We introduced what I thought was neat system for AE results whereby a dedicated monitor would display a filtered list of all AE blood requests with a flag to indicate if results were ready. This refreshed automatically a few times a minute to ensure it always up to date. Sadly we could not get around the issue of staff logging off the PC or closing the window to use another program, even though the PC was supposed to be a hidden unit!
Stuart
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Kay
Sent: 16 December 2015 19:27
To: [log in to unmask]
Subject: Re: Telephoning Cardiac Troponin results
One of the issues in finding the best processes for this communication is the degree of pushiness that is desirable from the information system. In addition to getting the reports into the patients' records it's worth considering some sort of rolling presentation with the following being considered:
* Orientation by clinical location rather than individual patient identity
* Reducing the need to log-in to see if there's anything new that needs to be acted on
* Escalation on failure to view (or even failure to act).
'Phone calls are inherently rather pushy as well being very expensive and not making it easy to check what happened. Automated feeds to printers in clinical areas are also rather pushy.
Any good description of pushy systems that anyone would like to share that don't have the disadvantages of those two media?
Jonathan
On 16 Dec 2015, at 18:37, Lou, Amy <[log in to unmask]> wrote:
> Hi,
>
> We call troponin T> 50ng/L (the first one within 14 days) to all physicians except for patients from Cardiac units.
>
> Cheers,
>
> Amy
> Amy Lou, M.D. Ph.D. FCACB
> Clinical Biochemist
> Division of Clinical Chemistry
> Department of Pathology and Laboratory Medicine Nova Scotia Health
> Authority Assistant Professor of Pathology, Medicine Dalhousie
> University Rm 617 Mackenzie Bldg, QEII Health Science Centre
> 5788 University Ave, Halifax, NS. B3H 1V8
> Ph: 902-473-1528
> Fax: 902-473-2123
> Email: [log in to unmask]
>
> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]] On Behalf Of Christine
> Collier
> Sent: Wednesday, December 16, 2015 2:04 PM
> To: [log in to unmask]
> Subject: Telephoning Cardiac Troponin results
>
> Hi there,
>
> We don't have critical values for our troponins.
>
> However, we have recently been asked by the emergency department to phone troponins over 100 ng/L. One reason was that with crowding the emergency department, physicians are often handling multiple patients, and no longer have a printed result being handed to them by a unit clerk who recognizes the importance of an abnormal troponin. Because no troponin value is "critical,"
> it does not even result in a red flag on the EDIS computer tracking screen.
> Moreover, chest pain patients may be in a hallway, or indeed still in the waiting rooms, when the troponin is resulted, sad but true.
>
> During the above request, it was mentioned that venous blood gas pO2's of < 35 mmHg were being flagged as critical and thus contributing to the alarm fatigue of red flags/phone calls. So we were able to remove these flags and address this issue.
>
> As we expect about 5 calls to be needed a day, we are doing a trial of calling Trops > 100 ng/L (the first one on a patient) to the emergency department only over the next few months.
>
>
> Cheers,
> Christine
>
>
> C. Collier, PhD FCACB,
> Clinical Chemistry,
> Kingston General Hospital,
> Ontario, Canada
>
> ------------------------------ Original Message
> ------------------------------
> Subject: Re: Telephoning Cardiac Troponin results
> From: "Andrew Lyon" <[log in to unmask]>
> Date: Wed, December 16, 2015 10:05 am
> To: [log in to unmask]
> ----------------------------------------------------------------------
> --------
>
> Our laboratories serve a network of three hospitals as well as a large volume of test requests for ambulatory community-based outpatients.
>
> We do not phone troponin results for patients in the hospitals (e.g. troponin tests are not on our critical test list).
> We have a few small number of troponin requests for community-based outpatients. If those troponin results are >50 ng/L, (presumably unexpected !) the results are phoned to the community-based physicians that ordered the test.
>
> regards, Andrew
>
>
> Dr. A. Lyon
> Saskatoon Health Region,
> Saskatoon, SK, Canada.
>
>
> ----- Original Message -----
> From: Bosomworth Mike (LEEDS TEACHING HOSPITALS NHS TRUST)
> <[log in to unmask]>
> To: [log in to unmask]
> Sent: Wed, 16 Dec 2015 03:52:46 -0700 (MST)
> Subject: Telephoning Cardiac Troponin results
>
> Dear All, I am being put under pressure to agree to telephone out all high cardiac troponin (cTn) results. Do other labs do this and if so at what level (please include your diagnostic cut off value for ACS if you do and you respond)? If we were to telephone out all raised TnI results i.e. those > 50 ng/L I calculate that it would take over 2 hours which is clearly not feasible, or at least not with existing resources. Thank you in anticipation of your help. With best wishes for Christmas and the New Year.
>
> Mike
>
> Dr Mike Bosomworth
> Clinical Service Lead for Blood Sciences and Specialist Laboratory
> MedicineConsultant Clinical Biochemist
>
> **********************************************************************
> **********************************************
>
>
> This message may contain confidential information. If you are not the
> intended recipient please inform the
>
> sender that you have received the message in error before deleting it.
>
> Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents:
>
> to do so is strictly prohibited and may be unlawful.
>
>
> Thank you for your co-operation.
>
>
> NHSmail is the secure email and directory service available for all
> NHS staff in England and Scotland
>
> NHSmail is approved for exchanging patient data and other sensitive
> information with NHSmail and GSi recipients
>
> NHSmail provides an email address for your career in the NHS and can
> be accessed anywhere
>
>
> **********************************************************************
> **********************************************
>
>
>
> ------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
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
>
> ------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
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
>
> ------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
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
------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
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
Barking, Havering & Redbridge University Hospitals NHS Trust: Working to make our hospitals better.
This communication, together with any files or attachments transmitted with
it contains information which is confidential and may be subject to legal
privilege and is intended solely for the use by the person(s) or entity to
whom it is addressed. If you are not the intended recipient you must not
copy, distribute, publish or take any action in reliance on it. If you have
received this communication in error, please notify
[log in to unmask] and delete it from your computer systems.
Barking, Havering & Redbridge University Hospitals NHS Trust reserves the
right to monitor all communications for lawful purposes. Receipt of this email
does not imply consent to use or provide this email address, or any others
contained therein, to any third party for any purposes. The contents of this
email are protected under international copyright law.
To save energy and paper please print this email only if you really need to.
_____________________________________________________________________________
This email has been scanned for viruses using antivirus software by
Barking, Havering & Redbridge University Hospitals NHS Trust. Whilst every
care is taken to avoid the transmission of virus code; please ensure that you
have up to date virus detection software before opening any E-mail
messages or attachments
______________________________________________________________________________
------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
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|