ECRI shows how to ensure tests don't get lost in the shuffle

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The ECRI Institute has published information aimed at improving the tracking of diagnostic testing results, including a white paper with case studies on implementing best practices at ambulatory care facilities.

The white paper explores the application of recommendations issued in 2017-2018 by the ECRI's Partnership for Health IT Patient Safety, a multistakeholder collaborative, aimed at avoiding delayed, missed, and incorrect diagnoses related to diagnostic testing and specialty referral processes.

It reflects experience at sites with different setups, including specialty test volume, type of electronic health record (EHR) system, and available IT personnel. One site, for example, was a community-based family medicine provider. Experts were available to guide quality improvement at sites, and a heavy emphasis was placed on improving tracking through tools and processes.

A multistakeholder collaborative of the ECRI Institute released new research on 'closing the loop' to reduce errors related to diagnostic testing and specialty referral tracking. Image courtesy of ECRI.A multistakeholder collaborative of the ECRI Institute released new research on "closing the loop" to reduce errors related to diagnostic testing and specialty referral tracking. Image courtesy of ECRI.

The white paper cited research showing that 7% of abnormal laboratory results and 8% of abnormal imaging studies lack timely follow-up. Processes at the sites were analyzed, and areas at risk for errors -- gaps in the tracking of tests -- were identified. Issues that presented problems included incomplete testing or specialty referrals, incomplete or denied prior authorizations, lack of tracking, and large backlogs.

Solutions for improving tracking and flagging gaps were customized to the participating sites and involved collaboration with EHR vendors and in-house IT personnel. Challenges for implementing solutions included a lack of staff, funding, and support from leadership, according to the white paper.

In addition to the white paper, ECRI published a step-by-step guide on how to implement processes that will help ensure patients are diagnosed in a timely manner and that information about test results is effectively communicated. The guide describes how to develop a "closed-loop" process to eliminate gaps in test ordering and reporting processes. Failure to do so can result in missed or incorrect diagnoses and delays in care.

"Closing the loop therefore is a priority in all care, whether acute, long term, or ambulatory," according to the guide.

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