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| ID | Type | Description | Link |
|---|---|---|---|
| 1R18HS019603-01 | U.S. AHRQ Grant/Contract | View source |
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| Name | Class |
|---|---|
| Agency for Healthcare Research and Quality (AHRQ) | FED |
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Clinically significant test results require timely clinician follow-up including the non-urgent clinically significant, or actionable, test results that have received less standardized management and attention. Unfortunately, failure to correctly manage actionable test results is not infrequent and may be associated with important delays in diagnosis and treatment and patient harm. The investigators have designed a safe practice intervention to improve the management of actionable test results for ambulatory patients in a large healthcare system.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Actionable Test Results | Other | Creating standardized policies and procedures around actionable test results (ATR) management, and implementing them network-wide:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Actionable Test Result Management/Standardization | Other | The intervention includes enterprise-wide standardization of actionable test result (ATR) definitions with stratification of significant results into alert levels, expected timeframes for clinician responses, a set of policies for ATR follow-up, metrics to measure ATR management and performance feedback. |
| Measure | Description | Time Frame |
|---|---|---|
| Acknowledged Sub-Critical/Abnormal ATRs | The primary outcome of interest is the proportion of sub-critical/abnormal (Level 3 Laboratory and Level 2 Cardiology) ATRs documented as acknowledged by the responsible clinician and having appropriate, follow-up action(s). | Acknowledgement within 15 business days from the Level 3 Laboratory ATR alert and acknowledgement within 8 business hours of the cardiology Level 2 ATR alert |
| Measure | Description | Time Frame |
|---|---|---|
| Diagnosis and/or Treatment Delays | The frequency of delays to diagnoses and/or treatment of conditions of interest | Minumum of 3 months post ATR |
| Undiagnosed/Untreated Condition Frequency and Severity |
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Inclusion Criteria:
Primary care physicians will be enrolled in the study by virtue of being an actively practicing clinician in an PHS ambulatory practice, and having at least one patient with a diagnostic test included in the PHS CCSTR intervention. The patient population will consist of adult patients >17 years of age with diagnostic tests in the affiliated ambulatory practices of PHS. Patients will be recruited into the study by a review of electronic medical record data to identify patients with a diagnostic test specified in the PHS CCSTR intervention.
Exclusion Criteria:
Participants who do not meet the inclusion/eligibility requirements will be excluded.
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| Name | Affiliation | Role |
|---|---|---|
| Jeffrey Rothschild, M.D. | Brigham and Women's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Partners Healthcare | Boston | Massachusetts | 02115 | United States |
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| ID | Term |
|---|---|
| D012015 | Reference Standards |
| ID | Term |
|---|---|
| D014894 | Weights and Measures |
| D008919 | Investigative Techniques |
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The frequency and severity of undiagnosed or untreated conditions of interest that occur during the study period.
| Minumum of 3 months post ATR |