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.
Dr Benjamin Cassell and colleagues determined the process of communication of test results and recommendations in their inpatient gastroenterology (GI) consult service.
Test recommendations on 304 consecutive new GI consults over a 2-month period were recorded.
Demographic factors were extracted from the electronic medical record.
|24% of recommended tests did not have documented follow-up|
|Digestive Diseases & Sciences|
The team independently reviewed charts 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, 89% were performed, and 46% had actionable findings.
Of these, the team observed that 24% did not have documented follow-up.
The researchers noted that failure of follow-up was higher for upper endoscopy compared to colonoscopy.
Women, patients on Medicare, and procedures supervised by advanced GI fellows were less likely to receive follow-up.
The team found that median income and identification of a primary provider did not influence follow-up rates, and 30-day readmission rates were not impacted.
Female gender, insurance status, and attending type remained independent predictors of failure of follow-up on multivariate regression.
Dr Cassell's team concludes, "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 will be required to improve communication."