Evidence map›Paper›PMID 28942776›Full record

ArticleJoint Commission journal on quality and patient safety2017

Clinician Perspectives on the Management of Abnormal Subcritical Tests in an Urban Academic Safety-Net Health Care System.

Cassidy Clarity, Urmimala Sarkar, Jonathan Lee, Margaret A Handley, L Elizabeth Goldman

Abstract read
In one paragraph

Article in Joint Commission journal on quality and patient safety, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Communicating blood test results in primary care: a mixed-methods systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Pooled it
  2. Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer.Joint Commission journal on quality and patient safety · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Cassidy Clarity
Urmimala Sarkar
Jonathan Lee
Margaret A Handley
L Elizabeth Goldman

Funding

Building an Ambulatory Patient Safety Learning Laboratory for Diverse PopulationsP30HS023558 · AHRQ · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SARKAR, URMIMALA · 2014 to 2017
$3.9M
AHRQ HHS P30 HS023558
6 · The paper itself

Abstract

backgroundMissed or delayed follow-up of abnormal subcritical tests (tests that do not require immediate medical attention) can lead to poor patient outcomes. Safety-net health systems with limited resources and socially complex patients are vulnerable to safety gaps resulting from delayed management. Clinician perspectives to identify system challenges, vulnerable situations, and potential solutions were sought in focus groups.

methodsFive semistructured focus groups were conducted in 2015 with purposefully sampled clinicians from radiology, hospital medicine, emergency medicine, risk management, and ambulatory care from an urban, academic, integrated, safety-net health system. Thematic analysis identified challenges of current management of abnormal subcritical tests, vulnerable situations, and solution characteristics. A total of 43 clinicians participated.

resultsClinicians cited challenges in assigning responsibility for follow-up and identified tests pending at discharge and tests requiring delayed follow-up as vulnerable situations. The lack of tracking systems and missing contact information for patients and providers exacerbated these challenges. Proposed solution characteristics involved protocols to aid in assigning responsibility, reliable paths of communication, and systems to track the status of tests. Clinicians noted a strong desire for integration of the work flow and technology solutions into existing structures.

conclusionIn an urban safety-net setting, clinicians recommended outlining clear chains of responsibility and communication in the management of subcritical test results, and employing simple, integrated technological solutions that allow for tracking and management of tests. Existing test management solutions should be adapted to work within safety-net systems, which often have fewer resources and more complex patients and may function in the absence of integrated technology systems.

Indexed as

Attitude of Health PersonnelAftercareAmbulatory CareCommunicationDiagnostic Techniques and ProceduresFocus GroupsHealth PersonnelHumansSafety-net ProvidersUrban Population

Identifiers

PMID28942776
PMCPMC7757427

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.