Testing process errors and their harms and consequences reported from family medicine practices: a study of the American Academy of Family Physicians National Research Network

Hickner, John; Graham, Deborah; Elder, Nancy C.; Brandt, Elias; Emsermann, Caroline; Dovey, Susan; Phillips, Robert L.

doi:10.1136/qshc.2006.021915

Cited by 125 publications

(119 citation statements)

References 14 publications

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“…There was a balance in the yearly distribution of the articles' publication: four in 2007 9,10,11,12 , six in 2008 13,14,15,16,17,18 , three in 2009 19,20,21 , ten in 2010 22,23,24,25,26,27,28,29,30,31 , six in 2011 32,33,34,35,36,37 and four in 2012 38,39,40,41 (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies 12,17,21,30,31,41 used a combination of data sources. Reporting system were the most frequent data source: 15 studies (45%) 9,11,12,13,14,15,18,19,21,30,32,35,37,38,41 . The definition of adverse events differed, while the great majority of studies did not present a definition for these events.…”

Section: Resultsmentioning

confidence: 99%

“…Some studies used administrative data from incident reporting systems fed by health professionals 9,13,14,15,18,19,37,38 or by health professionals and patients and family members 32 . Data were also obtained from focus groups with physicians and other health professionals 23 , or with health professionals and patients and family members 20 .…”

Section: Resultsmentioning

confidence: 99%

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Patient safety in primary health care: a systematic review

Marchon

Mendes

2014

Cad. Saúde Pública

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Patient safety in primary health care: a systematic review

Marchon

Mendes

2014

Cad. Saúde Pública

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“…[1][2][3][4][5][6][7][8][9] Test result management in an electronic health record (EHR)-enabled health care system is susceptible to both technological and non-technological vulnerabilities. 10,11 EHR-based test result notification systems are aimed at reducing delays in follow-up of abnormal test results, and likely represent an improvement over communication using paper-based methods.…”

Section: Introductionmentioning

confidence: 99%

Electronic Detection of Delayed Test Result Follow-Up in Patients with Hypothyroidism

et al. 2017

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BACKGROUND: Delays in following up abnormal test results are a common problem in outpatient settings. Surveillance systems that use trigger tools to identify delayed follow-up can help reduce missed opportunities in care. OBJECTIVE: To develop and test an electronic health record (EHR)-based trigger algorithm to identify instances of delayed follow-up of abnormal thyroid-stimulating hormone (TSH) results in patients being treated for hypothyroidism. DESIGN: We developed an algorithm using structured EHR data to identify patients with hypothyroidism who had delayed follow-up (>60 days) after an abnormal TSH. We then retrospectively applied the algorithm to a large EHR data warehouse within the Department of Veterans Affairs (VA), on patient records from two large VA networks for the period from January 1, 2011, to December 31, 2011. Identified records were reviewed to confirm the presence of delays in follow-up. KEY RESULTS: During the study period, 645,555 patients were seen in the outpatient setting within the two networks. Of 293,554 patients with at least one TSH test result, the trigger identified 1250 patients on treatment for hypothyroidism with elevated TSH. Of these patients, 271 were flagged as potentially having delayed follow-up of their test result. Chart reviews confirmed delays in 163 of the 271 flagged patients (PPV = 60.1%). CONCLUSIONS: An automated trigger algorithm applied to records in a large EHR data warehouse identified patients with hypothyroidism with potential delays in thyroid function test results follow-up. Future prospective application of the TSH trigger algorithm can be used by clinical teams as a surveillance and quality improvement technique to monitor and improve follow-up.

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“…Some authors have introduced the "pre-pre-" and "post-post-" analytical phases to identify activities associated with the initial selection of tests and with the interpretation by clinicians respectively, to differentiate them for the pure collection/transport activities (pre-analytical phase) and reporting (postanalytical phase) 13, 14 . There is some evidence that these steps are more error-prone than other pre-and postanalytical activities [13][14][15][16][17][18] .However, the definition and use of such terms is not universal. Indeed the definition of even basic terms such as pre-analytical, analytical and post-analytical can vary between authorities.…”

Section: Introductionmentioning

confidence: 99%

Errors in laboratory medicine: The role of quality indicators

Mohanty¹

2020

IJCBR

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Errors in laboratory are heterogeneous in nature as it involves various complex procedures and a variety of persons preforming all the processes, starting from ordering of tests to reporting of result to its influence on ultimate patient care. The core job of a laboratory is to produce the correct test result. If we can't get the test results right, then we aren't doing our core job. It's our profession to know all the details of testing and instrumentation and quality control. It's our profession to assure that test results are correct. Improvements need not be only at "pre" or "post" or "analytical" -it should be at all three stages, as the consequence of error in any of the stage is the same: poor patient care. No error is worse than the other. We must make efforts on all fronts. Even if this means making small improvements in each area, a unified improvement effort will achieve better test results and better patient care than narrow efforts in either the pre-, post-or analytical area. To have a uniform consensus, the laboratories should have certain quality indicators to have control over the procedures that tend to generate errors.

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Testing process errors and their harms and consequences reported from family medicine practices: a study of the American Academy of Family Physicians National Research Network

Cited by 125 publications

References 14 publications

Patient safety in primary health care: a systematic review

Patient safety in primary health care: a systematic review

Electronic Detection of Delayed Test Result Follow-Up in Patients with Hypothyroidism

Errors in laboratory medicine: The role of quality indicators

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