Good practice statements on safe laboratory testing: A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.
BACKGROUND
The systems-based management of laboratory test ordering and results handling is a known source of error in primary care settings worldwide. The consequences are wide-ranging for patients (e.g. avoidable harm or poor care experience), general practitioners (e.g. delayed clinical decision making and potential medico-legal implications) and the primary care organization (e.g. increased allocation of resources to problem-solve and dealing with complaints). Guidance is required to assist care teams to minimize associated risks and improve patient safety.


OBJECTIVE
To identify, develop and build expert consensus on 'good practice' guidance statements to inform the implementation of safe systems for ordering laboratory tests and managing results in European primary care settings.


METHODS
Mixed methods studies were undertaken in the UK and Ireland, and the findings were triangulated to develop 'good practice' statements. Expert consensus was then sought on the findings at the wider European level via a Delphi group meeting during 2013.


RESULTS
We based consensus on 10 safety domains and developed 77 related 'good practice' statements (≥ 80% agreement levels) judged to be essential to creating safety and minimizing risks in laboratory test ordering and subsequent results handling systems in international primary care.


CONCLUSIONS
Guidance was developed for improving patient safety in this important area of primary care practice. We need to consider how this guidance can be made accessible to frontline care teams, utilized by clinical educators and improvement advisers, implemented by decision makers and evaluated to determine acceptability, feasibility and impacts on patient safety.
a NHS Education for Scotland , Glasgow , UK.
Paul
P
Bowie
Eleanor
E
Forrest
Julie
J
Price
Wim
W
Verstappen
David
D
Cunningham
Lyn
L
Halley
Suzanne
S
Grant
Moya
M
Kelly
John
J
Mckay
D064790:Clinical Laboratory Services / Q000592:standards*; D006801:Humans; D016272:Occupational Health / Q000592:standards*; D061214:Patient Safety; D011320:Primary Health Care
LINNEAUS collaboration; Laboratory tests; patient safety; primary care; results management