Many Hospital Tests Ordered Don't Get Read
< Aug. 15, 2012 > -- Doctors who order tests on patients who are about to be discharged from the hospital often fail to look at the results, either before or after the patient goes home, a new study says.
That failure to review test results may mean that people are getting unnecessary tests or that they are missing out on important information that might help their recovery.
"We know that many tests that are ordered in hospitals never get looked at, yet these tests carry as much important information about patient health as other tests," says lead study author Enrico Coiera, Ph.D., at the Centre for Health Informatics at the University of New South Wales.
For the study, Dr. Coiera and his colleagues reviewed more than 660,000 tests ordered for more than 6,700 patients at a metropolitan hospital in Australia.
Many left unread
Although tests ordered on the day that patients were discharged accounted for only about 7 percent of all tests ordered, they made up 47 percent of unread tests at the time of discharge and 41 percent of unread tests two months after discharge.
Gordon Schiff, M.D., at Harvard Medical School, says the problem is also a significant one in the U.S.
Although many tests done just before discharge don't uncover any serious problems, a significant number do, says Dr. Schiff, who was not involved with the study.
But often, it's not clear whose responsibility it is to look at test results once the patient had been discharged, he says.
Dr. Coiera proposed several ways to fix the problem, including keeping records that match patient discharge to tests done and that warn staff that the patient has left the hospital. In addition, electronic medical records could also help by reminding doctors to look at these test results.
Patients also can play a role by keeping track of their tests and asking their doctor about the results, Dr, Schiff says. They can also ask the hospital for a phone number to call to track their test results.
The study was published online this week in the Archives of Internal Medicine.
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Preparing to Leave the Hospital
If you're in the hospital for surgery, you'll get to go home once you've met the discharge criteria for that surgery. Hospitals usually require that patients ride home with a friend or family member because of the effects of anesthesia on coordination and reflexes.
Your discharge plan may include instructions on how to take care of wound dressings, what medications to take, and what exercises to do. Before you go home, you should be clear on what you can and can't do and whether you will need special care, assistance, or equipment at home.
Here are other questions to ask your doctor:
Do I need to follow any special dietary restrictions?
How soon can I start driving and doing other routine tasks like housework or lawn care?
When can I go back to work?
How do I take care of my incision site?
How long should I expect pain?
Do I need any follow-up therapy to this surgery?
How many weeks after surgery should I see my doctor?
In what instances should I call my doctor about a potential problem?
Always talk with your health care provider to find out more information.
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Agency for Healthcare Research and Quality - Better Information Helps Patients When They Leave the Hospital
Agency for Healthcare Research and Quality - Questions are the Answer
Archives of Internal Medicine - Last Orders: Follow-up of Tests Ordered on the Day of Hospital Discharge