Research Article Open Access Quality in Primary Care (2014) 22 (5): 238-37 Short Report 2014 Insight Medical Publishing Group Measuring system safety for laboratory test ordering and results management in primary care: international pilot study Paul Bowie NHS Educaion for Scotland, UK Insitute of Health and Wellbeing, University of Glasgow, UK Julie Ferguson NHS Educaion for Scotland, UK Julie Price Medical Protecion Society, UK & Ireland Eva Frigola Catalan Ministry of Health, Spain Katarzyna Kosiek Medical University of Lodz, Poland Wim Verstappen Radboud University Nijmegen Medical Centre, The Netherlands John McKay NHS Educaion for Scotland, UK ABSTRACT The systems-based management of laboratory test ordering and results handling is a signiicant patient safety concern in primary care internationally. In this pilot study, we describe the testing of a method to systematically measure and monitor compliance with basic safe performance in this area in different European primary care settings. The indings show high overall compliance with the safe system measures developed although the data indicates performance variation within and between the different systems audited, which suggests that aspects of the reliability (and safety) of these systems could be improved by care teams. However, the overall utility of the method is still to be determined and this will require testing on a greater scale in more diverse practices with larger samples of patients and blood tests, and using different technology support systems. Introducion The design quality of systems for managing laboratory test ordering and results handling in international general practice settings varies widely and can have multiple impacts on the safety of patient care 1-2 . For patients this can lead to preventable harms or poor care experiences, while for general practitioners (GPs) this can delay clinical decision-making and have potential medico-legal implications 3-4 . Organisationally, poor or inadequate system design, can lead to increased allocation of resources to problem-solve when things go wrong and also to deal with avoidable complaints from patients and relatives 5 . However, safety may be created and practice risks minimized by introducing and standardizing processes to improve the overall reliability of results handling systems 6 . As part of the LINNEAUS EURO-PC programme, preliminary guidance on the safe management of laboratory tests ordering and results management systems was developed based on the limited research available and more recent programme- related studies, including review of medical indemnity database information 1-9 . In this short report, we describe a collaborative programme output which aimed to develop and test a method to systematically measure and monitor compliance with basic safe performance and, where necessary, direct subsequent practice team improvement efforts. Method Intervenion We developed a ‘care bundle’ measurement approach which if implemented routinely would normally involve undertaking small audits on a frequent basis to determine the reliability (a safety indicator) of the results handling system using a composite “all or nothing” measure (Box 1) 10-11 . For the purposes of this