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Ordering the wrong test, missing results and forgetting to notify patients are among the many testing mistakes that occur routinely at the offices of family doctors, a new study shows.
The report, published in the journal Quality & Safety in Health Care, looked at testing procedures and mistakes that were reported anonymously by 243 doctors, nurses and staff members in eight small and large family physician practices in seven states. During an eight-month period, researchers from the University of Chicago analyzed the error reports related to medical testing, including ones they observed “should not have happened and that you don’t want to happen again.” The tests included lab work, diagnostic imaging and other procedures like pulmonary function tests and electrocardiograms.
Nearly 1,000 testing mistakes involving 590 patients were reported during the collection period. The study wasn’t designed to detect the overall rate of testing errors. However, data collected from earlier studies show that medical errors or adverse events in family practices occur in about one in four patient visits. About 14 percent of the time, the mistake involves a medical test. That’s a rate of one testing mistake per 30 office visits.
Mistakes in test ordering accounted for about 13 percent of the errors, including not ordering a test or requesting the wrong test. In 18 percent of the cases, the right test was ordered but it wasn’t conducted properly. Often the test wasn’t done at all, or the wrong test was given. Sometimes the wrong specimen was collected or specimens were lost.
But the biggest problems involved getting the results back from the lab, which occurred 25 percent of the time. Mistakes included delays in returning results, errors on the results report or failure by the lab to provide any results to the doctor’s office. The problems were compounded by lack of follow-up by the physician’s office. About 7 percent of the mistakes involved failing to notify patients of the results.
In about three out of four cases, patients suffered as a result of the mistakes, the study showed. In about 24 percent of cases, the mistake led to delays in proper treatment. In 22 percent of the errors, the mistake forced the patient to spend additional time or money. Mistakes caused pain and suffering in 11 percent of the cases; and 2 percent of the time, the mistake resulted in poorer health.