What determines where one sends a sample to for an assay that one's lab doesn't
carry out?
1. The lab consultant used to work there? (is this similar to the clinician
having worked at a previous hospital?)
2. It's just down the road, so you can use a van rather than the expense of
a courier.
3. There are 100 different assay types which you 'send away' for (more than
you perform in the DGH lab) and you don't want to send samples all over the
UK to 100 different labs. So you compromise and try and reduce the number of
labs you use. Surely we do a similar kind of thing with the assays we perform
in our own labs. No one immunoassay analyser has the 'perfect' performance for
all the assays we want. So we have to compromise - unless we can afford lots
of different machines!
4. Lab X is cheaper than lab Y (?!)
5. Only lab Z does the test so you have no choice, even if the turn around time
is long or the report format is difficult.
Sometimes it's useful to chat with the clinician about the send away service
so that they have input. After all, they are the one having to treat the patient!
It's not that the result may be any different but for some of the more complicated
tests the way the data is presented ie the comments/interpretation of the results
may be very different depending on the lab issuing the report.
Rob
>I don't feel that clinicians should instruct the laboratory where to send
>tests unless the test is extremely esoteric and a very good reaon is given.
>The clinicians should trust their laboratory to provide the best service. If
>we take it to extremes, we will find doctors refusing to believe results
>done on a daimler analyser as opposed to a rolls royce - this is plainly
>untenable !
>With best wishes
>
>Richard
>
>
>-----Original Message-----
>From: [log in to unmask] [mailto:[log in to unmask]]
>Sent: Wednesday, March 06, 2002 15:37
>To: [log in to unmask]
>Subject: Re: SAS reports
>
>
>Not always true. There are some clinicians who like to know that a 'send
>away
>test' was analysed at a specific hospital. They may have trained at that
>hospital
>and like to make sure that the lab sends the sample to the lab of their
>choice....:~)
>
>
>Rob
>
>
>>I agree, it is utterly irrelevant to the result user whether the value for
>serum rhubarb came from London or Mars. It is reasonable to expect the lab
>to
>record where the result came from in the event of litigation later [so they
>know who to pass the writ to ;-) but the clinican-on-the-street doesn't
>care
>whether the analyser is a L100,000 mchine sitting i=n his local lab or a
>postman
>on a bike, provided the result gets there eventually...
>>
>>TIM
>>
>>**********************************************
>>Prof. Tim Reynolds,
>>Clinical Chemistry Department,
>>Queens Hospital,
>>Belvedere Rd.,
>>Burton-on-Trent,
>>STAFFORDSHIRE,
>>DE13 0RB,
>>UK.
>>tel: 01283 511511 ext. 4035
>>fax: 01283 593064
>>email: tim.reynolds@queens,burtonh-tr.wmids.nhs.uk
>>alternative email for the all too frequent occasions when the NHS email
>connection
>doesn't work:
>>[log in to unmask]
>>
>>
>>-----Original Message-----
>>From: p=NHS NATIONAL
>>INT;a=NHS;c=GB;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
>>Sent: 05 March 2002 18:53
>>To: p=NHS NATIONAL
>>INT;a=NHS;c=GB;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
>>Subject: Re: SAS reports
>>
>>
>>The practice at Lewisham is very similar to that done by Louise
>>Tilbrook. No comments from clinicians who may not be aware what work is
>>referred elsewhere. We have the destination laboratory as part of the
>>tests definition in the LIMS but do not report it at present. For the
>>record I think that it is an irrelevance to include it on reports.
>>The data is documented both in the test definition and the date sent,
>>destination and date results received is recorded in other fields in the
>>system. If CPA require it we shall have to find a way of doing it both
>>on paper which should be simple but ?? how to do it electronically to
>>the ward database, which does not have a field for this data, and GPs
>>who also probably would not have a place or wish to record the
>>additional data?
>>
>>Paul Eldridge
>>Biochemist
>>Lewisham Hospital
>>London SE13
>>
>>
>>>>> Louise Tilbrook <[log in to unmask]> 03/05 2:33
>>pm >>>
>>There is a long running discussion here regarding reports on work we
>>have referred elsewhere. At present we manually enter the results in our
>>system along with any comments, and store the original report. (Complex
>>assays such as lymphocyte subsets we send a copy of the report to the
>>requesting clinician).
>>One clinician in particular is anxious that as well as doing this, we
>>should send out copies of all reports of referred work, to all
>>clinicians.
>>
>>I would be interested to hear what other centres are currently doing.
>>Thanks in advance
>>
>>Louise Tilbrook
>>
>>Louise Tilbrook
>>Principal Clinical Scientist
>>Pathology Department
>>Princess Alexandra Hospital
>>Hamstel Rd
>>Harlow
>>Essex
>>CM20 1QX
>>Tel: 01279 827034
>>Fax: 01279 416846
>>[log in to unmask]
>>
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>
>Dr Robert Lord
>Department of Clinical Biochemistry
>Rotherham District General Hospital
>Moorgate Road
>Oakwood
>Rotherham
>S60 2UD
>
>Tel 01709 820000
>
>E mail [log in to unmask]
>
>------ACB discussion List Information--------
>This is an open discussion list for the academic and clinical
>community working in clinical biochemistry.
>Please note, archived messages are public and can be viewed
>via the internet. Views expressed are those of the individual and
>they are responsible for all message content.
>
>ACB Web Site
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>
Dr Robert Lord
Department of Clinical Biochemistry
Rotherham District General Hospital
Moorgate Road
Oakwood
Rotherham
S60 2UD
Tel 01709 820000
E mail [log in to unmask]
------ACB discussion List Information--------
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community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
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