Closed loop communication using provider team-specific smartphones improves the critical laboratory value notification process in paediatric inpatients
| Autor: | Kathryn Westphal, Susan Geisler, Demetra Callas, Robert Falkiner, Mallorie B. Heneghan, Christina Kendrich, Kyle L. MacQuarrie, Shakita Malone, Lora Filipova, Juanita Martinez, Shannon Haymond, Lina Bergman |
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| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
Quality management business.product_category Leadership and Management Teach-Back Communication Acknowledgement Short Report quality improvement paediatrics Patient safety R5-920 Multidisciplinary approach medicine Humans Child Inpatients communication business.industry Health Policy Public Health Environmental and Occupational Health medicine.disease Call centre Transplantation Laboratory Test Result Smartphone Medical emergency Laboratories Pager business |
| Zdroj: | BMJ Open Quality, Vol 10, Iss 3 (2021) BMJ Open Quality |
| ISSN: | 2399-6641 |
| DOI: | 10.1136/bmjoq-2021-001420 |
| Popis: | Appropriate handling of ‘critical’ laboratory test result values is an essential component of timely, quality patient care. While interinstitutional variability exists,1 critical values have historically been defined as potentially ‘life-threatening’ if not attended to quickly,2 necessitating prompt notification of a responsible clinician. Given patient safety implications, timely communication of results to a provider is a common regulatory element, including: (1) Joint Commission patient safety goals,3 (2) Clinical Laboratory Improvement Amendments4 and (3) the International Organization for Standardization.5 Inpatient values comprise a significant proportion of notifications,6 and among inpatients, oncology inpatients typically constitute a substantial volume.7 After laboratory result generation, contacting a responsible clinician can be complicated by multiple barriers. Previous approaches to improve this process include using call centres, automatic pager notifications and automatic personal digital assistant (PDA) telephone notifications.8–11 In our hospital, the inpatient haematology/oncology/stem cell transplantation (H/O) service had an overall notification success rate substantially lower than the hospital average as an effect of the large volume of critical results that typically returned in a short time period at certain times of day, leading to a multidisciplinary initiative to improve the notification process. In our free-standing 360-bed paediatric hospital, ‘overall’ successful critical result notification must: (1) be acknowledged by a licenced individual provider (LIP) and (2) meet criteria for ‘timely’ notification, indicating that both outgoing notification from the laboratory/call centre and LIP acknowledgement occur within 30 min of result generation. H/O inpatients account for 15%–20% of all inpatient critical values but had a significantly lower overall successful notification rate than the hospital average. Timely outgoing notification occurred >90%, but timely LIP acknowledgement was |
| Databáze: | OpenAIRE |
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