2017 - Competency CC-A

Table of Contents

<< Move to CM-B

>> Move to CC-B

Competency A: The practice effectively tracks and manages laboratory and imaging tests important for patient care and informs patients of the result

CC 01 (Core): The practice systematically manages lab and imaging tests by

A. Tracking lab tests until results are available, flagging and following up on overdue results

The practice tracks lab tests from the time they are ordered until results are available, and flags test results that have not been made available. The flag may be an icon that automatically appears in the electronic system or a manual tracking system with a timely surveillance process. The practice follows up with the lab (and the patient, if necessary) to determine why results are overdue, and documents follow-up efforts until reports are received.

B. Tracking imaging tests until results are available, flagging and following up on overdue results.

The practice tracks imaging tests from the time they are ordered until results are available, and flags test results that have not been made available. The flag may be an icon that automatically appears in the electronic system or a manual tracking system with a timely surveillance process. The practice follows up with the diagnostic center (and the patient, if necessary) to determine why results are overdue, and documents follow-up efforts until reports are received.

C. Flagging abnormal lab results, bringing them to the attention of the clinician.

Abnormal results of lab tests are flagged and brought to the attention of the clinician, to ensure timely follow-up with the patient/family/caregiver

D. Flagging abnormal imaging results, bringing them to the attention of the clinician.

Abnormal results of imaging tests are flagged and brought to the attention of the clinician, to ensure timely follow-up with the patient/family/caregiver

F. Notifying patients/families/caregivers of abnormal lab and imaging test results.

The practice provides timely notification to patients about test results (normal and abnormal). Filing the report in the medical record for discussion during a scheduled office visit does not meet the requirement.

CC 02 (1 Credit): Follows up with the inpatient facility about newborn hearing and blood-spot screening.

The practice follows up with the hospital or state health department if it does not receive screening results. Documented process and evidence of implementation is required

CC 03 (2 Credits): Uses clinical protocols to determine when imaging and lab tests are necessary.

Redundant or inappropriate use of imaging or lab tests leads to unnecessary costs and risks and does not enhance patient outcomes. The practice has established clinical protocols, based on evidence-based guidelines, to determine when imaging and lab tests are necessary. The practice may implement clinical decision supports to ensure that protocols are used (e.g., embedded in order entry system).

Evidence of implementation is required and you must have examples of clinical decision support related to both imaging and lab tests. Clinical decision support must be based on evidence-based-guidelines and you need to list the specific guidelines you are using.

Consider using Bright Futures as evidence-based guidelines within your well visit protocols and lead or chlamydia screening lab test orders based on age. For imaging tests, consider using chest x-ray for pneumonia, ultrasound for appendicitis and echocardiogram for heart murmur. These could be imaging standing orders displayed within certain protocols. Be sure to refer to specific evidence based guidelines when using those imaging orders.