Last Orders: Follow-up of Tests Ordered on the Day of Hospital Discharge

Failure to follow up test results contributes to patient harm, affecting between 20% and 61% of inpatient tests.^1- 2 Such missed results are clinically significant, with the potential to affect patient care.^3- 5 One factor that might shape test follow-up is the time available for review during admission. Tests requested early in an admission have more chance of being reviewed than those that are requested later in the hospital stay. Tests ordered on the day of discharge have a very limited chance of being reviewed. If time available for review is indeed a determinant of follow-up rates, there may be a potential to target the tests with limited review and increase the opportunity to improve follow-up rates. Previous studies have not accounted for this factor in their data analyses. In this study, we examined the risk for missed follow-up given the time available for follow-up. We hypothesized that test follow-up was a function of the opportunity for follow-up, measured as the number of admission days available for test review. We focused on tests ordered on the day of discharge, because this class of tests provides a unique opportunity for targeted intervention.