Spotlight falls on abdominal ultrasound delays

A seven-month delay in completing a referral for an abdominal ultrasound scan was considered to be "unacceptable" in a case involving a woman later found to have neuroendocrine cancer, according to a report issued by New Zealand Health and Disability Commissioner Morag McDowell.

In 2019, a woman who had been admitted to a medical center received a recommendation in her discharge summary that she be referred for an abdominal ultrasound and to cardiology outpatient services. However, these referrals were not acted on in a timely manner and she was eventually diagnosed with neuroendocrine cancer, noted the commissioner's report.

After reviewing the case in response to a complaint from the patient, McDowell found the initial physician in breach of the country's Code of Health and Disability Services Consumers' Rights due to the "unacceptable delay in management of the woman's referrals."

The commissioner recommended that the doctor report back regarding the additional strategies he has implemented to ensure that referrals are acted on as soon as possible, as well as the strategies that will assist him during particularly busy periods and staff shortages.

In addition, the commissioner recommended that the medical center review the current strategies for ensuring that staff act on the advice from other providers and provide evidence that all current staff have received training on the new "Management of Clinical Correspondence, Test Results and other Investigations Policy and Processes."

McDowell also recommended that an audit of 10 randomly selected patient referrals be undertaken to ensure that the new practice policy regarding tracking and follow-up of referrals is being followed.

"The report highlights the importance of critical thinking and of actioning referrals in a timely manager, and of doctors implementing strategies to mitigate the risks associated with a high workload," she stated.