BACKGROUND: Concern is growing about missed test results, but data assessing their effect on patient safety are limited. OBJECTIVE: To examine the frequency with which computed tomography (CT)-documented dilations of the abdominal aorta are accompanied by evidence in the electronic medical record (EMR) that a clinician recognized the abnormality. DESIGN: Retrospective cohort study. SETTING: 2 hospitals in the Veterans Affairs Health Care System. PATIENTS: Patients with new dilations of the abdominal aorta detected on CT performed in 2003. MEASUREMENTS: Radiology report and EMR evidence that the radiologist notified the clinical service, aneurysm size, and interval between CT and EMR recognition. RESULTS: Computed tomography scans of 4112 patients were reviewed and 440 (11%) aortic dilations were identified, of which 91 were new findings. Radiologists directly notified clinical teams about 5 (5%) new dilations. Clinical teams did not record in the EMR recognition of 53 of 91 (58%) dilations within 3 months of the CT, and 9% of these dilations were 5.5 cm or larger. The median time to recognition of aneurysm in the EMR was 237 days, and no EMR documentation existed for 16 abnormalities (29% of surviving patients) during a mean follow-up of 3.2 years. No evidence indicated that any of the aneurysms ruptured or that patient deaths resulted from the delayed follow-up. LIMITATION: Clinicians may have recognized some aneurysms but did not document them in the EMR. CONCLUSION: Clinicians neglect to note a substantial proportion of new aortic dilations in the EMR. The findings highlight the need for better strategies to ensure documentation of follow-up of tests.
BACKGROUND: Concern is growing about missed test results, but data assessing their effect on patient safety are limited. OBJECTIVE: To examine the frequency with which computed tomography (CT)-documented dilations of the abdominal aorta are accompanied by evidence in the electronic medical record (EMR) that a clinician recognized the abnormality. DESIGN: Retrospective cohort study. SETTING: 2 hospitals in the Veterans Affairs Health Care System. PATIENTS: Patients with new dilations of the abdominal aorta detected on CT performed in 2003. MEASUREMENTS: Radiology report and EMR evidence that the radiologist notified the clinical service, aneurysm size, and interval between CT and EMR recognition. RESULTS: Computed tomography scans of 4112 patients were reviewed and 440 (11%) aortic dilations were identified, of which 91 were new findings. Radiologists directly notified clinical teams about 5 (5%) new dilations. Clinical teams did not record in the EMR recognition of 53 of 91 (58%) dilations within 3 months of the CT, and 9% of these dilations were 5.5 cm or larger. The median time to recognition of aneurysm in the EMR was 237 days, and no EMR documentation existed for 16 abnormalities (29% of surviving patients) during a mean follow-up of 3.2 years. No evidence indicated that any of the aneurysms ruptured or that patient deaths resulted from the delayed follow-up. LIMITATION: Clinicians may have recognized some aneurysms but did not document them in the EMR. CONCLUSION: Clinicians neglect to note a substantial proportion of new aortic dilations in the EMR. The findings highlight the need for better strategies to ensure documentation of follow-up of tests.
Authors: Michelle Greiver; Jan Barnsley; Richard H Glazier; Rahim Moineddin; Bart J Harvey Journal: Can Fam Physician Date: 2011-10 Impact factor: 3.275
Authors: Ronilda Lacson; Luciano M Prevedello; Katherine P Andriole; Stacy D O'Connor; Christopher Roy; Tejal Gandhi; Anuj K Dalal; Luke Sato; Ramin Khorasani Journal: AJR Am J Roentgenol Date: 2014-11 Impact factor: 3.959
Authors: Stephanie W Edmonds; Fredric D Wolinsky; Alan J Christensen; Xin Lu; Michael P Jones; Douglas W Roblin; Kenneth G Saag; Peter Cram Journal: Contemp Clin Trials Date: 2012-10-17 Impact factor: 2.226
Authors: Ronilda Lacson; Nathanael Sugarbaker; Luciano M Prevedello; Ip Ivan; Wendy Mar; Katherine P Andriole; Ramin Khorasani Journal: Open Med Inform J Date: 2012-08-10