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A Virtual Breakthrough Series Collaborative for Missed Test Results: A Stepped-Wedge Cluster-Randomized Clinical
Lisa Zubkoff1,2, Andrew J Zimolzak3,4, Ashley N D Meyer3,4
1Birmingham/Atlanta Geriatric Research Education and Clinical Center, Birmingham VA Healthcare System, Birmingham, Alabama.
JAMA Network Open
|October 30, 2024
Summary
The Virtual Breakthrough Series (VBTS) did not improve follow-up rates for missed test results across all sites. However, this quality improvement collaborative showed potential benefits for healthcare facilities with initially low follow-up rates.
Area of Science:
- Health Services Research
- Quality Improvement Science
- Clinical Informatics
Background:
- Missed test results are a significant issue in healthcare, leading to diagnostic and treatment delays.
- Effective strategies are needed to improve the timely follow-up of critical diagnostic test results.
Purpose of the Study:
- To assess the impact of the Virtual Breakthrough Series (VBTS) quality improvement collaborative on follow-up rates for abnormal chest imaging (lung cancer) and laboratory findings (colorectal cancer).
Main Methods:
- A stepped-wedge cluster-randomized trial was conducted across 12 Department of Veterans Affairs medical centers.
- The VBTS intervention involved teams receiving instruction on reducing missed test results.
- Follow-up rates were measured using validated electronic algorithms before and during the intervention phases.
Main Results:
- No significant overall improvement in the percentage of abnormal test results followed up was observed across study phases.
- The VBTS intervention demonstrated a significant increase in follow-up rates at the site with the lowest baseline performance (27.8% to 55.6%).
Conclusions:
- The VBTS intervention did not lead to a statistically significant improvement in overall test result follow-up rates.
- The collaborative approach may be beneficial for improving care at sites struggling with low baseline follow-up rates for critical test results.
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