A Virtual Breakthrough Series for Missed Test Results
Importance
Missed test results happen when healthcare providers do not follow up on test outcomes in a timely manner, causing delays in diagnosis and treatment.
Objective
This study aimed to assess how a quality improvement program, called the Virtual Breakthrough Series (VBTS), impacts the follow-up rates of two critical test results: chest imaging for lung cancer and lab results for colorectal cancer.
Study Overview
This clinical trial took place from February 2020 to March 2022 across 12 Department of Veterans Affairs (VA) medical centers. It involved three phases: preintervention, action, and continuous improvement. Teams included a project leader and various experts from different fields. Data analysis occurred from April 2022 to March 2024.
Intervention
All teams engaged in the VBTS, which provided training on how to reduce missed test results in their facilities.
Main Outcomes
The primary goal was to measure changes in the follow-up rates of abnormal test results between the preintervention and action phases. Secondary goals included evaluating the intervention’s effects across different cohorts and sites.
Results
Eleven teams completed the VBTS, implementing 47 unique strategies to address missed test results. In total, 40,027 colorectal cancer tests were conducted, revealing 5,130 abnormal results, with 1,286 flagged as missed. For lung cancer, 376,765 tests were done, with 7,314 abnormal results, and 2,436 flagged as missed. Overall, there was no significant change in follow-up rates across all study phases. However, one site with the lowest follow-up rate improved from 27.8% to 55.6% after the intervention.
Conclusions
While the VBTS did not show a general improvement in follow-up rates, it proved beneficial for sites with previously low performance.
Trial Registration
ClinicalTrials.gov Identifier: NCT04166240.
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