Health Care Risk Insights: Test Result Risk Management
Failure to perform or communicate test results is a preventable error that can lead to unnecessary harm to patients and costly medical malpractice claims. In a recent review of claims arising out of doctors’ offices, the top cause was failure or delay in ordering tests. Although many times this is a result of factors such as judgement, vigilance, memory or lack of knowledge, failure or delay in ordering tests is often preventable by making simple changes to the system. To mitigate the risk of system errors that could lead testing errors and claims, reform and standardise practices across the facility.
Error-Proof Your Systems
Consider these tips to make your system less susceptible to malpractice claims from testing errors:
- Document the conversation with the patient in which the doctor explains tests to be performed.
- Create checklists or prompts in assessment and order forms, reminding GPs to order tests.
- Ensure that referral forms are comprehensive and that they include the following information:
- Patient history
- Physical examination findings
- Test results
- Differential diagnosis
- Expectations of the consultation
- Urgency level
- Allow access to test results by consultants.
- Establish a test result management system to ensure all tests are completed. Standardised order forms combined with either an electronic or paper database should document:
- Complete list of ordered tests
- Review by GPs
- Follow-up with the patient
- Additional studies
- Space to mark when completed
- Require doctors to sign and date all forms.
- Establish a dissemination policy for test results.
- Define which results require expedited, reliable communication, and develop critical test values.
- Define appropriate time parameters for action on critical test results. Flag critical results so they are acted on quickly.
- Establish criteria for escalating critical results to a back-up doctor in the absence of the referring doctor.
To mitigate the risk of claims arising out of testing errors, staff cooperation critical. Work with staff to identify best practices and integrate them into new programmes. When staff members are engaged and participate in the process, they are more likely to support and implement changes to your system, reducing the risk of testing errors.