Clinical question: How adequately do hospital discharge summaries document laboratory tests with pending results?
Background: Discharge summaries commonly lack important clinical and administrative information. Poor communication among hospital providers about tests that are pending at hospital discharge represents a patient-safety concern.
Study design: Retrospective cohort.
Setting: Two academic medical centers.
Synopsis: Discharge summaries were reviewed for 668 patients who had laboratory test results pending at hospital discharge. A total of 2,927 results were pending at discharge, most often corresponding to microbiology (47.7%), hematology (17.1%), or chemistry (10.8%) studies. Among the pending tests, 296 (10%) were rated as “actionable,” meaning they required a change in therapy, a follow-up test, or an outpatient visit. Only 168 (25%) of the 668 discharge summaries mentioned any pending tests. Information about the outpatient provider or clinic to which test results could be sent did not appear in 33% of the discharge summaries.
The study did not determine whether the laboratory test results received appropriate follow up and did not assess clinical outcomes. Other types of tests (e.g., radiology studies) were not analyzed.
Bottom line: Hospital discharge summaries often omit information about pending laboratory test results or the outpatient provider to whom such tests results could be sent.
Citation: Were MC, Li X, Kesterson J, et al. Adequacy of hospital discharge summaries in documenting tests with pending results and outpatient follow-up providers. J Gen Intern Med. 2009;24(6):1002-1006.
Reviewed for TH eWire by Kelly Cunningham, MD, Elizabeth Rice, MD, Eduard Vasilevskis, MD, Joshua LaBrin, MD, Kelly Sopko, MD, Shelley Ellis, MD, MPH, Sunil Kripalani, MD, MSc; Section of Hospital Medicine, Vanderbilt University
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