Background and objectives: Ineffective communication is one of the leading causes of medical errors and patient dissatisfaction. We implemented an initiative for dynamic endocrine tests to enhance communication with primary care colleagues and patients.
Methods: We introduced a comprehensive system of organising dynamic tests, structured documentation, weekly endocrine meeting to discuss the results and standardised escalation process for suspected abnormal results. We retrospectively analysed 50 tests prior to and 50 after the initiative was introduced (n=100). Most were routine short synacthen tests (SST) with a small proportion of other tests including urgent/semi-urgent SST, dexamethasone suppression tests, TRH and GnRH stimulation tests, prolonged oral glucose tolerance test and prolonged supervised fast.
Results: The mean time from the date of test and the letter to general practitioner/patient of routine tests reduced from 22.07 days to 13.92 days for normal SSTs and 5.16 days to 4.83 days for abnormal SSTs, although the latter was not statistically significant. The other test numbers were too small to establish significance. There was no significant difference in time taken for organising the tests and no patient harm was reported in both groups. Anecdotal reports from trainees suggested that there were more training opportunities with the introduction of the new process.
Discussion: Our data suggests that streamlining the dynamic endocrine function test system reduces the delay in communicating normal routine dynamic endocrine test results and can increase the training opportunities for trainees. We aim to perform another analysis with a larger sample and analyse patient satisfaction data and consider confounding factors such as time taken from the dictation of letters to typing and postal delays, and observer effect from trainees. The endocrine meeting is not happening every week, and trainees are not attending it consistently due to other clinical commitments. We are actively looking to rectify these issues.
20 - 23 May 2017
European Society of Endocrinology