Taylor Julie R, Thompson Pamela J, Genzen Jonathan R, Hickner John, Marques Marisa B
Division of Laboratory Systems, Centers for Disease Control and Prevention, Retired, 83 Lorelei Loop, Lakemont, GA 30552
Division of Laboratory Systems, Centers for Disease Control and Prevention, Atlanta, GA.
Lab Med. 2017 Feb;48(1):97-103. doi: 10.1093/labmed/lmw048. Epub 2016 Oct 15.
The 2015 Institue of Medicine report Improving Diagnosis in Health Care highlighted that diagnostic errors cause patient harm and that improvement in the diagnostic process requires better collaboration among physicians and laboratory professionals. The purpose of this study is to understand why physicians do not contact laboratory professionals when facing diagnostic challenges and identify opportunities for laboratory professionals to become more recognized members of the clinical care team.
A random sample of 31,689 physicians from the American Medical Association Masterfile were surveyed about diagnostic challenges in laboratory test ordering and results interpretation, solutions to these challenges, and interactions with laboratory professionals.
We received responses from 1768 physicians (5.6%). When faced with diagnostic challenges, they reported using electronic resources because they find it difficult and time-consuming to contact the laboratory. Only 20% had an effective way to access laboratory professionals, mostly seeking help for logistical but less for clinical issues. Continuing medical education, professional articles, and updates from the laboratory were helpful.
Laboratory professionals have an opportunity to play a greater role in the diagnostic process by becoming active members of the clinical care team, beyond providing results. This study provides strategies to increase laboratory professionals' role in the diagnostic process.
2015年医学研究所发布的《改善医疗保健中的诊断》报告强调，诊断错误会对患者造成伤害，且诊断过程的改进需要医生和实验室专业人员之间更好地协作。本研究的目的是了解医生在面对诊断挑战时为何不联系实验室专业人员，并确定实验室专业人员成为临床护理团队中更受认可成员的机会。
对从美国医学协会主文件中随机抽取的31689名医生进行了调查，内容涉及实验室检查医嘱和结果解读中的诊断挑战、这些挑战的解决方案以及与实验室专业人员的互动。
我们收到了1768名医生（5.6%）的回复。当面对诊断挑战时，他们表示会使用电子资源，因为他们觉得联系实验室既困难又耗时。只有20%的人有有效的方式联系实验室专业人员，大多是寻求后勤方面的帮助，而临床问题方面的帮助较少。继续医学教育、专业文章以及实验室提供的最新信息很有帮助。
实验室专业人员有机会通过成为临床护理团队的积极成员，在诊断过程中发挥更大作用，而不仅仅是提供结果。本研究提供了增加实验室专业人员在诊断过程中作用的策略。
