Faculty Collaboration Database

Four-year impact of an alert notification system on closed-loop communication of critical test results. AJR Am J Roentgenol 2014 Nov;203(5):933-8

Date

10/24/2014

Pubmed ID

25341129

Pubmed Central ID

PMC4426858

DOI

10.2214/AJR.14.13064

Scopus ID

2-s2.0-84924921176 (requires institutional sign-in at Scopus site)   53 Citations

Abstract

OBJECTIVE: One of the patient safety goals proposed by the Joint Commission urges hospitals to develop a policy for communicating critical test results and to measure adherence to that policy. We evaluated the impact of an alert notification system on policy adherence for communicating critical imaging test results to referring providers and assessed system adoption over the first 4 years after implementation.

MATERIALS AND METHODS: This study was performed in a 753-bed academic medical center. The intervention, an automated alert notification system for critical results, was implemented in January 2010. The primary outcome was adherence to institutional policy for timely closed-loop communication of critical imaging results, and the secondary outcome was system adoption. Policy adherence was determined through manual review of a random sample of radiology reports from the first 4 years after the intervention (n = 37,604) compared with baseline outcomes 1 year before the intervention (n = 9430). Adoption was evaluated by quantifying the use of the system overall and the proportion of alerts that used noninterruptive communication as a percentage of all reports generated by 320 radiologists (n = 1,538,059). A statistical analysis of the trend at 6-month intervals over 4 years was performed using a chi-square trend test.

RESULTS: Adherence to the policy increased from 91.3% before the intervention to 95.0% after the intervention (p < 0.0001). There was a ninefold increase in the critical results communicated via the system (chi-square trend test, p < 0.0001). During the first 4 years after the intervention, 41,445 alerts (41% of the total number of alerts) used the system's noninterruptive process for communicating less urgent critical results, which was substantially unchanged over the 4 years postintervention, thus reducing unnecessary paging interruptions.

CONCLUSION: An automated alert notification system for communicating critical imaging results was successfully adopted and was associated with increased adherence to institutional policy for communicating critical test results and with reduced workflow interruptions.

Author List

Lacson R, Prevedello LM, Andriole KP, O'Connor SD, Roy C, Gandhi T, Dalal AK, Sato L, Khorasani R

MESH terms used to index this publication - Major topics in bold

Boston
Decision Support Systems, Clinical
Diagnostic Imaging
Guideline Adherence
Guidelines as Topic
Hospital Communication Systems
Longitudinal Studies
Radiology
Referral and Consultation
Utilization Review
Workflow
Workload