Dialogue Volume 15 Issue 1 2019 - Page 41

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