication
and follow-up. Participation of key stakeholders is recommended to enhance buy-in from personnel and to help ensure the policies feasibility and sustainability.
Conclusions: The proposed recommendations for ensuring safe test-result communication may be potentially useful to a wide variety of institutions and health care settings. These practical suggestions, based on research findings and experiences with a previous policy, may be a useful
guide for designing or amending policies for safe test-result communication in both inpatient and outpatient settings.
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