Julian Barth makes an important general point regarding the vetting of out of
hours requests. The laboratory must decide policy a priori regarding which tests
are to be accepted 'out of hours' so that MLSOs are not placed in the position
of 'arguing the toss' about what should be accepted in the middle of the night
when both parties may be tired and under stress. Such interchanges can lead to
frayed tempers and deterioration of relationships between the laboratory and
clinical staff.
Several years ago we introduced three 'Authorisation Levels' for out of hours
tests. Briefly this consists of Level 1 tests (basic emergency repertoire) all
orderable by junior medics; Level 2 (e.g. LFTs, CK etc) requires authorisation
by Consultant in charge of patient (contacted by the junior, whose word we
accept if the say they have agreed it) ; Level 3 (all tests not in 1 or 2,
including endocrine tests) must be authorised by Consultant Chemical Pathologist
or Clinical Scientist on call requested by the Consultant in charge. Using this
system for the past 4 years or so we have had no hassles and no significant
arguments. We thought we might have to use feedback to Consultants to keep Level
2 requesting 'honest' but this hasn't been necessary. Further details available
on request.
************************************
Home Address:
Dermot Neely
52 Albert St
Durham
DH1 4RJ Tel. 0191-384 6125
Work Address:
Dr R.D.G.Neely BSc MD FRCP FRCPath
Department of Clinical Biochemistry
Dryburn Hospital
North Road
Durham
DH1 5TW Tel. 0191-333 2440
Fax. 0191-333 2679
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|