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Assessment of quality of data provided on Pap test requisitions: implications for quality of care and patient safety.

Naryshkin S, Schultz BL - Cytojournal (2009)

Bottom Line: The effect of incomplete/inaccurate information on quality of patient care has not been previously quantified.Patient history and clinical information from the slips were compared to data from our laboratory information system and/or electronic patient medical records.Requisition slips were properly completed with a high frequency, but the check boxes did not elicit all the information expected, so revision was necessary.

View Article: PubMed Central - HTML - PubMed

Affiliation: Mercy Hospital Laboratory, Janesville, WI, USA. snaryshkin@mhsjvl.org

ABSTRACT

Background: The reliability of patient history and clinical information on Pap test requisitions has been questioned but not previously objectively determined. The effect of incomplete/inaccurate information on quality of patient care has not been previously quantified. Our objectives were (1) to find out how clinicians and their assistants viewed the requisition slip, and whether they understood the reasons for supplying the information requested, (2) to measure the completeness and accuracy of information on the requisition slips, and (3) to determine whether the clinical information and patient history provided on Pap test requisitions could be relied upon to accurately assign a Pap test to the laboratory's "high-risk rescreen" pool.

Methods: Clinicians and their assistants were surveyed. A total of 899 consecutive Pap test requisition slips were reviewed. Patient history and clinical information from the slips were compared to data from our laboratory information system and/or electronic patient medical records.

Results: Most survey respondents felt that proper completion of requisitions was important, but only 17% of clinicians and less staff realized that negative high-risk Pap tests underwent a quality assurance rescreen. Clinicians and/or staff recorded the last menstrual period, specimen source, and clinical information on the requisition slips 96%, 97%, and 88% of the time, respectively. Of 695 Pap tests with applicable computerized records, 171 (25%) qualified for high-risk rescreen based upon information provided on the requisition slip alone. An additional 52 Pap tests (7%), or 23% of the total high-risk Pap tests were discovered to be of high risk only after review of the electronic records.

Conclusions: Clinicians and staff were receptive to discussions concerning the completion of requisition slips, but laboratory expectations could be better communicated. Requisition slips were properly completed with a high frequency, but the check boxes did not elicit all the information expected, so revision was necessary. The high accuracy of the completion of requisition slips permitted 77% of high-risk Pap tests to be identified via the requisition slip alone. Our findings challenge the conventional anecdotal impressions of "notoriously unreliable" information on Pap test requisition slips, but our experience may not be applicable to other settings.

No MeSH data available.


Related in: MedlinePlus

Original Pap test requisition slip
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Related In: Results  -  Collection

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Figure 0002: Original Pap test requisition slip

Mentions: Figure 1 shows the frequency of information provided on the requisition slips. During our initial pilot phase of the project, which was reported in the previously published abstract,[2] we discovered that the check boxes on our requisition slips then in use [Figure 2] did not elicit all the information we expected and that we needed in order to triage a Pap case to our high-risk rescreen pool. Therefore, we redesigned our requisition slip mid-project [Figure 3] making sure to provide a check box for each of the high-risk criteria chosen by our laboratory.


Assessment of quality of data provided on Pap test requisitions: implications for quality of care and patient safety.

Naryshkin S, Schultz BL - Cytojournal (2009)

Original Pap test requisition slip
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2712721&req=5

Figure 0002: Original Pap test requisition slip
Mentions: Figure 1 shows the frequency of information provided on the requisition slips. During our initial pilot phase of the project, which was reported in the previously published abstract,[2] we discovered that the check boxes on our requisition slips then in use [Figure 2] did not elicit all the information we expected and that we needed in order to triage a Pap case to our high-risk rescreen pool. Therefore, we redesigned our requisition slip mid-project [Figure 3] making sure to provide a check box for each of the high-risk criteria chosen by our laboratory.

Bottom Line: The effect of incomplete/inaccurate information on quality of patient care has not been previously quantified.Patient history and clinical information from the slips were compared to data from our laboratory information system and/or electronic patient medical records.Requisition slips were properly completed with a high frequency, but the check boxes did not elicit all the information expected, so revision was necessary.

View Article: PubMed Central - HTML - PubMed

Affiliation: Mercy Hospital Laboratory, Janesville, WI, USA. snaryshkin@mhsjvl.org

ABSTRACT

Background: The reliability of patient history and clinical information on Pap test requisitions has been questioned but not previously objectively determined. The effect of incomplete/inaccurate information on quality of patient care has not been previously quantified. Our objectives were (1) to find out how clinicians and their assistants viewed the requisition slip, and whether they understood the reasons for supplying the information requested, (2) to measure the completeness and accuracy of information on the requisition slips, and (3) to determine whether the clinical information and patient history provided on Pap test requisitions could be relied upon to accurately assign a Pap test to the laboratory's "high-risk rescreen" pool.

Methods: Clinicians and their assistants were surveyed. A total of 899 consecutive Pap test requisition slips were reviewed. Patient history and clinical information from the slips were compared to data from our laboratory information system and/or electronic patient medical records.

Results: Most survey respondents felt that proper completion of requisitions was important, but only 17% of clinicians and less staff realized that negative high-risk Pap tests underwent a quality assurance rescreen. Clinicians and/or staff recorded the last menstrual period, specimen source, and clinical information on the requisition slips 96%, 97%, and 88% of the time, respectively. Of 695 Pap tests with applicable computerized records, 171 (25%) qualified for high-risk rescreen based upon information provided on the requisition slip alone. An additional 52 Pap tests (7%), or 23% of the total high-risk Pap tests were discovered to be of high risk only after review of the electronic records.

Conclusions: Clinicians and staff were receptive to discussions concerning the completion of requisition slips, but laboratory expectations could be better communicated. Requisition slips were properly completed with a high frequency, but the check boxes did not elicit all the information expected, so revision was necessary. The high accuracy of the completion of requisition slips permitted 77% of high-risk Pap tests to be identified via the requisition slip alone. Our findings challenge the conventional anecdotal impressions of "notoriously unreliable" information on Pap test requisition slips, but our experience may not be applicable to other settings.

No MeSH data available.


Related in: MedlinePlus