One of the most irritating things you have to do an emergency room is call people back about results of tests that became available after they were discharged. The most common examples are official reads of x-rays or CAT scans, and blood and urine culture results.
First it’s a giant pain in the ass to get in touch with people. Half the time you get someone else on the phone and you can’t talk to them because of HIPAA. The other half the time you leave a message or the person that picks up the phone speaks no English. After leaving several messages, you’re forced to send a certified letter to cover your ass medico-legally.
Then, when you eventually get in touch with the patient, you have to try to explain the results.
Often you have to call in a new prescription. Or you have to admit that we made a mistake and misread an X-ray or something else.
Sometimes you have to tell people to immediately return to the ER and other times you have to try to convince anxious people there’s no reason to return to the ER! Sometimes the people get angry but most of the time they just don’t understand what the heck you’re talking about. What I prefer to do is to refer people back to their doctor after speaking to the doc about all the results.
Then after you spend 20 minutes doing this, you have to document that you did it in the chart. This is all annoying enough for primary doctors who know their patients but when the emergency room has to do it and we don’t know the person at all, it’s a giant pain. The hospital I used to work at employed nurses to do this task. Personally I would consider this money very well spent were my hospital to adopt a similar policy.
25
Jun
Us primary care people, just send a letter if it is normal, the RN will call the patient some abnormals (pap) and the physician or NP will call on am abnormal (mammo) or critical result (usually an INR)
“Then after you spend 20 minutes doing this, you have to document that you did it in the chart”
Time required to talk to the family doc to get her agreement to contact and follow up with patient: 3 minutes
Time required to ask the ER unit clerk to both fax the test report to family doc & document that it’s been sent: 1 minute (or less)
Time required to amend your patient records stating these have been done: 1 minute.
Total Time: 5 minutes. Voila!
I suspect you could cut down on the problems considerably by having a form listing who you can contact with results and what languages they understand.