FEATURE
what can be expected of any individual physi-
cian due, in part, to the nature of their practice
and the health system resources available to
them,” said Dr. Copps.
The draft makes a distinction between
coverage for patient care and coverage for test
results. While having a plan in place is suf-
ficient to coordinate care for patients outside
of regular operating hours, critical test results
need around the clock coverage. Coverage
arrangements could include participating in
an after-hours call group, telephone triage,
or making specific on-call arrangements with
other physicians or practices. This is simply a
refinement of the current expectation found in
the Test Results Management policy.
“We heard through the preliminary consulta-
tion feedback that laboratories often experience
great difficulty communicating critical test re-
sults to physicians, even if they have provided
coverage information,” said Dr. Copps. This,
of course, puts patients at great risk, as critical
test results could be a matter of life and death
and may require patients to seek out immedi-
ate intervention, she said.
The draft also requires that physicians have
an office telephone that is answered and/or a
voicemail system that allows messages to be left
during operating hours and outside operating
hours.
“Good communication and collaboration are
fundamental components of high quality care,
but are not possible if patients and health-care
providers are unable to contact physicians,”
said Dr. Copps.
Managing Tests
This draft policy sets out the
College’s expectations for physi-
cians regarding the management
of all types of tests. This draft is
a revision of the College’s cur-
rent Test Results Management policy.
Managing tests effectively is an essential part
of continuity of care. It includes having a robust
test management system, ordering and tracking
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DIALOGUE ISSUE 2, 2018
tests, following up with patients once test results
are known, communicating and collaborating
with other health-care providers, and providing
opportunities for patient engagement.
This draft covers a number of expectations
about different aspects of test management,
including addressing the ‘No News is Good
News’ approach that many physicians adopt in
regard to test result management.
‘No news is good news’ approaches are
permitted in the draft policy; however, there
are a number of caveats to this approach, said
Dr. David Rouselle, a Newmarket obstetrician,
who is on the working group.
“Ultimately, we landed on the expecta-
tion that those physicians who do want to
use a ‘no news is good news’ strategy must be
confident that their test result management
system is sufficiently robust to ensure that no
test results will be missed and that no news
really does mean good news. That is, that the
absence of a call back to the patient means
that the test result was received, reviewed and a
determination was made that no follow-up was
required,” said Dr. Rouselle.
But, he added, that even with a robust test
results management system, a ‘no news is good
news’ strategy may not always be appropriate.
Physicians must use their professional judgment
to determine when a ‘no news is good news’
strategy can be used. This could be influenced,
for example, by the nature of the test that was
ordered, the patient’s current health status, the
patient’s anxiety about the test and the signifi-
cance or implications of the potential result.
Physicians must inform patients as to wheth-
er they are using a ‘no news is good news’
strategy and must tell patients that they have
the option to personally contact the physician’s
office for the test result if they prefer to do so.
The draft policy provides guidance to physi-
cians on how to involve their patients in their
own care related to tests and te