Page 16 - 2022 Risk Basics - Systems

SVMIC Risk Basics: Systems

Tracking Systems

Many of these failures could be prevented by employing highly reliable
and consistently followed tracking procedures. The most common failure

contributing to patient injury is failure to track or follow up on ordered
tests, appointments, and referrals. Maintaining a system for tracking

test results, referred patients, and missed appointments is essential to
avoiding delays in diagnosis and/or treatment. Missed diagnosis is a

top claim received at SVMIC. A patient may fall through the cracks if an
abnormal or unexpected test result is misplaced or filed away without

taking appropriate action, or when a patient fails to keep a recommended
appointment, either with the referred physician or your practice.

Once the physician orders a lab, diagnostic test, or referral, he/she has
a duty to follow up on the results appropriately. This may require the

implementation of a policy to prioritize the result based on whether or
not it is abnormal and, if abnormal, assess how significant the risk is if the

patient is not notified immediately. The office policy might define the test
results as “Normal”, “Abnormal”, or “Critical”, with correlating responses

appropriate for each. Regardless, the patient should be notified of all test
results. The staff should be trained on the critical results policy to alert

the ordering physician and notify the patient accordingly.

Tracking procedures should be simple, organized, and followed by
everyone in the practice. Staff should be trained and accountable for

accurately maintaining the system. It should be understood by everyone
that once the tracked tests or reports are received, they must be handled

appropriately by following one of the recommended processes detailed
later in this course.

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