Follow-up on test referrals and results: Whose responsibility is it?

Background Inadequate test follow-up is a major patient safety concern which can have implications for missed or delayed diagnosis and treatment. The community medicine setting poses challenges for test follow-up, which involves ensuring patient performance, receiving information about abnormal results, and informing patients. Objective This research aimed to learn how community physicians perceive and cope with test follow-up. Methods In-depth interviews were conducted with 20 community physicians: 10 family physicians and 10 other specialists. Findings The potential for inadequate follow-up on tests emerged from the interviews as a significant risk factor for patients. According to interviewees, inadequate follow-up includes both ensuring that referred tests are performed and receiving and informing patients about abnormal results. It stems from heavy workloads, poor communication between family physicians and specialists, and patients being treated by multiple physicians. The coping strategies employed by physicians, such as encouraging patients to perform tests, contacting patients, documenting follow-ups, and using the healthcare organization’s information technology alert system, are described as insufficiently effective. Conclusions Suggestions are made for enhancing the responsibility of all parties in order to improve the management of test referrals follow-up, ensure that physicians receive the test results, and thus reduce the incidence of adverse events.