A computerized laboratory alerting system in a psychogeriatric unit

We evaluated the contribution of a computerized laboratory alerting system to patient care in a 34-bed psychogeriatric unit. With this system the results of routine laboratory tests are automatically retrieved and registered on a daily computer-based medication report. During the first 33 days in which the alerting system was in use, a senior psychiatrist monitored the total number of altering messages sent, the number of new messages per day, the number indicating physician unawareness, the number already dealt with, and the number that initiated a decision to treat the patient or repeat a laboratory test. The alerting system retrieved a mean (+/- SD) of 0.77 +/- 0.11 messages per patient per day. Twelve percent were new messages and 88% were rotating messages. Three resident psychiatrist-case managers were unaware of half the rotating messages (i.e., 6% of all messages). Seven percent of the new messages initiated treatment, and 15% resulted in laboratory retesting. We conclude that the alerting system results in a simple, efficient report that contributes substantially to safe patient care.