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Diagnosis

Official Journal of the Society to Improve Diagnosis in Medicine (SIDM)

Editor-in-Chief: Graber, Mark L. / Plebani, Mario

Ed. by Argy, Nicolas / Epner, Paul L. / Lippi, Giuseppe / Singhal, Geeta / McDonald, Kathryn / Singh, Hardeep / Newman-Toker, David

Editorial Board: Basso , Daniela / Crock, Carmel / Croskerry, Pat / Dhaliwal, Gurpreet / Ely, John / Giannitsis, Evangelos / Katus, Hugo A. / Laposata, Michael / Lyratzopoulos, Yoryos / Maude, Jason / Sittig, Dean F. / Sonntag, Oswald / Zwaan, Laura


CiteScore 2018: 0.69

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2194-802X
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Patient groups, clinicians and healthcare professionals agree – all test results need to be seen, understood and followed up

Maria R. Dahm
  • Corresponding author
  • Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
  • Email
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/ Andrew Georgiou
  • Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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/ Robert Herkes / Anthony Brown
  • Health Consumers NSW, Sydney, NSW, Australia
  • Men’s Health Information and Resource Centre, Western Sydney University, Sydney, NSW, Australia
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/ Julie Li
  • Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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/ Robert Lindeman / Andrea R. Horvath
  • Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
  • Clinical Chemistry and Endocrinology, Prince of Wales Hospital, NSW Health Pathology, Sydney, NSW, Australia
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/ Graham Jones
  • Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
  • SydPath, St Vincent’s Hospital, Sydney, NSW, Australia
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/ Michael Legg
  • Michael Legg & Associates, Wollongong, NSW, Australia
  • Faculty of Engineering and Information Science, University of Wollongong, Wollongong, NSW, Australia
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/ Ling Li
  • Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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/ David Greenfield
  • Australian Institute of Health Service Management, University of Tasmania, Sydney, NSW, Australia
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/ Johanna I. Westbrook
  • Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Published Online: 2018-10-17 | DOI: https://doi.org/10.1515/dx-2018-0083

Abstract

Background

Diagnostic testing provides integral information for the prevention, diagnosis, treatment and management of disease. Inadequate test result reporting and follow-up is a major risk to patient safety. Factors contributing to failure to follow-up test results include unclear delineation of responsibility about who is meant to act on a test result; poor coordination across different levels of care; and the absence of integrated health information systems for the efficient information communication.

Methods

A 2016 Australian Stakeholder Forum brought together over 30 representatives from 14 different consumer, clinical and management stakeholder organisations to discuss safe and effective test result communication, management and follow-up. Thematic analysis was conducted drawing on multimodal data collected in the form of observational fieldnotes and document artefacts produced by participants.

Results

The forum identified major challenges which pose immediate risks to patient safety. Participants recommended priorities for addressing issues relating to: (i) the governance of test result management processes; (ii) integration of health care processes through the utilisation of effective digital health solutions; and (iii) involving patients as key partners in the decision-making and care process.

Conclusions

Stakeholder groups diverged slightly in their priorities. Consumers highlighted the lack of patient involvement in the test result management process but were less concerned about standardisation of reports and critical result thresholds than pathologists. The forum foregrounded the need for a systems approach, capable of identifying and addressing interconnections and multiple factors that contribute to poor test result follow-up, with a strong emphasis on enhancing the contribution of patients.

Keywords: diagnostic error; pathology; patient safety; test result follow-up

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About the article

Corresponding author: Dr. Maria R. Dahm, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW 2109, Australia


Received: 2018-06-13

Accepted: 2018-09-25

Published Online: 2018-10-17

Published in Print: 2018-11-27


Author contribution: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: This forum was held as part of a larger project funded under the National Health and Medical Research Council, Partnership Project Grant number 1111925.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Diagnosis, Volume 5, Issue 4, Pages 215–222, ISSN (Online) 2194-802X, ISSN (Print) 2194-8011, DOI: https://doi.org/10.1515/dx-2018-0083.

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