Efficiency of test report delivery to the requesting physician in an outpatient setting: an observational study

Abstract

Background: Clinical laboratories accredited according to ISO 15189 quality standards are obliged to implement and continuously monitor quality indicators for evaluation of the laboratory's contribution to patient care. Reporting laboratory results to the requesting physician is one important phase of the clinical laboratory testing process. Failure to report results may indicate the ineffectiveness of the laboratory service. We aimed to analyze the proportion and type of laboratory reports for outpatients that were not delivered to the requesting physician. Methods: This retrospective observational study was conducted during an 11-month period from January to December 2007 at our outpatient biochemistry laboratory unit. Data on demographic characteristics, request types and laboratory findings for all uncollected reports were retrieved from the laboratory information system and compared with one random 2-week representative period. Results: During the study period our laboratory issued 22,445 patient reports with more than 150,000 biochemistry analyses. Of these, 464 (2.1%) were uncollected laboratory reports. When compared to the representative period, patients who never collected their laboratory reports were younger (p-0.001) or suffering from some chronic disease. Routine biochemistry tests were the most prevalent ()50%). The majority of routine biochemistry tests were almost equally represented during the study and representative period, while molecular diagnostic tests were several times more frequently uncollected (p-0.001). Reports with electrolytes, metabolites and glucose were the least likely to be uncollected (p-0.001). The total cost for those tests was 30% of the average monthly laboratory budget. Conclusions: A significant amount of the laboratory budget is wasted for tests that never reach the requesting physician. Such misutilization of the laboratory reveals the substantial lack of medical necessity for test requests. Further studies are needed to explore the possible efficiency of the various inter-

Injudicious use of laboratory facilities in tertiary care hospitals at rawalpindi, pakistan: a cross-sectional descriptive study

“…This unnecessary expense not only increases the workload of already overburdened laboratory staff but also prevents the introduction of newer and more sensitive/specific tests due to loss of a considerable amount of the laboratory budget on useless investigations. In a similar study it was reported that out of a total of 22445 laboratory tests, 464 test reports were not collected with 30% of the average monthly budget been wasted [7]. The physicians are in the habit of ordering a panel of tests for a particular condition with only one or two investigations out of them contributing towards clinical use.…”

“…Total number of tests performed at AFIP and CMH Rawalpindi laboratory during the study period and number of uncollected reports were noted. Laboratory reports were considered uncollected if not collected either by hand, on the telephone or via the internet within 3 months after being issued [7]. Moreover, we interviewed the physicians and pathologists at CMH Rawalpindi, MH Rawalpindi and AFIP to get their point of view regarding incomplete laboratory request forms, inappropriate test requests at various professional levels and uncollected reports all the above mentioned issues.…”

“…Results that never reach the physician affect the quality of patient care and unnecessarily waste financial health resources. A study reports a significant amount of the laboratory budget is wasted on laboratory test reports that are never collected from the laboratory [7]. …”

Repeat Western Blot Testing After Receiving an HIV Diagnosis and Its Association with Engagement in Care

“…Young age is associated with reduced likelihood of returning for test results [14] and being more likely to have unstable living situations [15-18]. These associations will reduce the chances that a young individual will learn the results of HIV testing from providers or public health personnel.…”

Seven Q-Tracks Monitors of Laboratory Quality Drive General Performance Improvement: Experience From the College of American Pathologists Q-Tracks Program 1999–2011

“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] From the beginning to the end of the laboratory testing process, the generic monitors were QT17-outpatient order-entry error rates, 13,14 QT1-identification (ID) band defect rates, 15,16 QT3-specimen rejection rates, [17][18][19][20] QT15-median troponin order-to-report times, 21,22 QT8-STAT test receipt-to-report TAT outlier rates, 23,24 QT10-critical value reporting event-defect rates, 25,26 and QT16-corrected report rates. 27,28 …”