At the UW Health Belleville Clinic, a Microsystems team led by Jennifer Lochner, MD, has developed a more streamlined approach for how clinic physicians and staff communicate lab results to patients in between visits.
The team’s accomplishment—and the resulting improved efficiency—was recognized with a James E. Davis Award for Quality Improvement at the Renner Hansen awards ceremony on November 14, 2013.
Defining ‘RN-Appropriate’ Lab Results
The project kicked off in January 2013 with a team meeting to evaluate current processes for communicating lab results outside of a clinic visit.
In addition to Dr. Lochner, team members included: Kayce Basye, medical assistant; Tammy Bastian, LPN; Michael Bloyer, lab technician; Lisa Go, MD (resident); Anna Helwig, RN; Sally Jeglum, coach in training; Wendy Mellum, scheduler; Kim Sies, medical assistant.
The team found that Dr. Lochner communicated approximately 90 percent of lab results by herself. As a result, they identified specific lab results that would be appropriate for an RN to communicate, and aimed to ensure that the RN communicated those results 100 percent of the time.
“RN-appropriate” lab results included:
- Normal labs not accompanied by an undiagnosed problem
- Abnormal labs accompanied by a follow-up care plan for lipids, INR, urinalysis, throat culture, thyroid function, A1C, and wet prep.
“We really thought about how to include care team members in ways that were appropriate to their skills and level of training,” Dr. Lochner said. “We wanted to come up with clear protocols for how someone other than a physician could notify a patient of a straightforward lab result.”
Meeting the 100 Percent Goal
Throughout March and April of 2013, the team changed its processes, routing RN-appropriate lab results to Helwig via the electronic health record so she could notify patients.
Dr. Lochner tracked progress during clinic huddles, and by the end of April, the team had met the goal of 100 percent RN-appropriate lab result communication.
She estimates that this protocol reduces the number of lab results she personally communicates to patients by about 25 percent.
“It’s also clarified expectations for our team members, and made communication more timely for patients,” she explained. “There is still flexibility for physicians to have their own personal preferences, but this protocol provides the underlying framework and standards.”
Published: January 2014