Watson Jessica, Salisbury Chris, Whiting Penny F, Hamilton William T, Banks Jonathan
Centre for Academic Primary Care.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol.
Br J Gen Pract. 2022 Jun 6;72(723):e747-54. doi: 10.3399/BJGP.2022.0069.
Rates of blood testing in primary care are rising. Communicating blood test results generates significant workload for patients, GPs, and practice staff.
To explore GPs' and patients' experience of systems of blood test communication.
Qualitative interviews with patients and GPs in UK primary care in both urban and rural practices in the West of England.
A total of 28 patients and 19 GPs from six practices were recruited, with a range of socioeconomic and demographic characteristics. Patients were interviewed at two time points: a) at or soon after their blood test and b) after they had received their test results. The GPs who requested the tests were also interviewed (they could complete a maximum of two interviews about different patients). Eighty qualitative interviews were undertaken; 54 patient interviews and 26 GP interviews.
Methods of test result communication varied between doctors and were based on habits, unwritten heuristics, and personal preferences rather than protocols. Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety. Text messaging and online methods of communication have benefits, but were perceived by some patients as 'flippant' or 'confusing'. Delays and difficulties obtaining and interpreting test results can lead to anxiety and frustration for patients.
Current systems of test result communication are complex and confusing, and mostly based on habits and routines rather than clear protocols. This has important implications for patient-centred care and patient safety.
基层医疗中的血液检测率正在上升。传达血液检测结果给患者、全科医生和医疗机构工作人员带来了巨大的工作量。
探讨全科医生和患者对血液检测结果沟通系统的体验。
对英格兰西部城乡基层医疗中的患者和全科医生进行定性访谈。
从六个医疗机构招募了共28名患者和19名全科医生，他们具有不同的社会经济和人口统计学特征。在两个时间点对患者进行访谈：a）在血液检测时或检测后不久；b）在他们收到检测结果后。要求进行检测的全科医生也接受了访谈（他们最多可就不同患者完成两次访谈）。共进行了80次定性访谈；54次患者访谈和26次全科医生访谈。
医生之间传达检测结果的方法各不相同，基于习惯、不成文的启发法和个人偏好而非规范流程。医生期望患者知道如何获取检测结果。相比之下，患者通常不确定，靠猜测来决定何时以及如何获取检测结果。患者和医生通常都认为对方会主动联系，这对患者安全可能产生影响。短信和在线沟通方式有好处，但一些患者认为它们“轻率”或“令人困惑”。获取和解读检测结果的延迟及困难会给患者带来焦虑和沮丧。
当前的检测结果沟通系统复杂且令人困惑，大多基于习惯和常规而非清晰的规范流程。这对以患者为中心的医疗和患者安全具有重要影响。
