Following up test results

The following need to be reviewed and acted on where required:

• pathology results
• imaging reports
• investigation reports
• clinical correspondence.

How fast to act on results/reports and how much effort is required to contact the patient to discuss them depends on their clinical significance. Clinical significance is determined by the:

• probability that the patient will be harmed
• seriousness of the harm.

 

Practice staff must keep patient contact details up to date and follow practice procedures for follow up systems. Staff roles may include running reports on results received or confirming patient identity using specified identifiers. 

A follow up system needs to be documented and followed consistently by all staff so that:

• all results and reports received by the practice are seen by the referring doctor
• the referring doctor indicates what action is required
• there is a process for each type of response action required, including how to notify patients
• the result is not ‘closed’ on the system until the required action has been completed
• cases where tests have been ordered but the results have not arrived are identified and followed up according to the clinical significance
• cases where a patient has been referred to a specialist but no report has been received are identified and followed up according to the clinical significance
• follow up actions are documented in the patient’s record, including all attempts to contact a patient.

Arrangements need to be made for another practitioner to review and manage follow up of abnormal results when the referring doctor is on leave or otherwise not able to review their results.

This depends on the circumstance’s clinical significance. For example:

• for equivocal blood test results requiring re-testing within 6 months, standard practice protocols may be appropriate, i.e. three phone calls/SMS at different times over different days followed by a letter
• in the case where a result is seriously abnormal and life threatening (such as a perilously high international normalised ratio), if you cannot contact the patient it might be appropriate to ask for urgent police assistance.

Recall = action is needed within a timeframe following a clinically significant result, e.g. cancer diagnosis, dangerously high international normalised ratio 

Reminder = preventive health care, e.g. flu vaccination, cervical screening