Do Consultants Follow Up on Tests They Recommend? Insights from an Academic Inpatient Gastrointestinal Consult Service
| العنوان: | Do Consultants Follow Up on Tests They Recommend? Insights from an Academic Inpatient Gastrointestinal Consult Service |
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| المؤلفون: | Jeffrey W. Brown, Gregory S. Sayuk, Saad Alghamdi, C. Prakash Gyawali, Benjamin Cassell, Harold J. Boutte, Jason G. Bill, Ted Walker, Pierre Blais |
| المصدر: | Digestive Diseases and Sciences. 62:1448-1454 |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Quality management, Adolescent, 020205 medical informatics, Gastrointestinal Diseases, Physiology, Interprofessional Relations, Colonoscopy, 02 engineering and technology, Medicare, Zip code, Article, Young Adult, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, Humans, Medicine, 030212 general & internal medicine, Fellowships and Scholarships, Referral and Consultation, Aged, Retrospective Studies, Aged, 80 and over, Service (business), Academic Medical Centers, Physician-Patient Relations, Primary Health Care, Inpatient care, medicine.diagnostic_test, business.industry, Communication, Gastroenterology, Electronic medical record, Continuity of Patient Care, Middle Aged, United States, Test (assessment), Hospitalization, Family medicine, Insurance status, Emergency medicine, Female, business |
| الوصف: | Inpatient care is a fundamental part of gastroenterology training and involves the recommendation, performance, and interpretation of diagnostic tests. However, test results are not always communicated to patients or treating providers. We determined the process of communication of test results and recommendations in our inpatient gastroenterology (GI) consult service. Test recommendations on 304 consecutive new GI consults (age 60.2 ± 1.0 year) over a 2-month period were recorded. Demographic factors (age, race, gender, zip code, insurance status) were extracted from the electronic medical record (EMR). Charts were independently reviewed 6 months later to determine results of recommended tests, follow-up of actionable test results, 30-day readmission rates, and predictors of suboptimal communication. Of 490 recommended tests, 437 (89.2%) were performed, and 199 (45.5%) had actionable findings. Of these, 48 (24.1%) did not have documented follow-up. Failure of follow-up was higher for upper endoscopy (31.9%) compared to colonoscopy (18.0%, p = 0.07). Women (p = 0.07), patients on Medicare (p = 0.05), and procedures supervised by advanced GI fellows (p = 0.06) were less likely to receive follow-up. Median income and identification of a primary provider did not influence follow-up rates; 30-day readmission rates were not impacted. Female gender, insurance (Medicare) status, and attending type remained independent predictors of failure of follow-up on multivariate regression (p ≤ 0.03). Failure to follow up test results on inpatient services at a large academic center was unacceptably high. Maximizing personnel participation together with diligence and technology (EMR) will be required to improve communication. |
| تدمد: | 1573-2568 0163-2116 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e053ca0eee41b48e598299395510b4e7 https://doi.org/10.1007/s10620-017-4563-5 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....e053ca0eee41b48e598299395510b4e7 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 15732568 01632116 |
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