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PROFESSIONAL ISSUESProgress sought in managing test results; information technology seen as keyResearchers say patient safety and physician liability are at risk under current, paper-based systems.By Andis Robeznieks, AMNews staff. March 21, 2005. Gordon D. Schiff, MD, said the health care system needs to do a better job of managing and communicating critical test results -- and he has a piece of paper in his pocket that proves his point. Dr. Schiff said he was working after hours when he heard the front telephone ringing incessantly and wondered why the answering service did not pick up the call. So he picked it up himself and found that it was a medical laboratory calling to let them know that one of his colleague's diabetic patients had a low blood glucose reading of 23 mg/dL. The internist wrote down the information on a piece of paper and, after using his "broken Spanish" to communicate with the patient's family who did not speak English, Dr. Schiff was able to reach the patient at work on the telephone. The patient knew how to monitor his own blood sugar and, after some discussion, he adjusted his insulin and everything worked out fine, said Dr. Schiff, a senior attending physician at John H. Stroger Jr. Hospital of Cook County in Chicago. This story emphasized Dr. Schiff's point, which he made in the February issue of the Joint Commission Journal on Quality and Safety, that medicine's test management system is a series of "poorly designed nonstandardized steps with frequent fumbles." And it needs to be transformed so that it resembles a trapeze artist's performance "where each hand-off is flawlessly designed, timed and executed." "I think the image of a trapeze artist fits what we're currently doing: It's like we're flying through the air making all kinds of decisions with dangerous consequences if someone fails," Dr. Schiff said. "There are doctors all over the country with the pockets of their white coats filled with scraps of paper and Post-it notes." [...]Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2005 American Medical Association. All rights reserved.
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