ENOUGH OF THESE HYPOTHETICALS - real here and now case
GP sample from 08:10 this morning
32 year old female
request has no pt address or even postcode
clin det : c/o pain in throat, D&V, previous underactive thyroid
SNA 122 SK 6.1 SU 10.9 SCRE 136 TSH 0.02
FT4 14.9 FT3 8.91
I took executive action to do cortisol COR <50
Telephoned GP "thursday half day"
that would not have got permission to do cortisol
telephoned cover service "don't know patient"
that would not have got permission to do cortisol either
Full information given to emergency service - prompt action
with best wishes
Richard
Richard Mainwaring-Burton
Consultant Biochemist
Queen Mary's Hospital
Sidcup, Kent
DA14 6LT
020-8308-3084
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: 22 April 2004 15:42
To: [log in to unmask]
Subject: Add on tests /interpretive comments/
Is part of the problem that we are all trying to make allowance for poor IT
systems? Looking at results gives different information, which if one had a
more useful user friendly IT system might be made a lot easier by allowing
us to choose what should be looked at. Ward ordering is supposed to be the
way forward, so why are summarised clinical details not downloaded with the
request?
All analytes are not the same. For example, I would suggest that for core
Biochemistry adding interpretive comments is a waste of time, unless you are
looking to see which team seem to be overordering, sending you aged samples,
requesting unusual combinations - many of which would alert one to talk to
the team, but would not justify delaying the reporting of the U/E etc.
However, adding comments to endocrinology, toxicology and tumour markers can
be worthwhile. How else would we pick up trends of inappropriate requesting,
treatment reflecting misinterpretation of results etc. However, again a good
IT sytem is required which shows the interretive comment, in a way that is
easy to enter and to read. I never thought I would be saying that Labstar
was superior to APEX (the newer system) for this.I believe if General
Practitioners and others will give the clinical details, if they know
someone is reading them, and who will comment on the report or phone them.
Likewise it is only by looking at Troponin results that you identify the
teams who take samples at the time of chest pain only.
____________________________________________________________
Dr. Helen Grimes, Dept. of Clinical Biochemistry, UCH, Galway, Ireland
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------ACB discussion List Information--------
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community working in clinical biochemistry.
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