SHM Converge Scientific Abstract ePoster Gallery-Improving the Timeliness of Test Result Management After Discharge: A Pediatric Quality Improvement Initiative

Pdf Summary

This quality improvement project addressed delays in managing test results pending at discharge (TRPAD), which are a known patient safety risk. At the authors’ pediatric hospital medicine service, there was no standardized process for handling these results after discharge. The team set a goal of increasing the percentage of TRPAD managed within 36 hours of result availability from 53% to 95% over 3 months, with sustained improvement for an additional 9 months.<br /><br />Using the Model for Improvement and repeated PDSA cycles, the team implemented several changes: a shared results pool in the electronic medical record, delegation of responsibility to the admitting physician with backup support, daily review of results, and categorization of TRPAD into four groups based on urgency and impact on care. They also created standardized workflows, documentation templates, instructional guides, and written co-management agreements with subspecialists. Monthly performance reports were reviewed with the hospitalist group.<br /><br />The intervention was highly effective. The proportion of TRPAD managed within 36 hours rose from a median of 53% to 98%, and the median time to mark results as done dropped from 426 hours to 10.1 hours. Eleven percent of TRPAD were abnormal, and 4% of those required immediate management changes. Hospitalists spent an average of only 10 minutes per day managing results in the shared pool. Survey feedback indicated overall satisfaction with the new process.<br /><br />Overall, the project successfully improved timeliness of post-discharge test result follow-up and likely reduced the risk of missed or delayed care. Future steps include enhancing patient portal communication and involving resident trainees in the workflow.

Asset Subtitle

Meenu Krishnasamy

Meta Tag

Author List Courtney Port DO, MPH, Khoa Luong, Lydia Nashed, Meenu Krishnasamy, Rhiya Dave

Category Innovations

Concept Test Result Pending at Discharge

Concept Patient Safety

Concept Follow-up

Concept Quality Improvement

Concept Delay

Distinguished Non-Finalist

Presenter Organization Inova Children's Hospital

Presenting Author Meenu Krishnasamy

Track Quality Improvement

Keywords

test results pending at discharge

TRPAD

patient safety

quality improvement

PDSA cycles

electronic medical record

post-discharge follow-up

hospital medicine

workflow standardization

shared results pool

Test Result Pending at Discharge

Patient Safety

Follow-up

Quality Improvement

Delay