We at SAS Endocrine lab, get 3 types of requests:
1) The Requests desperately needing result, interpretation (most
commonly with faster turn around time); This group usually hold
discussion with us prior to shipping the sample; So we decide based on
the clinical status on the TAT and the result with the interpretation
over the phone. The printed result usually follows this as this
reporting is not within our domain.
2) The second group is those who give clinical and other relevant
lab details with a query to rule out a particular one or more disease
groups; This group gets the result with normal TAT with comment or
reporting the result directly to the concerned Chemical pathologist /
Principal /Senior Biochemist if the result warrants
3) The last group is the routine requests as part of monitoring or
differential diagnosis just for the documentation purpose.
This gets the same treatment as the second group.
About the results we receive from referral hospitals, this again belongs
to 3 groups:
Group I: On receipt of a oral request from the clinician (SOS call) we
assist the clinician to procure the right sample in a right way and
transport the sample to the reference lab after a telephonic discussion
about the sample and the relevancy of the test. On receiving the result
we contact the clinician and again discuss if it is required. When we
get the written result, we simply enter the result & put the comment and
the report status
Group II: As a routine we send samples to the reference lab in a normal
channel. Results are entered into the computer. If it is critical (e.g
toxic level of the TDM drug) the concerned clinician/GP informed via
phone/air call and this follows the printed report
Group III: Some of the samples are sent directly to the reference lab
from the ward (commonly)/GP (rare); Results are sent to us or
phoned. This group is a problem group. We have to search the LIS for a
request, if it is not there we generate the request and enter the result
into the computer with a note saying "Sample not sent through the lab".
Sometimes, the patient wont be in the LIS. This creates headache to the
lab staff. Then only we think of lab manager to sort out this problem.
For group I & II if there is a query regarding the result we help them
by contacting the reference lab.
Of course, the send out requests/results are documented as the incoming
requests as separate file in the scan file for easy & quick reference.
Extremely sorry for the long mail
Regards
Vivek
Guy's & St.Thomas' Hospital
London
in On Wed, 4 Oct 2000, Taylor,
Andrew wrote:
> we enter the summary onto the lab computer for a report and send a copy of
> the full report to th requesting consultant, and possibly phone them to
> discuss results
> A
>
> > -----Original Message-----
> > From: [log in to unmask] [SMTP:[log in to unmask]]
> > Sent: 04 October 2000 10:47
> > To: [log in to unmask]
> > Subject: reference lab results review
> >
> > As a reference lab providing urinary steroid profile analysis, I would be
> > interested in comments from list members on how they handle the reports
> > they
> > receive. My reports, like those of other similar services in the UK,
> > consist of an extensive list of values for different metabolites and a
> > comment. Whilst not every value may be said to be relevant to a particular
> > diagnosis, I report a standard list, both because being selective requires
> > more decision making and therefore more time and also because alternative
> > interpretations based on new information are still possible. Having
> > laboured
> > to produce an A4 word processed sheet which contains, in my view, no
> > superfluous information, I had always assumed that a copy of this would
> > find
> > its way, via the clinical chemist, to the patient's notes.
> >
> > It has recently become apparent that many labs retype the result onto
> > their
> > reporting systems and may only transmit the comment. Among reasons given
> > are that paper storage is difficult to reconcile with electronic systems
> > and
> > that "the clinician will not understand all that detail".
> >
> > On the last point, I'm not sure why another clinical chemist thinks they
> > understand what a doctor will understand better than I do. I aim to write
> > my
> > reports for the doctor and asssume that the clinical chemist, if asked to
> > further explain, will call on me if need be. The other is more tricky.
> > It
> > is obviously a waste of a trained person's time to act as a copy typist,
> > and
> > errors are inevitable. Will this be resolved by wider use of scanners?
> > At
> > the risk of sounding like a dinosaur, it would be a poor pathology
> > reporting
> > system that forced its users to compress and distort external reports.
> > What
> > about referral labs moving over to electronic transmission?
> >
> > All feedback appreciated!
> >
> > Norman Taylor
> >
> >
> >
> >
> > Norman F. Taylor
> > Clinical Scientist/Hon Lecturer
> >
> > Phone (Direct) 020 7346 3731
> > Fax 020 7737 7434
>
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