An Automatic Notification System for Test Results Finalized after Discharge
Project Final Report (PDF, 195.47 KB) Disclaimer
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
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Project Details -
Completed
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Grant NumberR21 HS018229
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AHRQ Funded Amount$284,648
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Principal Investigator(s)
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Organization
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LocationBostonMassachusetts
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Project Dates09/30/2009 - 03/31/2012
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Technology
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Care Setting
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Population
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Type of Care
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Health Care Theme
When results of tests are finalized after a patient has been discharged from a hospital, they may not come to the attention of the provider. These finalized results of tests pending at discharge (TPADs) represent a significant patient safety concern. Lack of followup on these results can lead to delayed diagnosis, delayed treatment, redundant test ordering, and harm to patients.
This project developed an automated email notification system of TPADs and conducted an evaluation of the tool’s impact on provider awareness of these tests. The system was implemented for patients who were discharged from the inpatient general medicine and cardiology services at Brigham and Women’s Hospital in Boston, Massachusetts.
The objectives of this project were to:
- Create an automatic notification system to prompt physicians of test results finalized after discharge.
- Evaluate the impact of this system on physician awareness of test results finalized after discharge.
A cluster-randomized controlled trial was conducted in which the inpatient attending physician as well as the primary care provider (PCP) were randomized to either receive an email notification or usual care for all patients discharged with TPADs over an 8-month period. The providers were surveyed regarding their awareness of any TPAD results, actionable TPAD results, and satisfaction with the tool.
Providers who received the automated email had a statistically significant improvement in their awareness of TPADs than those who did not. Inpatient attendings were significantly more aware of actionable TPADs when receiving automated emails. Eight-nine percent of attendings and 70 percent of PCPs indicated satisfaction with the tool. The project team concluded that automated email notification of TPADs is an effective strategy for managing these results. Future areas of research include down-stream actions taken on results post-discharge, impact on readmissions, the relative effect on network versus non-network PCPs, and post-discharge health service utilization.
Citation:
Liao JM, Roy CL, Eibensteiner K, et al. Lost in transition: discrepancies in how physicians perceive the actionability of the results of tests pending at discharge. J Hosp Med 2014 Jun;9(6):407-9. PMID: 24585757.
Principal Investigator:
Dalal, Anuj K.
Document Type:
Journal Publication
Research Method:
Quantitative, Randomized Controlled Trial (RCT), Survey
Population:
Physician
Citation:
Dalal AK, Roy CL, Poon EG, et al. Impact of an automated email notification system for results of tests pending at discharge: a cluster-randomized controlled trial. J Am Med Inform Assoc 2014 May 1;21(3):473-80.
Principal Investigator:
Dalal, Anuj K.
Document Type:
Journal Publication
Research Method:
Randomized Controlled Trial (RCT)
Citation:
Dalal A. An Automatic Notification System for Test Results Finalized after Discharge - Final Report. (Prepared by Brigham and Women's Hospital under Grant No. R21 HS018229). Rockville, MD: Agency for Healthcare Research and Quality, 2012.
Link:
PDF (195.47 KB)
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
Principal Investigator:
Dalal, Anuj K.
Document Type:
Report
Citation:
Dalal AK, Schnipper JL, Poon EG, et al. Design and implementation of an automated email notification system for results of tests pending at discharge. J Am Med Inform Assoc 2012 Jul 1;19(4):523-8.
Principal Investigator:
Dalal, Anuj K.
Document Type:
Journal Publication
Research Method:
Descriptive
Disclaimer
Disclaimer details
Description:
This is a questionnaire designed to be completed by physicians in an inpatient setting. The tool includes questions to assess the current state of and attitudes around clinical messaging.
Document Type:
Questionnaire/Survey
Research Method:
Attitude Assessment, Current State Assessment
Population:
Physician
Care Setting:
Inpatient
Technology:
Clinical Messaging
Copyright Status:
Permission has been obtained from the survey developers for unrestricted use of this survey; it may be modified or used as is without additional permission from the authors.
Organization:
Brigham and Women's Hospital
Location:
Boston, Massachusetts
Disclaimer
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