Resident Physician Inova Children's Hospital McLean, Virginia, United States
Background: The delay or failure to follow-up test results pending at discharge (TRPAD) is a well-documented safety concern occurring in 20-61% of inpatients. Driving factors include ambiguity in the physician responsible and variable handoff practices between the inpatient and outpatient provider. Test result management encompasses many contextual factors such as clinical workflow, user behaviors, and organizational policies and procedures. Objective: Increase the percentage of TRPAD that are managed within 36 hours of resulting from 53% to 95% in 3 months. Design/Methods: TRPAD were routed to a shared pool within the EMR for patients discharged by a pediatric hospitalist. Results are reviewed on a daily basis by a designated physician. Results are categorized into four separate groups based on result type, effect on care plan, and urgency. A standardized workflow was created for each category. Standard agreements with subspecialists were made when co-managing patient results. Project measures include results managed within 36 hours (process), abnormal results (outcome), and time needed to manage results (balancing).
