Researchers tackle physician challenge of correctly ordering laboratory tests

March 21, 2013

(Boston) - A new study involving researchers from the Boston University School of Medicine (BUSM) has identified barriers that clinicians face in correctly ordering appropriate laboratory tests and highlights some solutions that may simplify this process and improve patient outcomes. The study, published in the March 2013 issue of the Journal of General Internal Medicine, was led by Elissa Passiment, EdM, of the American Society for Clinical Laboratory Science and James L. Meisel, MD, associate professor of medicine at BUSM.

Passiment, Meisel and colleagues identified a number of significant problems, including the multiplicity of names and abbreviations used for a laboratory test, as well as the complexity and lack of standardized test nomenclature. As an example, they note that the commonly ordered laboratory test "brain naturetic peptide (BNP)" has a number of other names and abbreviations and looks and sounds similar to another commonly ordered test, "basic metabolic panel (BMP)." The incorrect ordering of such tests can lead to increased medical cost, physician frustration, and at worst, delayed diagnosis and treatment. This has been perceived as having a direct impact on patient safety. The AHRQ Patient Safety Network (PSNet) cited the article in the January "What's New" feature of patient safety literature, news and other resources.

"We found that attempts to standardize or establish a naming convention for laboratory tests were either short-lived or did not yield systems that were clinician or patient friendly," said Passiment.

The researchers suggest that certain technologies and programs that are familiar to many people could clarify some of the issues highlighted in this study. For example, search engines such as GOOGLE and BING help guide users to the most appropriate search results. If similar technology was employed in ordering laboratory tests, it could help guide clinicians towards identifying the appropriate tests, as well as conditions that would warrant the ordering of specific tests.

"Clinical laboratory tests lose their efficacy when clinicians are unable to quickly obtain accurate test results in a timely manner," said Meisel. "The goal is to have a system that clinicians find convenient, flexible and fast to best ensure the correct ordering and interpretation of laboratory tests."

The issues highlighted in this study will become more relevant as clinicians depend increasingly on electronic systems. "In the end these systems should be set up to mimic - as much as possible - the type of interaction a clinician would expect with a knowledgeable and helpful human being," added Meisel.
-end-
This publication is an outcome of the Clinical Laboratory Integration into Healthcare Collaborative (CLIHC)TM, a workgroup established by the Centers for Disease Control and Prevention (CDC's) Division of Laboratory Science and Standards.

Boston University Medical Center

Related Patient Safety Articles from Brightsurf:

Telehealth scales up during the pandemic to offer patient care in the safety of the home
The Medical University of South Carolina rapidly mobilized a four-pronged initiative to ensure continuity of care for patients with suspected or confirmed COVID-19 and continued ambulatory care for all other patients, reports a team of telehealth and bioinformatics experts in the Journal of the American Medical Informatics Association.

Universal preoperative COVID-19 screening improves pediatric patient safety
Universally screening pediatric patients for COVID-19 before they undergo surgical procedures has allowed hospitals to improve safety by identifying all patients who test positive for the virus, half of whom have no symptoms, according to new research led by Children's Hospital of Philadelphia (CHOP).

Nurses sleep less before a scheduled shift, hindering patient care and safety
Nurses sleep nearly an hour and a half less before work days compared to days off, which hurts patient care and safety, finds a new study by researchers at NYU Rory Meyers College of Nursing.

EHR medication lists lack accuracy, may threaten patient safety
Almost 1 in 4 medications were mismatched between the clinician's notes and the formal medication list in a patient's electronic medical record, according to study of ophthalmic medications by Kellogg Eye Center.

Using facial recognition technology to continuously monitor patient safety in the ICU
A team of Japanese scientists has used facial recognition technology to develop an automated system that can predict when patients in the intensive care unit (ICU) are at high risk of unsafe behaviour such as accidentally removing their breathing tube, with moderate (75%) accuracy.

Speaking up for patient safety
In a new study, a team led by clinician-researchers at Beth Israel Deaconess Medical Center (BIDMC) surveyed family members and patients with recent ICU experiences about their willingness to speak up about care concerns to medical providers.

Serious mortuary errors could be reduced by applying common patient safety protocols
New research investigating serious incidents occurring in the management of patient remains after their death concludes that safe mortuary care may be improved by applying lessons learned from existing patient safety work.

Listening to the patient's voice: A more patient-centered approach to medication safety
Involving the patient is critical for improving medication safety according to Regenstrief Institute researcher and Indiana University School of Medicine assistant professor of medicine Joy L.

Definitive global transfusion study supports patient safety, positive patient outcomes
Lower thresholds for blood transfusions during cardiac surgery have proven to be safe and provide good patient outcomes compared to traditional thresholds, according to the largest research study ever performed in this area.

ACP says patient safety must be improved in office-based practice setting
More needs to be done to improve patient safety in the outpatient setting, said the American College of Physicians (ACP) in a new policy paper released today.

Read More: Patient Safety News and Patient Safety Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.