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Health services research
Protocol
Delivering safe and effective test-result communication, management and follow-up: a mixed-methods study protocol
  1. Maria R Dahm1,
  2. Andrew Georgiou1,
  3. Johanna I Westbrook1,
  4. David Greenfield2,
  5. Andrea R Horvath3,4,
  6. Denis Wakefield3,5,
  7. Ling Li1,
  8. Ken Hillman6,7,
  9. Patrick Bolton8,
  10. Anthony Brown9,10,
  11. Graham Jones3,11,
  12. Robert Herkes12,
  13. Robert Lindeman13,
  14. Michael Legg14,15,
  15. Meredith Makeham16,
  16. Daniel Moses3,17,
  17. Dauda Badmus1,
  18. Craig Campbell1,4,
  19. Rae-Anne Hardie1,
  20. Julie Li1,
  21. Euan McCaughey1,3,18,
  22. Gorkem Sezgin1,
  23. Judith Thomas1,
  24. Nasir Wabe1
  1. 1 Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
  2. 2 Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
  3. 3 Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
  4. 4 Clinical Chemistry and Endocrinology, Prince of Wales Hospital, NSW Health Pathology, Sydney, New South Wales, Australia
  5. 5 Centre for Immunology, NSW Health Pathology, Sydney, New South Wales, Australia
  6. 6 The Simpson Centre for Health Services Research, SWS Clinical School, University of New South Wales, Kensington, New South Wales, Australia
  7. 7 Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
  8. 8 School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
  9. 9 Health Consumers New South Wales, Sydney, New South Wales, Australia
  10. 10 Men’s Health Information and Resource Centre, Western Sydney University, Penrith, New South Wales, Australia
  11. 11 SydPath, St Vincent’s Hospital, Sydney, New South Wales, Australia
  12. 12 Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
  13. 13 NSW Health Pathology, Chatswood, New South Wales, Australia
  14. 14 Michael Legg & Associates, Bulli, New South Wales, Australia
  15. 15 Faculty of Engineering & Information Science, University of Wollongong, Wollongong, New South Wales, Australia
  16. 16 Australian Digital Health Agency, Sydney, New South Wales, Australia
  17. 17 Medical Imaging Department, Prince of Wales Hospital, Randwick, New South Wales, Australia
  18. 18 Neuroscience Research Australia (NeuRA), University of New South Wales, Kensington, New South Wales, Australia
  1. Correspondence to Dr Maria R Dahm; maria.dahm{at}mq.edu.au

Abstract

Introduction The failure to follow-up pathology and medical imaging test results poses patient-safety risks which threaten the effectiveness, quality and safety of patient care. The objective of this project is to: (1) improve the effectiveness and safety of test-result management through the establishment of clear governance processes of communication, responsibility and accountability; (2) harness health information technology (IT) to inform and monitor test-result management; (3) enhance the contribution of consumers to the establishment of safe and effective test-result management systems.

Methods and analysis This convergent mixed-methods project triangulates three multistage studies at seven adult hospitals and one paediatric hospital in Australia.

Study 1 adopts qualitative research approaches including semistructured interviews, focus groups and ethnographic observations to gain a better understanding of test-result communication and management practices in hospitals, and to identify patient-safety risks which require quality-improvement interventions.

Study 2 analyses linked sets of routinely collected healthcare data to examine critical test-result thresholds and test-result notification processes. A controlled before-and-after study across three emergency departments will measure the impact of interventions (including the use of IT) developed to improve the safety and quality of test-result communication and management processes.

Study 3 adopts a consumer-driven approach, including semistructured interviews, and the convening of consumer-reference groups and community forums. The qualitative data will identify mechanisms to enhance the role of consumers in test-management governance processes, and inform the direction of the research and the interpretation of findings.

Ethics and dissemination Ethical approval has been granted by the South Eastern Sydney Local Health District Human Research Ethics Committee and Macquarie University. Findings will be disseminated in academic, industry and consumer journals, newsletters and conferences.

  • patient safety
  • information technology
  • quality in healthcare

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-020235

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    Footnotes

    • Contributors AG, JIW, ARH, DG, LL and RL initiated the project and led the development of the National Health and Medical Research Council (NHMRC) grant proposal. AG, JIW, DG, ARH, DW, LL and KH are chief investigators on the project and all made contributions to the grant proposal and protocol in their specific areas of expertise. PB, AB, RH, GJ, ML, MM and DM are associate investigators on the NHMRC grant and provided input to the grant proposal and protocol, particularly in the areas of consumer engagement (AB) and standards for pathology reporting (GJ and ML). RL and RH are funding partners on the NHMRC partnership proposal and have made contributions in their areas of expertise, especially the use of health information system in pathology and patient safety policy related to test result management. DB, CC, MRD, R-AH, JL, EM, GS, JT and NW are members of the project team and contributed to the protocol in relation to data collection, interpretation of qualitative data and quantitative data linkage procedures. MRD prepared the first draft of this manuscript based on the grant proposal. All authors have reviewed and provided input.

    • Funding National Health and Medical Research Council, Partnership Project Grant number 1111925.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Ethics approval granted by the Human Research Ethics Committee of the South Eastern Sydney Local Health District (HREC/16/POWH/412), ratified by Macquarie University. All relevant site-specific assessments have been approved.

    • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.