A national study conducted with residents (who take on a lot of the care in hospitals, especially larger hospitals) noted that more than half of the time, they saw patients who were either readmitted, or had subsequent issues when results for test pending at discharge (TPADs) hadn’t been acted upon and treatment hadn’t been given.
So what can your organization do to practically combat TPADs and prevent potential harm?
The Office of the National Coordinator, a government agency that deals with electronic health records, published guidelines called the Safer Guidelines or Safety Assurance Factors for EHR Resilience. The intent behind these guidelines is to show research and collected data from other providers that establishes best practices. They point out how other organizations are working with the EHR, particularly regarding test results. Organizations can look to the ONC for the Safer Guides, specifically on this topic, to help them figure out how are they going to manage the process.
In addition, the National Patient Safety Goals from the Joint Commission have gone a step further and look at defining down to the test level. Some test levels are more critical than others. For example, if you have a test that’s going to potentially tell you whether you have cancer, that should have more urgency assigned to it. The Joint Commission is asking organizations to incorporate a tiered type of system where results that are urgent and need to be responded to in a more timely manner have a greater level of focus.
Check out Keith’s recommendations for what can be done at the organizational level to prevent delayed test results in episode 2 of “Get to the Point.”