Standardized Automated Notification Process for Safe and Effective Management of Test Result Delivery in a VA Faciliity.

Abstract

Laboratory and other diagnostic tests are often performed on patients to assist in diagnosing illnesses or monitoring health status. Failure to communicate follow-up test results, especially abnormal tests, is a major safety issue since delays to diagnosis and treatment can potentially result in patient harm. However, the best ways to communicate test results to patients in primary care are unknown. Additionally, the provision of timely accurate test results assists patients in integrating the information so that personal health decisions can be made. A quality improvement project was conducted and implemented at a Veterans Administration facility in Honolulu, Hawaii. The goal was to implement a standardized and consistent automated test result notification process while focusing and improving on providers’ challenges with proper test result delivery. The Iowa Model Revised was the conceptual framework that guided this project. The literature review revealed that many different factors can affect the timely notification of test results. The literature clearly indicates that when abnormal test results are not communicated in a timely manner, patient safety is at risk. The intended outcomes for the project were at least 90% of abnormal test results were communicated to the patients within seven days and the expected implications were- providers’ increased adherence to the test results delivery process and improved patient health outcomes. The pre-implementation assessment revealed that 5% of abnormal test results communicated to the patients in March 2016. The quality improvement project was implemented in June 2016. The post-implementation chart review and provider need assessment and satisfaction questionnaire results were suggestive that the providers’ compliance with test result reporting increased. Though the goal of 90 percent of the providers notifying patients of their abnormal v test results in a seven-day period was not achieved, it was improved from a low 5% pre-implementation to a high of 81% post-implementation. Although the project was conducted over a short timeframe, it was effective in engaging the providers to adopt the practice change. Thus, the implementation of a standardized and consistent automated test result notification process appeared to be beneficial for both the providers and patients.