AHRQ Study: Alert System Helps Ensure Patients Get Radiology Test Results

An AHRQ-funded study found that an electronic alert notification system improved the frequency of notifications to patients about their radiology test results. Before the alerts, 19 percent of patients did not hear back from their doctors; afterward, just 5 percent weren’t notified. The researchers evaluated the impact of the patient safety initiative with an alert notification system to reduce the number of times doctors did not communicate critical radiology results to patients. Researchers also assessed potential overuse of the alerting system, finding evidence that the system did not notify physicians more often than necessary with noncritical results. Future studies are needed to evaluate whether such systems prevent subsequent patient harm, they concluded. “Impact of an Electronic Alert Notification System Embedded in Radiologists’ Workflow on Closed Loop Communication of Critical Results: A Time Series Analysis,” was published online September 15 in the journalBMJ Quality & Safety. Read the study abstract.

2015 Sep 15. pii: bmjqs-2015-004276. doi: 10.1136/bmjqs-2015-004276. [Epub ahead of print]

Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loopcommunication of critical results: a time series analysis.

Lacson R1, O'Connor SD1, Sahni VA1, Roy C2, Dalal A2, Desai S3, Khorasani R1.

Author information

Abstract

INTRODUCTION:

Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation ofclosed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alerts for transmission and acknowledgement of critical test results. We evaluated the impact of a patient safety initiative with an alertnotification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results.

METHODS:

We implemented an alert notification system-Alert Notification of Critical Results (ANCR)-in January 2010. We reviewed radiology reports finalised in 2009-2014 which lacked documented communication between the radiologist and another care provider, and assessed the impactof ANCR on the proportion of such reports with critical findings, using trend analysis over 10 semiannual time periods. To evaluate potential overuse of ANCR, we assessed the proportion of reports with non-critical results among provider-communicated reports.

RESULTS:

The proportion of reports with critical results among reports without documented communication decreased significantly over 4 years (2009-2014) from 0.19 to 0.05 (p<0.0001, Cochran-Armitage trend test). The proportion of provider-communicated reports with non-critical resultsremained unchanged over time before and after ANCR implementation (0.20 to 0.15, p=0.45, Cochran-Armitage trend test).

CONCLUSIONS:

A patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers. We observed no change in documented communication of non-critical results, suggesting thesystem did not promote overuse. Future studies are needed to evaluate whether such systems prevent subsequent patient harm.

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