EPIC Risk Reduction Guideline

EPIC Risk Reduction Guideline

Variations and Late Reports

Purpose:

Provide a mechanism to assure appropriate and timely follow-up of laboratory, radiology and EKG reports that arrive in the emergency department after the patient has been discharged from emergency department

Guidelines:

Each Division of EPIC will develop and submit to the EPIC Board of Managers a detailed set of guidelines and procedures that assure appropriate and timely follow-up of abnormal laboratory reports, and for radiology and EKG variation reports, that arrive in the emergency department after the patient has left the department. The following are the minimum guidelines to be met:

·  All EPIC physicians document a preliminary reading on imaging studies that they render an independent preliminary interpretation, that is easily accessible by the radiologist.

·  All EPIC physicians render an interpretation of all EKG’s that they order in the emergency department. This report should be readily accessible by the physician that provides EKG over-reads for the hospital.

·  Coordinate the program with the respective departments in the hospital to assure a fail-safe and timely feedback system for critically abnormal laboratory values and for over-reads that are significantly discrepant from the emergency physician’s initial reading.

·  Establish specific mechanisms to identify and track variations in interpretation of imaging studies, and EKG’s and late arriving abnormal laboratory reports.

·  Establish specific mechanisms to notify the patient of clinically relevant variations in interpretation and abnormal laboratory reports.

·  Establish specific mechanisms that close the loop and documents the results of the notification of the patient.

Suggestions:

·  Use notebooks in the emergency department to file variations.

·  Generate an addendum to the respective chart for the permanent medical record that details the new finding(s) and the recommendations to the patient.

·  Have a system set up in the department to generate certified mail to those that cannot be notified by phone by the end of day the variation is received.

·  Develop form letters to be used for mailings.

¦ It is neither the purpose nor intent of these guidelines to serve as a final authoritative source on any medical condition, treatment plan, or clinical intervention, nor should these guidelines be used to rigorously define a rigid standard of care that should be practiced by all clinicians. These guidelines provide the medical provider with a reasonable clinical guide that is composed of suggestions and opinions of EPIC. These guidelines are a general reference resource and clinical roadmap designed to assist the medical provider. These guidelines cannot replace the clinical judgment of the medical provider and cannot possibly describe every possible aberration, nuance, clinical scenario, or presentation and cannot define standards for clinical actions or procedures.