Follow-up of discrepancies in x-ray and electrocardiogram interpretations, and positive laboratory results

• Published in: The Journal of emergency medicine Vol. 20; no. 3; pp. 315 - 319
• Main Authors: Santoro, John P, Blank, Fidela S.J, Smithline, Howard
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2001; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Continuity of Patient Care - organization & administration; discrepant interpretations; Electrocardiography; Emergency and intensive care: techniques, logistics; Emergency Medicine; Emergency Service, Hospital - organization & administration; Emergency Service, Hospital - standards; follow-up program; Humans; Intensive care medicine; Intensive care unit. Emergency transport systems. Emergency, hospital ward; Massachusetts; Medical sciences; Patient Care Team; quality assurance of EKG and X-ray readings; Quality Assurance, Health Care; Radiology Department, Hospital; telephone follow-up; X-Rays; Massachusetts; discrepant interpretations; follow-up program; telephone follow-up; quality assurance of EKG and X-ray readings; Human; Sanitary program; Radiodiagnosis; Malpractice; Exploration; Interpretation; Prevention; Radiography; Electrodiagnosis; Quality assurance; Surveillance; Follow up study; Laboratory investigations; Public health organization; Error diagnostic; Electrocardiography; Hospital ward; Emergency; Public health
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/S0736-4679(01)00288-8

This article describes the 1-year follow-up program implemented at Baystate Medical Center Emergency Department during 1999. Our previous system used staff who worked clinically, which led to prolonged delays in follow-up. Before initiating the program, 57% [95% confidence interval (CI): 55–59%] of all follow-up cases were done within 3 days. After program implementation, 69% (95% CI: 67–72%) of all follow-up cases were completed in the same time frame. We reduced our “delayed” follow-up cases from 20% (95% CI: 18–22%) to 4% (95% CI: 3–5%) of all cases. Critical to the new system is the assignment of nurse-physician pairing to do follow-up when they are not doing direct patient care.