PRACTICE PARTNER
cally significant result,” such as a blood
culture.
In a hospital ED, hospital administration
shares in the responsibility of ensuring that
an effective test results management system
is in place, with policies on who should
be informed of the result, and the require-
ments for documentation of the result in
the patient record, stated the Committee.
ii) Inability for province-wide access to
laboratory test results through the Ontario
Laboratory Information Service (OLIS)
The patient was transferred to Hospital B.
However, providers there were unable to
access laboratory test results from other
institutions through the Ontario Labora-
tory Information Service (OLIS). OLIS is
still being phased in across the province and
there are a number of options for organiza-
tions to access OLIS.
If tests results from a hospital visit else-
where in the province are not available on
OLIS, appropriate efforts should be made
to track down the results through the hos-
pital or the laboratory that did the testing,
stated the Committee.
iii) Involving patients
The CPSO guidelines note that, “it is bene-
ficial to involve patients in the management
of their own test results and to encourage
them to be active participants in their own
care.” It is also noted that, “encouraging
patients to get involved in the follow-up
process does not relieve the physician of
their duty to follow up, but may add a layer
of protection to the test results manage-
ment system and may be empowering for
patients.”
In selected cases, providing patients with
a record of their ED visit and list of tests
pending, empowers patients and/or their
family to ensure outstanding test results
don’t fall through the cracks
2. Legibility of notes
In this case, the handwritten hospital
records were very difficult to read. This
hampers the reader’s ability to understand
relevant clinical findings, recorded labora-
tory test results and summation/interpre-
tation of the above; all of this creates a
problem in transitions of care both within
and outside a hospital as well as in retro-
spective review of a chart for other reasons.
Physicians must have a legible medical
record. Please refer to the College’s Medical
Records policy for more information.
3. Patient and family education
Prosthetic valve endocarditis (PVE) occurs
in 3 to 4% of patients within five years
of surgery. Aortic root abscess and valve
dehiscence occur in up to 60% of patients
with PVE.
The patient’s family was very engaged
in his care. Advising patients of potential
adverse outcomes would be consistent with
best practices.
MD
ISSUE 1, 2019 DIALOGUE
41