Best practice in Managing Test Results
Part of the daily job of a GP is ordering tests of various sorts- bloods, swabs from different sites, urine samples, smears, skin lesions etc. This guide will focus ONLY on tests performed by the doctors and nurses in the practice. It also assumes the practice has organised the transport of these tests to a hospital/laboratory.
Ideally each practice should have a robust protocol to ensure the following:
- The correct test is ordered.
- These tests get to the relevant labs.
- Results are received in a timely manner.
- Tests are recorded in correct patients file.
- Appropriate follow-up of tests.
These steps may involve different members of staff. But the overall responsibility for carrying out these steps lies with the clinician. Thus a rigorous system should be in place to minimise errors and potential harm to patient. The staff involved in these steps need to be properly trained and aware of their roles and responsibilities. We recommend that practices make every effort to educate patients on the importance of following up test results. A written protocol given to the patient may help in this area.
Step 1: The correct test & correct patient
The doctor must be clear on what test/s is needed – itemise each individual test i.e fasting etc. This should be documented clearly in the patients file (e.g. not documented as “routine bloods” ordered). Individual printed labels may help with poor hand writing. Ideally a “masterplan “of all tests sent from the practice is recorded each day. Many computer systems will facilitate accurate recording of same, however a paper based or spreadsheet record will suffice.
Step 2: Tests arrive to correct lab/hospital
The practice may have an HSE courier or a local courier they trust. Samples sent by post should get a receipt from the post office e.g. smears.
Step 3: Results are received in a timely manner
Currently many hospitals communicate via “HealthLink”. This is a very efficient and timely process. Other hospitals send results by post but may ring the practice with a very abnormal result. If there are delays the practice needs to contact their local lab.
Step 4: Tests are recorded in correct patient files
Tests that arrive via Healthlink should be integrated so that abnormal results can be highlighted.
Step 5: Appropriate follow-up of test
A clinician should be assigned on a daily basis in each practice to review ALL tests results that arrive. . There should be a protocol in place to follow up all abnormal tests. This will assume the practice has relayed to the patient in advance how they will contact them – phone, email, letter or follow up visit to practice.
There equally needs to be a protocol in place to ensure that tests that do not arrive in a timely manner are noted and followed up.
It may help to have a dedicated phone-in time for patients to ring in for their results. There may need to be more robust systems in place where there is a lot of partners or a lot of locums working in the practice.
Equally there needs to be a protocol in place to ensure where tests that do not arrive in a timely manner are noted and followed up.
Step 6: Repeat testing
A system should be put in place that alerts the clinician regarding repeating a test at the appropriate time where that is clinically indicated.
Approved by Medisec GP Advisory Panel October 2016
The contents of this publication are indicative of current developments and contain guidance on general medico legal queries. It does not constitute and should not be relied upon as definitive legal, clinical or other advice and if you have any specific queries, please contact Medisec for advice.