Title: Development and evaluation of a system to improve communication of test results in primary care
Funder: Department of Health (England)

Abstract: Background We have undertaken a survey of the methods by which test results are relayed to patients in primary care and found enormous variation between practices. Results frequently fail to reach patients. We have also found that no clear guidelines are currently in place, despite the potential for test result communication to affect both patient’s safety and satisfaction with care. A literature review has revealed little existing research on test result communication in primary care. We will research attitudes of patients and staff to current procedures and in consultation with both groups, design an improved system of test result communication using the principles of lean design. Finally we will implement the new system and conduct a pilot study using an action research model Aims 1) Determine what patients think are the strengths and weaknesses of the system they have experienced and see how opinions vary among patients and by type of test. 2) Consult with patients and practice staff on how they think the service can be improved and how different patient wishes can be accommodated. Using this feedback and principles of ‘lean’ and Failure Mode Effects Analysis (FMEA), design a prototype system to reduce delay and cost and improve understanding and satisfaction. 3) We will iterate with staff and patients to refine the new system prior to its use. 4) Pilot the new system across two practices and further refine it using an action research model. Plan of Investigation Phase I: From each of four practices, we will seek opinions on current test result communication systems using focus groups consisting separately of patients and staff from each practice. Phase II: Consult with focus groups consisting of patients and staff working together and combined across practices to co-design a new system, seeking to accommodate variability in patient preference and using the principles of ‘lean’ and FMEA. Phase III: The design will be appraised by the above focus groups on an iterative basis thereby improving the design. Phase IV: The new system will be rolled-out across two practices and staff and patients surveyed via questionnaire and focus group to determine effects on an action research model Potential Impact The successful communication of test results can impact positively on the health outcome of the individual. Yet at present there are acknowledged weaknesses in the process of test result communication, including confusion surrounding the relation of the test to the patient’s condition and the failure to relay test results, whether normal or abnormal. Designing a system that provides the patient with the information they want by the means they choose, will not only yield greater patient satisfaction but safe and better care. In addition, when lean thinking has been employed elsewhere in health care in the UK, the increased optimisation of resources has led to a measurable reduction in waste and notable financial savings.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE