Catch as Catch Can: How Physicians Manage Tests Pending at Discharge

1University of California, Los Angeles, San Francisco, CA
2University of California, Los Angeles, San Francisco, CA
3University of California, Los Angeles, San Francisco, CA
4University of California, Los Angeles, San Francisco, CA

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 39

Background:

With increasing pressure to shorten the length of stay of hospitalized patients, physicians are discharging more patients with tests pending at discharge (TPAD). Little is known about how physicians currently manage TPADs.

Methods:

Using the same survey instrument, we conducted a cross‐sectional survey of hospitalists programs at 8 academic medical centers, as well as departmental leadership of emergency medicine, hospital medicine, neurology, neurosurgery, obstetrics and gynecology, pediatrics, surgery, and urology at our own institution. We asked both groups whether they had a mechanism to identify and manage TPADs, and if their program had either a formal policy or informal expectations about TPAD management.

Results:

Eighty‐eight percent of hospitalist programs recognized the clinical importance of TPADs and expect their physicians to follow up TPADs they order. None of the hospitalist programs surveyed, however, had a formal policy regarding how physicians should manage TPADs. Only 2 hospitalist groups had a mechanism to systematically manage TPAD results. Each of these mechanisms, however, is a system that supports that the individual physician manage TPADs. None of the programs surveyed had a team‐based system for TPAD management. Instead each program relied on individual hospitalists to follow up on TPADs for patients they discharged. Of the 8 local departments surveyed, 75% expected their physicians to follow up TPADs they ordered, but none had a formal policy. Only 2 departments (emergency medicine, obstetrics and gynecology) had an established mechanism to help physicians manage TPAD results. Both of these systems were team‐based and allowed physicians to manage TPADs for patients of other physicians within their department. As with hospitalists nationally, most local departments relied on individual physicians to follow up on TPADs.

Conclusions:

All clinical departments recognize the importance of TPAD management, yet only a few departments have systems to support physicians with this task. These findings suggest an opportunity to engage clinical leaders in system implementation targeting TPAD management. Given their cross department work with consultative and comanagement services, Hospitalists are in an optimal position to take the lead in this effort.

Author Disclosure:

C. Coffey, Jr., none; S. Ranji, none; A. Auerbach, none; A. Vidyarthi, none.

To cite this abstract:

Coffey C, Ranji S, Auerbach A, Vidyarthi A. Catch as Catch Can: How Physicians Manage Tests Pending at Discharge. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 39. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/catch-as-catch-can-how-physicians-manage-tests-pending-at-discharge/. Accessed November 13, 2019.

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