Abstract
Objectives
Diagnostic management teams (DMT) are groups of experts with specialized knowledge to guide test selection and interpretation of results. They have been active in institutions over the past 20 years. To date, there are limited data on whether the presence of experts to advise healthcare providers on appropriate laboratory test selection and interpretation of complex test results positively impacts patient care.
Methods
A retrospective study at a regional healthcare system with 257,000 patient encounters between 2011 and 2022 reviewing test interpretations provided by clinical laboratory experts on a diagnostic management team.
Results
Cases reviewed by the coagulation DMT were 6 times more likely to have an established, scientifically based diagnosis compared to those without a DMT. Patients who have a coagulation DMT review were twice as likely to receive a diagnosis vs. having no diagnosis.
Conclusions
This study demonstrates that for several objective clinical outcomes, specifically diagnostic conclusions and length of stay, a DMT of coagulation experts assessing patients’ test results has had a major impact on outcomes and delivery of care.
Acknowledgments
The authors would like to thank Jose Salazar, Peter McCaffrey, Vicki Freeman, and Carol Carmen for their guidance and recommendations.
-
Research ethics: Not applicable.
-
Informed consent: Not applicable.
-
Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: The authors state no conflict of interest.
-
Research funding: None declared.
-
Data availability: Not applicable.
References
1. Freedman, DB. Towards better test utilization – strategies to improve physician ordering and their impact on patient outcomes. EJIFCC 2015;26:15–30.Search in Google Scholar
2. Newman-Toker, DE, Zhu, Y, Saber Tehrani, AS, Fanai, M, Hassoon, A, Nassery, N, et al.. Burden of serious harms from diagnostic error in the USA. BMJ Qual Saf 2023. https://doi.org/10.1136/bmjqs-2021-014130.Search in Google Scholar PubMed PubMed Central
3. Singh, H, Graber, ML. Improving diagnosis in health care – the next imperative for patient safety. N Engl J Med 2015;373:2493–5. https://doi.org/10.1056/NEJMp1512241.Search in Google Scholar PubMed
4. Whitehead, NS, Williams, L, Meleth, S, Kennedy, S, Epner, P, Singh, H, et al.. Interventions to improve follow-up of laboratory test results pending at discharge: a systematic review. J Hosp Med 2018;13:631–6. https://doi.org/10.12788/jhm.2944.Search in Google Scholar PubMed PubMed Central
5. Forsman, RW. Why is the laboratory an afterthought for managed care organizations? Clin Chem 1996;42:813–16, https://doi.org/10.1093/clinchem/42.5.813.Search in Google Scholar
6. Wade, J, Dean, CL, Krummey, SM, Roback, JD, Sullivan, HC. How do I implement diagnostic management teams in transfusion medicine? Transfusion 2020;60:237–44. https://doi.org/10.1111/trf.15618.Search in Google Scholar PubMed PubMed Central
7. Seegmiller, AC, Kim, AS, Mosse, CA, Levy, MA, Thompson, MA, Kressin, MK, et al.. Optimizing personalized bone marrow testing using an evidence-based, interdisciplinary team approach. Am J Clin Pathol 2013;140:643–50. https://doi.org/10.1309/AJCP8CKE9NEINQFL.Search in Google Scholar PubMed PubMed Central
© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Opinion Paper
- Exploring synthesis as a vital cognitive skill in complex clinical diagnosis
- Original Articles
- Physiologic measurements of cognitive load in clinical reasoning
- Impact of diagnostic management team on patient time to diagnosis and percent of accurate and clinically actionable diagnoses
- Game-based learning to improve diagnostic accuracy: a pilot randomized-controlled trial
- A patient follow-up intervention to improve medical decision making at an internal medicine residency program
- Application of a diagnosis flow draft based on appearance impression for detection of vulvar disease
- The consequences of delayed diagnosis and treatment in persons with multiple sclerosis given autologous hematopoietic stem cell transplantation
- Troponin testing in routine primary care: observations from a dynamic cohort study in the Amsterdam metropolitan area
- Use of saliva-based qPCR diagnostics for the accurate, rapid, and inexpensive detection of strep throat
- Short Communications
- Improving communication of diagnostic uncertainty to families of hospitalized children
- Association of diagnostic error education and recognition frequency among Japanese medical students: a nationwide cross-sectional study
- Updated statistics on Influenza mortality
- Letters to the Editor
- How case reports can be used to improve diagnosis
- Clinical assessment of Ortho VITROS SARS-CoV-2 antigen chemiluminescence immunoassay
- Convicting a wrong molecule?
- Case Reports - Lessons in Clinical Reasoning
- Lessons in clinical reasoning – pitfalls, myths, and pearls: a woman brought to a halt
- Lessons in clinical reasoning – pitfalls, myths, and pearls: shoulder pain as the first and only manifestation of lung cancer
- Congress Abstracts
- The Future of Diagnosis: Achieving Excellence and Equity
- The Future of Diagnosis: Navigating Uncertainty
Articles in the same Issue
- Frontmatter
- Opinion Paper
- Exploring synthesis as a vital cognitive skill in complex clinical diagnosis
- Original Articles
- Physiologic measurements of cognitive load in clinical reasoning
- Impact of diagnostic management team on patient time to diagnosis and percent of accurate and clinically actionable diagnoses
- Game-based learning to improve diagnostic accuracy: a pilot randomized-controlled trial
- A patient follow-up intervention to improve medical decision making at an internal medicine residency program
- Application of a diagnosis flow draft based on appearance impression for detection of vulvar disease
- The consequences of delayed diagnosis and treatment in persons with multiple sclerosis given autologous hematopoietic stem cell transplantation
- Troponin testing in routine primary care: observations from a dynamic cohort study in the Amsterdam metropolitan area
- Use of saliva-based qPCR diagnostics for the accurate, rapid, and inexpensive detection of strep throat
- Short Communications
- Improving communication of diagnostic uncertainty to families of hospitalized children
- Association of diagnostic error education and recognition frequency among Japanese medical students: a nationwide cross-sectional study
- Updated statistics on Influenza mortality
- Letters to the Editor
- How case reports can be used to improve diagnosis
- Clinical assessment of Ortho VITROS SARS-CoV-2 antigen chemiluminescence immunoassay
- Convicting a wrong molecule?
- Case Reports - Lessons in Clinical Reasoning
- Lessons in clinical reasoning – pitfalls, myths, and pearls: a woman brought to a halt
- Lessons in clinical reasoning – pitfalls, myths, and pearls: shoulder pain as the first and only manifestation of lung cancer
- Congress Abstracts
- The Future of Diagnosis: Achieving Excellence and Equity
- The Future of Diagnosis: Navigating Uncertainty