MedStar Franklin Square Medical Center, Baltimore, MD
A Simple Intervention to Improve Timely Follow-Up for Laboratory Test Results in an Outpatient Resident and Faculty Clinic

Abstract

Background: Much outpatient care occurs when the patient is not in the office, including phone calls, requests for medication refills, and review of test results. We chose to study the response times to outpatient laboratories and develop a simple intervention to improve timely follow-up. Through weekly reminders via pagers or email, we hoped to shorten healthcare providers' response time to addressing test results and to improve awareness of outpatient follow-up.

Methods: Using EMRs in 2 primary care practice sites, we defined the sign time as the time between the responsible healthcare provider receiving an email notice of test results and signing off on the results. Before the intervention, the study was announced at 2 departmentwide conferences and providers received 4 weekly emails. All providers received weekly pager reminders to check their EMR inboxes during the intervention period (March 2, 2012–June 30, 2012), and EMR data was extracted to measure the response time.

Results: Compared to the preintervention control period of July 1, 2011 to January 31, 2012, we saw a shorter response time during the intervention. Preintervention, the sites had 8,390 laboratory tests with a mean sign time of 1.41 (standard deviation 1.61). During the intervention, the sites had 4,257 tests with a mean sign time of 1.20 (standard deviation 1.56).

Conclusion: Our brief intervention showed that a simple weekly reminder to providers to check their inboxes resulted in shorter viewing and signing times. Further study is needed to determine if other forms of reminders, such as cell phone texts, would produce similar results and to extend the intervention beyond 16 weeks. Our study did not determine if medical errors were prevented or if patients received higher quality of care. Further, the study was completed at 1 medical center, so the results may not be applicable to other settings.