Page 26 - Registrar Orientation Manual 2016

Electronic Result Acknowledgement: The Responsibilities of Consultants and the Delegation of Responsibility to RMOs
It is the responsibility of SMOs to instruct their RMOs of their expectations and indicate:
• when the RMO can independently acknowledge results,
• what results the RMO should not acknowledge (for example histology),
• what results the RMO should inform the SMO about before or after acknowledging.
5. Principles of Delegated Responsibility for Electronic Acknowledgement to RMOs
RMOs work under delegated responsibility. RMOs should clarify what their delegated responsibilities are for acknowledging results, if there are results only the SMO can acknowledge and when the SMO wants to be informed about significant results.
While SMOs are ultimately responsible for the decisions and actions of RMOs, RMOs also have a responsibility to remain within their area of competence and to seek assistance when required.
It is expected that results for all inpatients are reviewed each weekday by RMOs, and the SMO informed of any result which might lead to significant patient impact or changes in management.
Potentially significant but unexpected incidental findings should be discussed with the SMO.
The on call RMOs need to be informed about any results that need to be followed up out of hours or at weekends. This should be included in written weekend action plans and at handovers.
By acknowledging a result one is taking responsibility for any action required. RMOs should speak to their SMO if they have any concerns about whether to acknowledge a particular result.
Through acknowledging a result that result will also disappear off all work lists and so RMOs must not acknowledge results that should be viewed and actioned by another doctor.
6. Responsibility of Departments
Each department needs to develop a process for ensuring all results are acknowledged. The Clinical Director must accept or delegate responsibility for this happening in their department.
There must be a process for acknowledging results of patients when SMOs are on leave. This is best done by arranging for a colleague to check the unacknowledged work list.
The department should generate a regular Compliance Summary Report and feedback to SMOs to identify variance from acceptable clinical practice and enable appropriate action to be taken.
7. OrganisationalResponsibility
The organisation is responsible for ensuring there is a reliable process to notify SMOs of the test results of their patients. Currently this is done using the CWS unacknowledged work lists.
Every month a Compliance Summary Report will be circulated to all SMOs to inform them of their outstanding unacknowledged results. This will be monitored by the CMA and Group Managers.
The organisation will provide appropriate computer access and support to allow SMOs to review results electronically and initiate any action required to acknowledging those results.
8. Responsibility of Radiology and the Laboratory
A timely electronic report must be generated and preliminary results finalised as soon as possible, so they can be acknowledged.
The test requestor will be contacted only if there are potentially life-threatening findings that were unexpected and/or require urgent action.
Any significant findings, including incidental findings, which may require action, should be included in the report summary.
If a report is amended after it has initially been issued, and there are significant changes in the diagnosis as a result, the requestor or the responsible consultant should be contacted by the radiologist/pathologist completing the final report.
If results appear on the wrong unacknowledged work list Radiology and the Laboratory will take responsibility for redirecting results to the responsible clinician.
Disclaimer: This document has been developed by Waikato District Health Board (DHB) specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at their own risk and Waikato DHB assumes no responsibility.
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