Process-of-care failures common in adults with rectal bleedi
The researchers judged the overall quality of care to be good or excellent in 77 percent of cases; however, in the workup of rectal bleeding, 71 percent of patients experienced at least one process-of-care failure. Clinicians failed to obtain an adequate family history, complete a pertinent physical exam, and order laboratory tests in 38, 23, and 16 percent of cases, respectively. The odds of poor or fair care were increased in association with failure to order or perform tests, or to make follow-up plans. There was little correlation between guideline concordance and quality judgements. One hundred twenty-eight delays could have been reduced or prevented.

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