We have live dashboards available for clinical areas to show progress/status of urgent samples through lab - clinicians (when they can be bothered to look at them ! again, probably the drawback )can see if sample has arrived, and if any/all results available - alss useful in lab area as prompt to keep to <60 mins!
dj
-----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/
This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail in error and delete this e-mail from your system. If you are not the intended recipient you are notified that disclosing, copying, distributing or taking any action in reliance on the contents of this information is strictly prohibited.
------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/
|
