Test Tracking and Referrals: Strategies for Advanced Practice Clinicians


Tracking of tests and consults is critically important in preventing diagnostic errors and preventing patient harm. The risk factors triggering an alleged malpractice claim were primarily related to the breakdown in clinical systems for test result management. Failures of systems often prevent providers from making timely and accurate diagnoses. Testing failures included test performance issues, misinterpretation of studies, receipt, and transmittal problems. Follow-up failures included lack of physician follow-up with the patient, referral management, inadequate provider to provider communication and patient noncompliance.

Course ID #: ANE 221087.0 Issue Date: 9/21/2022 Expiration Date: 9/21/2025

Description of the Professional Practice Gap (PPG)

In reviewing closed malpractice claims, The Doctors Company analyzed 2,148 closed claims from primarily medical ambulatory practices from 2009 and 2019. We found that 15 percent of these cases involved issues with the testing failures and 44 percent included failures with follow up. This course highlights the importance of adequate tracking systems to ensure tests and consults are received in a timely fashion, reviewed by the provider, responsibility for the patient is understood when consulting another provider and patients know if any results.

Learning Outcome

Learners will indicate increased confidence in their knowledge and skills related to best practices for clinical systems to manage consultation and test results reflect on the stability of process to manage referrals and test tracking within their own practices.

Learning Objectives

After completing this activity, learners will be able to:

  • Assess your practice’s tracking systems, processes, and documentation vulnerabilities that increase the risk of misdiagnosis and/or lead to patients “falling through the cracks.”
  • Educate others in your practice about how system and human failure impact patient safety and increase liability.
  • Determine what resources and tools can contribute to improvements in patient safety.

Course Developers

Kimberly Hathaway, MSN, RN, CPHRM, CPHQ, Director Patient Safety Healthcare Quality & Risk Management, The Doctors Company
Johanna Lackner, MPH, MSW, Senior Director, Continuing Professional Development, Department of Patient Safety and Risk Management, The Doctors Company

Accreditation and Disclosure Statements
The Doctors Company is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

The Doctors Company designates this activity for a maximum of
0.75 nursing contact hourLearners should claim only the credit commensurate with the extent of their participation in the activity.

No individual in a position to control or influence the content of this activity has reported relevant financial relationships with commercial interests. No commercial support was provided for this activity. 

Disclaimer Statement
This program is being offered for informational and educational purposes only from a Patient Safety Risk Management perspective and does not constitute legal advice. Laws vary from state to state, actual clinical situations often involve subtle differences and nuances from program scenarios or recommendations, and the recommendations provided in this activity may not apply to all practice situations. In complex circumstances, which present significant potential for an adverse event or litigation, TDC and the faculty recommend you consult directly with your corporate or personal counsel for professional legal guidance. 

Complies with State Requirements

Please SEE the Registered Nurse and Licensed Practical Nurse CE Requirements by State.

Technical Requirements

The activity is best experienced using the most current browser: Firefox, Chrome, Safari, or Microsoft Edge. Internet Explorer is not supported on this platform. All activities featuring audio must have a speaker. To view graphic images and references that appear in separate "pop-up" windows, JavaScript and session cookies must be enabled on your computer. Adobe Acrobat Reader may be required for certain activities.

Contact Us

If you have questions, contact educationsupport@thedoctors.com or call 800.421.2368.


Visit our Resource document for this program.