Journal of General Internal Medicine

, Volume 26, Issue 4, pp 393–398 | Cite as

Pending Laboratory Tests and the Hospital Discharge Summary in Patients Discharged To Sub-Acute Care

  • Stacy E. Walz
  • Maureen Smith
  • Elizabeth Cox
  • Justin Sattin
  • Amy J. H. Kind
Original Research

Abstract

Background

Previous studies have noted a high (41%) prevalence and poor discharge summary communication of pending laboratory (lab) tests at the time of hospital discharge for general medical patients. However, the prevalence and communication of pending labs within a high-risk population, specifically those patients discharged to sub-acute care (i.e., skilled nursing, rehabilitation, long-term care), remains unknown.

Objective

To determine the prevalence and nature of lab tests pending at hospital discharge and their inclusion within hospital discharge summaries, for common sub-acute care populations.

Design

Retrospective cohort study.

Participants

Stroke, hip fracture, and cancer patients discharged from a single large academic medical center to sub-acute care, 2003–2005 (N = 564)

Main Measures

Pending lab tests were abstracted from the laboratory information system (LIS) and from each patient’s discharge summary, then grouped into 14 categories and compared. Microbiology tests were sub-divided by culture type and number of days pending prior to discharge.

Key Results

Of sub-acute care patients, 32% (181/564) were discharged with pending lab tests per the LIS; however, only 11% (20/181) of discharge summaries documented these. Patients most often left the hospital with pending microbiology tests (83% [150/181]), particularly blood and urine cultures, and reference lab tests (17% [30/181]). However, 82% (61/74) of patients’ pending urine cultures did not have 24-hour preliminary results, and 19% (13/70) of patients’ pending blood cultures did not have 48-hour preliminary results available at the time of hospital discharge.

Conclusions

Approximately one-third of the sub-acute care patients in this study had labs pending at discharge, but few were documented within hospital discharge summaries. Even after considering the availability of preliminary microbiology results, these omissions remain common. Future studies should focus on improving the communication of pending lab tests at discharge and evaluating the impact that this improved communication has on patient outcomes.

KEY WORDS

laboratory tests hospital discharge sub-acute care 

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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Stacy E. Walz
    • 1
  • Maureen Smith
    • 1
    • 2
    • 3
  • Elizabeth Cox
    • 4
  • Justin Sattin
    • 5
  • Amy J. H. Kind
    • 1
    • 6
    • 7
  1. 1.Department of Population Health SciencesUniversity of Wisconsin School of Medicine & Public HealthMadisonUSA
  2. 2.Department of Family MedicineUniversity of Wisconsin School of Medicine & Public HealthMadisonUSA
  3. 3.Department of SurgeryUniversity of Wisconsin School of Medicine & Public HealthMadisonUSA
  4. 4.Department of PediatricsUniversity of Wisconsin School of Medicine & Public HealthMadisonUSA
  5. 5.Department of NeurologyUniversity of Wisconsin School of Medicine & Public HealthMadisonUSA
  6. 6.Department of Medicine, Geriatrics DivisionUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  7. 7.United States Department of Veterans AffairsWilliam S. Middleton Memorial Veterans Hospital, Geriatric Research Education and Clinical Center (GRECC)MadisonUSA

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