Laboratory testing in general practice: a patient safety blind spot
Physicians order a lot of tests in primary care. We use tests to diagnose patients’ complaints, monitor chronic diseases, check medication levels and screen for health risks and early disease. Sometimes, even in the office setting, the result for a test can be a matter of life or death. But more often, whether the results get reviewed by the physician and to the patient today, tomorrow or even next week, may not matter much to the physician or to the patient. Unfortunately, this laisser-faire attitude about test results has led to clinical offices where missing and lost test results, no patient notifications and lack of follow-up constitute the norm.
In the USA, studies in the late 1990s began delineating problems in the primary care testing process.1–3 In the following decade and a half, work by several teams of researchers brought more clarity about testing process errors, the harms they may cause and the role of cascading errors, mitigation and recovery.4–15 Litchfield et al16 ,17 set out to understand the status of the testing process in British general practice (GP) offices. Using focus groups of patients and GP staff, the authors previously published the separate views of the two groups about how test results are communicated to patients by the offices. In their current studies published in BMJ Quality & Safety journal,18 ,19 they present suggestions offered by GP staff and patients to improve the testing process and describe the findings of a survey of GP office staff (lead receptionists, practice managers) in order to expand our understanding of how test results are communicated with patients in GP offices.
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