Advances in Health Sciences Education

, Volume 14, Supplement 1, pp 51–56

Proposed interventions to decrease the frequency of missed test results



Numerous studies have identified that delays in diagnosis related to the mishandling of abnormal test results are an import contributor to diagnostic errors. Factors contributing to missed results included organizational factors, provider factors and patient-related factors. At the diagnosis error conference continuing medical education conference in 2008, attendees attended two focus groups dedicated to identification of strategies to lower the frequency of missed results. The recommendations were reviewed and summarized. Improved standardization of the steps involved in the flow of test result information, greater involvement of patients to insure the follow up of test results, and systems re-engineering to improve the management and presentation of data. Focusing the initial interventions on the specific tests which have been identified as high risk for adverse impact on patient outcomes such as tests associated with a possible malignancy or acute coronary syndrome will likely have the most significant impact on clinical outcome and patient satisfaction with care.


Diagnosis error Ambulatory care Laboratory tests Radiology tests Computerized medical record Error 

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  1. 1.Iowa City Department of Veterans Affairs (VA) Medical CenterIowa CityUSA
  2. 2.Division of General Medicine, Department of Internal MedicineUniversity of Iowa Carver College of MedicineIowa CityUSA
  3. 3.Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) VA HSR&D Center of ExcellenceIowa City Department of Veterans Affairs (VA) Medical CenterIowa CityUSA

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