Automated alerts speed critical communications

Adopting an automated alert notification system for critical imaging results appears to be effective at helping providers meet patient safety goals, as a recent study has shown automated notification was associated with a significant increase in timely closed-loop communication between providers.

Unnecessary delays in communicating test results can potentially jeopardize patient health and can lead to errors in management. Communication failures also increase the risk of adverse outcomes and account for significant malpractice claims. In light of these risks, the Joint Commission has recognized critical test results communication a national patient safety goal.

Hoping to lessen communication breakdowns between decision makers when it comes to patient care, Ronilda Lacson, MD, PhD, of Brigham and Women’s Hospital in Boston, and colleagues undertook a multi-year study analyzing the potential benefits, and drawbacks, of an automated alert system. Their findings were published in the November issue of the American Journal of Roentgenology.

Named simply the “Alert Notification of Critical Results,” or ANCR, the system was embedded in the workflow of radiologists and referring providers through integration with multiple communications systems including paging and e-mail systems. The automated response system allowed radiologists to communicate any critical findings they came across during readings through synchronous mechanisms like paging or asynchronously (like secure e-mail) and was implemented to help the study center be in compliance with a communication policy it previously enacted.

The policy includes three categories of urgency: red, orange and yellow alerts. Alert level is determined by level of urgency of the radiologist’s finding.

Red alerts are life-threatening and require documented, close-loop communication within 60 minutes. Orange and yellow alerts require communication within three hours and 15 days, respectively.

The object of the study was to evaluate the impact of the ANCR system on adherence to the institutional policy for communicating critical imaging test results and to assess the system’s adoption for the first four years after implementation.

Out of 1.9 million radiology reports generated in a five-year span (one year prior to the ANCR system being installed and four years after), a total of 9,430 reports were randomly sampled and reviewed from before ANCR implementation and 37,604 reports from after ANCR implementation.

The results show that in the year before ANCR was implemented, 91 percent of reports with critical results were adherent to the hospital’s closed-loop communication policy. After the system was implemented, 95 percent of reports with critical results were adherent to the policy.

Researchers found the adoption of ANCR increased in the first 18 months after implementation and was sustained.

“The use of an automated system to facilitate and track closed-loop communication of critical imaging results increased nine-fold within the first four years after implementation, reaching 9 percent of all finalized radiology reports and more than 80 percent of finalized reports with documented communication,” Lacson and team wrote.