Article Figures & Data
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Tables
Section Content Background on Laboratory Testing and Patient Safety ∙ Summary of the scope of laboratory testing in primary care
∙ Key points from the literature about laboratory testing, patient safety, and medical errors
∙ Examples of primary care laboratory testing process improvementsStep 1: How Do We Get Started? ∙ Quick self-assessment of laboratory issues in practice (checklist)
∙ Planning for a team to lead the improvement effort (checklist)Step 2: Priority Alignment ∙ Tips for aligning laboratory process improvement efforts with practice priorities
∙ Priority alignment assessment (worksheet)Step 3: Making It Real & Preparing for Change ∙ Tips for successful launch of the improvement effort
∙ “Preflight” communication reminders (checklist)Step 4: What Is Your Current Process for Laboratory Testing? ∙ Overview of how to map current laboratory testing processes
∙ Process mapping guidance (step-by-step instructions and example)
∙ Steps to review the process map (checklist)Step 5: How Are You Going to Fix the Problem? ∙ Step-by-step planning guide for developing and implementing an improvement plan (checklist)
∙ Improvement plan template (worksheet)Step 6: How Do You Know If You Made a Difference? ∙ Importance of (and tips for) selecting metrics to evaluate the success of the improvement plan
∙ Measurement selection planning tool (checklist and worksheet)Step 7: Make the Change! ∙ Planning tips for executing the improvement effort (worksheet) Step 8: Did We Improve Our Lab Testing Process? ∙ Guidance on reviewing data and planning for next steps
∙ Steps to review and use improvement data (checklist)- Table 2. Laboratory Testing Process Improvement Activities Selected by Practices and Stage of Completion by Study End
Clinic ID Testing Phase QI Activity Focus Toolkit Stage Completed Preanalytic 21 Test preparation Improve documentation of patient notification preferences and documentation of scheduled lab visits. Step 6 22 Test selection Improve the identification of patients requiring repeat MRSA testing to reduce the number of patients remaining on an MRSA protocol list. Step 6 1 Test ordering Reduce the number of lab tests rejected because of incorrect coding in electronic medical record. Step 3 2 Reduce the number of lab tests rejected because of incorrect coding in electronic medical record. Step 3 5 Reduce the number of incomplete laboratory orders sent from clinic. Step 7 19 Reduce the number of incomplete laboratory orders sent from clinic. Step 1 3 Specimen collection Improve rate of completed specimen collection by using on-site phlebotomy. Step 8 9 Improve rate of completed specimen collection by using on-site phlebotomy. Step 6 11 Improve rate of completed specimen collection by using on-site phlebotomy. Step 7 Postanalytic 7 Test result tracking Reduce the number of lab tests ordered that are not reconciled with results that can be found in the medical record. Step 5 8 Improve patient notification processes and documentation to reduce calls from patients requesting test results. Step 5 12 Standardize the order tracking system to reduce number of missing labs requiring patient notification. Step 8 16 Improve the lab tracking process by implementing a review process for an EHR-generated report of outstanding lab tests. Step 5 17 Improve the lab tracking process by implementing a review process for an EHR-generated report of outstanding lab tests. Step 5 20 Improve the lab tracking process by implementing a review process for an EHR-generated report of outstanding lab tests. Step 8 10 Patient notification Standardize patient notification processes to ensure 100% patient notification attempts of all laboratory test results. Step 7 13 Improve the timeliness of provider review of lab results to reduce number of patient calls. Step 7 14 Standardize the patient notification processes to ensure 100% patient notification attempts of all laboratory test results. Step 7 15 Improve the timeliness of provider review of lab results to reduce number of patient calls. Step 8 18 Improve the patient notification processes and documentation to reduce calls from patients requesting test results. Step 3 4 Did not select Did not select Step 4 6 Did not start Did not start Did not start EHR, electronic health record; MRSA, methicillin-resistant Staphylococcus aureus; QI, quality improvement.
