Management of test results in family medicine offices

Nancy C. Elder, Timothy R. McEwen, John M. Flach, Jennie J. Gallimore

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


PURPOSE: We wanted to explore test results management systems in family medicine offices and to delineate the components of quality in results management. METHODS: Using a multimethod protocol, we intensively studied 4 purposefully chosen family medicine offices using observations, interviews, and surveys. Data analysis consisted of iterative qualitative analysis, descriptive frequencies, and individual case studies, followed by a comparative case analysis. We assessed the quality of results management at each practice by both the presence of and adherence to systemwide practices for each results management step, as well as outcomes from chart reviews, patient surveys, and interview and observation notes. RESULTS: We found variability between offices in how they performed the tasks for each of the specific steps of results management. No office consistently had or adhered to office-wide results management practices, and only 2 offices had written protocols or procedures for any results management steps. Whereas most patients surveyed acknowledged receiving their test results (87% to 100%), a far smaller proportion of patient charts documented patient notification (58% to 85%), clinician response to the result (47% to 84%), and follow-up for abnormal results (28% to 55%). We found 2 themes that emerged as factors of importance in assessing test results management quality: safety awareness - a leadership focus and communication that occurs around quality and safety, teamwork in the office, and the presence of appropriate policies and procedures; and technological adoption - the presence of an electronic health record, digital connections between the office and testing facilities, use of technology to facilitate patient communication, and the presence of forcing functions (built-in safeguards and requirements). CONCLUSION: Understanding the components of safety awareness and technological adoption can assist family medicine offices in evaluating their own results management processes and help them design systems that can lead to higher quality care.

Original languageEnglish (US)
Pages (from-to)343-351
Number of pages9
JournalAnnals of family medicine
Issue number4
StatePublished - 2009
Externally publishedYes


  • Delivery of health care
  • Medical errors
  • Office management
  • Patient safety
  • Qualitative research
  • Quality of care

ASJC Scopus subject areas

  • Family Practice


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