Provider Management of and Satisfaction With Laboratory Testing in the Nursing Home Setting: Results of a National Internet-Based Survey

Objectives

To describe the management of and satisfaction with laboratory testing, and desirability of laboratory health information technology in the nursing home setting.

Design

Cross-sectional study using an Internet-based survey.

Participants and Setting

National sample of 426 nurse practitioners and 308 physicians who practice in the nursing home setting.

Measurements

Systems and processes available for ordering and reviewing laboratory tests, laboratory test result management satisfaction, self-reported delays in laboratory test result review, and desirability of computerized laboratory test result management features in the nursing home setting.

Results

A total of 96 participants (48 physicians and 48 nurse practitioners) completed the survey, for an overall response rate of 13.1% (96/734). Of the survey participants, 77.1% had worked in the nursing home setting for more than 5 years. Over half of clinicians (52.1%) reported 3 or more recent delays in receiving laboratory test results. Only 43.8% were satisfied with their laboratory test results management. Satisfaction was associated with keeping a list of laboratory orders and availability of computerized laboratory test order entry. In the nursing home, 35.4% of participants reported the ability to electronically review laboratory test results, 12.5% and 10.4% respectively had computerized ordering of chemistry/hematology and microbiology/pathology tests. The following 3 features were rated most desirable in a computerized laboratory test result management system: showing abnormal results first, warning if a test result was missed, and allowing electronic acknowledgment of test results.

Conclusion

Delays in receiving laboratory test results and dissatisfaction with the management of laboratory test result information are commonly reported among physicians and nurse practitioners working in nursing homes. Test result management satisfaction was associated with computerized order entry and keeping track of ordered laboratory tests, suggesting that implementation of certain health information technology could potentially improve quality of care.

Keywords: Laboratory techniques and procedures, laboratories, nursing homes, medication monitoring