About Failure to Follow Up
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Establishing and maintaining strong follow up and communication policies and procedures can help enhance patient care.
A physician who orders testing is responsible for reviewing results when received; documenting his or her review in the medical record; and initiating appropriate follow up.
A problem for many practices is the lack of a clearly defined tracking system for managing test results used across facilities, offices, laboratories, and other institutions. While tracking systems will vary from practice to practice, there are four basic steps physicians can follow to help ensure test results are managed properly.
- Track tests until results are received.
- Notify patients of the results.
- Document that the notification occurred.
- Ensure that patients with abnormal results receive recommended follow-up care.
Instituting a clear system for effective patient follow up is also recommended. In establishing policies and procedures, consider the following.
- Prioritize test results with “urgent,” “critical,” “action needed,” or “pending results.” A coding system may heighten awareness and trigger appropriate follow up.
- Standardize and simplify processes by using checklists, flow sheets, or tracking systems.
- Adopt technologies that employ built-in systems such as reminders, alerts, and the flagging of documentation issues. Recognize that these types of systems are only effective if there is a commitment to use them.
Avoid using the “no news is good news” approach for dealing with test results. Abnormal test results can be sent to the wrong office, misplaced, or accidentally filed without physician review.
Consider enlisting your patients in helping you track test results. Encourage them to call if they have not received their test results within a previously agreed upon timeline. Another way to enlist patients in their own care is to hold them accountable to their follow-up appointments. Emphasize the importance of follow up and encourage them to keep their appointments.
While involving patients in their own care can help overall outcomes, their involvement does not relieve the physician of his or her responsibility to follow up.
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