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患者群体、临床医生和医疗保健专业人员一致认为——所有检测结果都需要被查看、理解并跟进。

Patient groups, clinicians and healthcare professionals agree - all test results need to be seen, understood and followed up.

作者信息

Dahm Maria R, Georgiou Andrew, Herkes Robert, Brown Anthony, Li Julie, Lindeman Robert, Horvath Andrea R, Jones Graham, Legg Michael, Li Ling, Greenfield David, Westbrook Johanna I

机构信息

Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.

Australian Commission on Safety and Quality in Health Care, Sydney, Australia.

出版信息

Diagnosis (Berl). 2018 Nov 27;5(4):215-222. doi: 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.

摘要

背景 诊断检测为疾病的预防、诊断、治疗及管理提供不可或缺的信息。检测结果报告及后续跟进不足是患者安全的重大风险。导致检测结果后续跟进失败的因素包括:对检测结果应由谁采取行动的责任界定不明确;不同医疗层面之间协调不力;以及缺乏用于高效信息沟通的综合健康信息系统。方法 2016年澳大利亚利益相关者论坛汇聚了来自14个不同消费者、临床和管理利益相关者组织的30多名代表,讨论安全有效的检测结果沟通、管理及后续跟进。利用以观察性现场记录和参与者制作的文档制品形式收集的多模态数据进行主题分析。结果 该论坛确定了对患者安全构成直接风险的重大挑战。参与者建议优先解决以下相关问题:(i)检测结果管理流程的治理;(ii)通过利用有效的数字健康解决方案整合医疗流程;(iii)让患者作为关键伙伴参与决策和护理过程。结论 利益相关者群体在优先事项上略有分歧。消费者强调患者在检测结果管理过程中缺乏参与,但与病理学家相比,对报告标准化和关键结果阈值的关注较少。该论坛强调需要一种系统方法,能够识别和解决导致检测结果后续跟进不佳的相互联系和多种因素,同时大力强调增强患者的作用。

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