Journal article
Failure to Recognize Newly Identified Aortic Dilations in a Health Care System With an Advanced Electronic Medical Record
Annals of internal medicine, Vol.151(1), pp.21-27
2009
DOI: 10.7326/0003-4819-151-1-200907070-00005
PMID: 19581643
Abstract
Background: Concern is growing about missed test results, but data assessing their effect on patient safety are limited.
Objective: To examine the frequency with which computed tomography (CT)-documented dilations of the abdominal aorta are accompanied by evidence in the electronic medical record (EMR) that a clinician recognized the abnormality.
Design: Retrospective cohort study.
Setting: 2 hospitals in the Veterans Affairs Health Care System.
Patients: Patients with new dilations of the abdominal aorta detected on CT performed in 2003.
Measurements: Radiology report and EMR evidence that the radiologist notified the clinical service, aneurysm size, and interval between CT and EMR recognition.
Results: Computed tomography scans of 4112 patients were reviewed and 440 (11%) aortic dilations were identified, of which 91 were new findings. Radiologists directly notified clinical teams about 5 (5%) new dilations. Clinical teams did not record in the EMR recognition of 53 of 91 (58%) dilations within 3 months of the CT, and 9% of these dilations were 5.5 cm or larger. The median time to recognition of aneurysm in the EMR was 237 days, and no EMR documentation existed for 16 abnormalities (29% of surviving patients) during a mean follow-up of 3.2 years. No evidence indicated that any of the aneurysms ruptured or that patient deaths resulted from the delayed follow-up.
Limitation: Clinicians may have recognized some aneurysms but did not document them in the EMR.
Conclusion: Clinicians neglect to note a substantial proportion of new aortic dilations in the EMR. The findings highlight the need for better strategies to ensure documentation of follow-up of tests.
Details
- Title: Subtitle
- Failure to Recognize Newly Identified Aortic Dilations in a Health Care System With an Advanced Electronic Medical Record
- Creators
- Jennifer R. S GORDON - University of Iowa Carver College of Medicine and Iowa City Veterans Administration Medical Center, Iowa City, Iowa, United StatesTerry WAHLS - University of Iowa Carver College of Medicine and Iowa City Veterans Administration Medical Center, Iowa City, Iowa, United StatesRuth C CARLOS - University of Iowa Carver College of Medicine and Iowa City Veterans Administration Medical Center, Iowa City, Iowa, United StatesIraklis I PIPINOS - University of Iowa Carver College of Medicine and Iowa City Veterans Administration Medical Center, Iowa City, Iowa, United StatesGary E ROSENTHAL - University of Iowa Carver College of Medicine and Iowa City Veterans Administration Medical Center, Iowa City, Iowa, United StatesPeter CRAM - University of Iowa Carver College of Medicine and Iowa City Veterans Administration Medical Center, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- Annals of internal medicine, Vol.151(1), pp.21-27
- DOI
- 10.7326/0003-4819-151-1-200907070-00005
- PMID
- 19581643
- NLM abbreviation
- Ann Intern Med
- ISSN
- 0003-4819
- eISSN
- 1539-3704
- Publisher
- American College of Physicians; Philadelphia, PA
- Language
- English
- Date published
- 2009
- Academic Unit
- Neurology; Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984020886402771
Metrics
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