In message
<20030326103251.QULC9882.mta02-svc.ntlworld.com@[10.137.100.62]>, Craig
Webster <[log in to unmask]> writes
>I have been reading this debate with interest and it appears that despite all our
>efforts to produce good quality results, our end users of the service often want
>to "settle" for imperfect solutions in delivering the final product.
>
I had a good example of this today after being called to ITU to advise
on a patient with long standing hypercalcaemia. (Adjusted Calcium about
3.00). Despite many comments from the laboratory on our reports it
appears that they have just discovered it (though what they were doing
about all the raised ionised calcium results from their blood gas
analysers beats me). We have electronic requesting (ordering !) and the
results are sent back, comments and all, into the patient record. So
how did they miss our comments ?
Apparently they screen dump the front screen of results from the
hospital computer which does not have the comments on, (you have to go
to the detail page to get the full information ). So useful items like
sample haemolysed never get any further. It seems this wheeze was
discovered by the ward clerk who found it speeded up her getting the
results without bothering with all that text ! Although we identified
this as a risk several years ago, our Trust cannot afford to modify the
system to make the comments readable on the first page. We were one of
the laboratories who failed on this item in the recent survey of
authorisation and reporting just published in the Annals. On ITU it
appears that formal laboratory reports are filed without the information
passing through any grey matter. I had thought it superfluous to
telephone such obvious abnormalities but now I am not so sure !
Trevor
--
Trevor Gray
Dept. of Clinical Chemistry,
Northern General Hospital,
Sheffield S5 7AU
0114 271 4309
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