Paul, a patient with atrial fibrillation (heart arrhythmia), is placed on warfarin, a blood thinner, by his cardiologist. Peter goes to clinic weekly to have his INR, a measure of how thin his blood is, checked. One week he does not get a call after his blood work, and the week after he is admitted to the hospital with a bleeding ulcer. His INR that night is 6, indicating that his blood is dangerously thin. A team conducts a RCA. One root cause the team identifies is that the cardiology clinic does not have a specific method to make sure they reach all patients with INTs and communicate their results by the end of the week. Which of the following is the best recommended action statement?(A) The nurse in charge of calling patients with their results should be replaced.
(B) Have the phlebotomy lab automatically generate a list of patients all patients who had INRs drawn that day and email them to the nurse, with space to note if the nurse has reached the patient with their results, so that 99% of patients receive calls within two days of their results.
(C) Patients need to have their INRs checked more frequently.
(D) Patients awaiting lab results should be given access to MyChart, a part of the electronic health record that allows them to access their lab results themselves.

The correct option is B: Have the phlebotomy lab automatically generate a list of patients all patients who had INRs drawn that day and email them to the nurse, with space to note if the nurse has reached the patient with their results, so that 99% of patients receive calls within two days of their results.

Explanation:

When faced with such problem, changing the personnel in charge does not conform to standard practice, but changing the procedure. In process improvement, the people are not always the problem, but the process. Hence this is a case of process improvement and not personnel replacement, hence the option A would be a totally wrong option. However option B provides an improvement to the process of the hospital and also provides a means to measure outcome, where the space is left for the nurse to note the patients she has reached. This is a complete and all-round recommendation for this situation.

The correct Answer to the question is option B.

Have the phlebotomy lab automatically generate a list of patients all patients who had INRs drawn that day and email them to the nurse, with space to note if the nurse has reached the patient with their results, so that 99% of patients receive calls within two days of their results.

Explanation:

The best approach to the situation is to make sure that the results of the Clients' INR reaches them as soon as possible inorder for them to know their clotting/prothrombin time and how best to manage the situation.

Making the results available to the patient's through the Nurse will be much easier and precise. The results of all INR tests conducted should be collated from the lab and forwarded to the nurse so that the Nurse can forward them to the clients and document them too.

When results didn't get to clients,the purpose of the test hasn't really been achieved.

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