title: How do emergency departments in England process the results of laboratory investigations?
abstract: OBJECTIVE
  To determine how emergency departments in England process laboratory investigation results, to identify risk, and to note examples of good practice.
  
  
  METHODS
  A telephone survey was conducted, and data were entered anonymously into Excel spreadsheets. Fisher's exact test was used to test the independence of pairs of variables.
  
  
  RESULTS
  Data were collected from 167 out of 193 (87%) emergency departments in England. The majority had nurse-requested blood tests. There was a statistical association between nurse-requesting and failure by the clinician seeing the patient to check results. Fourteen (8%) departments did not allow patients to leave until all their results were available. A senior doctor did a second 'safety' check of results in 83 (50%) departments. Many respondents were able to give examples of patients who had been recalled to hospital after a second check. Only a minority of departments had information systems that could identify high-risk patients.
  
  
  CONCLUSIONS
  A second 'safety' check by an experienced consultant, associate specialist or middle grade doctor identifies error. This is time-consuming, but could be supported and simplified by using intelligently designed information systems.
authors.affiliation: Emergency Department, Horton Hospital, Oxford Radcliffe Hospitals' NHS Trust, Banbury, Oxon, UK.
authors.forename: Aman
authors.initials: A
authors.lastname: Ahmad
authors.forename: Tawfek
authors.initials: T
authors.lastname: Alaakel
authors.forename: Hassan
authors.initials: H
authors.lastname: Ali
authors.forename: Amit
authors.initials: A
authors.lastname: Arora
authors.forename: Grizelda
authors.initials: G
authors.lastname: George
authors.forename: Maria
authors.initials: M
authors.lastname: Queenan
authors.forename: Bryan S
authors.initials: BS
authors.lastname: Todd
authors.forename: Emma
authors.initials: E
authors.lastname: Warren
mesh_terms: D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004739:England; D006403:Hematologic Tests / Q000592:standards*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D024802:Nurse's Role; D010819:Physician's Role; D011795:Surveys and Questionnaires