Client Response Center Reporting Procedures
During itís hours of operation (M-F, 7am-5:00pm), the Laboratory Client
Response Center calls heparin protocol results on PT and PTT tests.
Technical staff are responsible for all other times including holidays.
Reporting STAT Results
STAT results are available in one hour or less after receipt of the
specimen in the Lab (exceptions are STAT-in-the-(6)AM rounds, and tests
discussed in sections D.3. and D.4. below). Unless otherwise indicated,
all reporting of results is done electronically via the Clinical
Information System (eD-H). Non-critical results on STAT requests
will be reported in eD-H without phone notification. Units with
STAT printers also receive their results by printer report as results
are verified in the Laboratory. Any Critical result, (except
Dialysis BUN/Creatinines/Phosphorus, or recurrent Hematology criticals)
will be called. Coagulation results that fail Delta Check Limits
will also be called. All CODE BLUE and OR results will be called to
the designated phone or beeper number. Persons receiving
results will be asked to identify themselves and verify results by
reading them back. All critical, Code Blue, Trauma and O.R. laboratory
results must be called regardless of the ordering locationís printer
Each laboratory section determines its own critical value listing.
When laboratory staff verbally communicate results they should include
the following information:
- Caller name and lab section
The patientís full name
The patientís MRN
- Critical or Code Blue laboratory results
Laboratory staff should request this information to be read back to
them in order to verify accuracy. The date, time and person they gave
the results to should be recorded in the Laboratory Information System
Every effort should be made by laboratory staff to communicate critical
results to a person to ensure they are enacted upon ASAP. Leaving a
message on voice mail for an ordering provider indicating that critical
results are available on a patient should only be done when all efforts
to contact the provider or covering provider are exhausted. Voice
message should include the lab contact name, phone number, patient name,
MRN, and name of test(s).
Faxing STAT Results
The Laboratory will FAX results upon request according to the Laboratory
Faxing Policy. Some FAX requests may not be honored if patient
confidentiality can not be assured.
Specific STAT Tests
The following Chemistry tests are done immediately and all results are
entered into the LIS system within 10 minutes. If received from the OR, ED or a Code Blue patient or if there are critical values, all results will be called.
Arterial or Venous pH/Blood Gasses, and Cooximetry, including CO,
Whole Blood Ionized Calcium, Whole Blood Sodium/Potassium, Whole Blood Glucose and Whole Blood Lactate.
The following Laboratory tests are available STAT. A STAT request is
reported within 1 hour after receipt of the specimen in the Laboratory.
Many of the listed individual tests are also available as part of Test
||CBC (WBC, HCT, HGB, Platelets, Differentials)
|Transfusion Reaction Investigation
||Fecal lactoferrin (stool WBC)
|Cord Blood Specimen Examination
||Rapid Flu EIA
|Blood Component Preparation/Issue
||CSF and Body Fluid Cell Counts
||Group A Strep Antigen
||Coagulation Tests (PT, PTT, TT, Fibrinogen, D-Dimer)
|Ketones (as BOHB)
|Osmolality (Urine or Serum)
Microbiology analysis of malarial smear and mono available STAT from
7AM to 11PM only. Analysis of Acid Fast Smears is available within
24 hours in appropriate clinical settings.
All tests not listed in D.1. or D.2. above, usually have analysis times
greater than 1 hour. If ordered STAT, these specimens will be analyzed
on the next scheduled batch before any routine samples. Occasionally,
some tests can be done on an emergency basis when the turn-around-time
is too long for the clinical situation. These will require an
evaluation on a case by case basis and approval from a Pathologist
(or designated Professional Staff). Examples of Microbiology tests
requiring consultation are Cryptococcal Antigen (CRAG), virology stains,
FLU, EIA, and examples of Chemistry tests requiring consultation are
Volatile Testing (Methanol and Ethylene Glycol).
All laboratory results are available through the Clinical Information
System (eD-H) and the Cerner Information System upon verification.
Final Medical Record Hard copy reports are generated and posted in the
patientís chart daily.
Laboratory results are, by policy reported back to the ordering
providers, or other person(s) associated with the care being rendered
or their designee(s) in compliance with New Hampshire state laws and
Medical Center policies governing the release of medical information.
The laboratory does not report or release results directly to patients
except in rare circumstances when arrangements have been made and when
there is written authorization from the patientís ordering provider to
release such information.