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Managing Tests policy in Ontario

Test results management can have a direct impact on patient safety and has been identified as a priority area by the World Health Organization.1 Failure to follow up on tests results could lead to diagnostic delays, resulting in suboptimal clinical outcomes, patient harm, and medicolegal consequences for physicians.2 In 2016, the College of Physicians and Surgeons of Ontario (CPSO) started the process of updating its test results management policy.3 The CPSO collected feedback from clinicians, medical organizations, and the general public; conducted a literature review; and ultimately published the Managing Tests policy, along with companion resources on continuity of care, on September 20, 2019, thereby establishing expectations for physicians to deliver patient-centred care in a way that maximizes patient safety.4 Specifically, the Managing Tests policy aims to ensure that physicians are tracking test results that are at risk of being clinically significant, applying judgment when deciding to track other tests, following up on noteworthy test results, and taking appropriate management action in a timely manner.4 The 2019 policy advises physicians to exercise caution when using “no news is good news” strategies for managing test results, to prevent any missed results that could potentially be important. The Managing Tests policy is similar to policies addressing test management in other Canadian provinces, as they all refer to physicians’ responsibility to ensure that they have an effective system for ordering, tracking, and following up on tests. However, Ontario’s policy adds detail to each policy statement and distinguishes between results of routine tests and those that are at high risk of being clinically significant.