The Lab Report That Arrived After ThePatient Went Home

Test results that come back after discharge often go unseen. Here’s why it happens and how connected systems close the loop.

Mr. Khalid is discharged on Thursday afternoon, feeling better. On Friday morning, one of his test results comes back abnormal. It lands in the inbox of a doctor who has finished their rotation. Nobody calls him.

He only finds out two weeks later, when he’s back in the emergency room.

It happens more than you’d think

A well-known study of more than 2,600 patients at two Boston hospitals found that 41% left with at least one test result still pending. For the results that needed action, the responsible doctors didn’t know about roughly six in ten of them. These were good hospitals with good doctors. The system simply didn’t make sure the right person saw the right result

Test results that come back after the patient leaves

Discharge with atleast one result pending
Result their doctors did not know about

Why results fall through the cracks

Shifts change. Results go to whoever ordered the test, not whoever is now responsible. Discharge happens on one screen and pending tests sit on another. And nothing in the process says, “This patient still has results coming.”

What connected systems do

They flag every pending test at the moment of discharge. They send results to the doctor currently responsible, with a reminder if nobody opens them. They let patients see their own results and get a message when something needs follow-up. And they close the loop: a result isn’t done until someone has acknowledged it

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