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The Essence: The Best of September 2019

By Anne-Margaret Olsson posted 10-07-2019 15:48


Last month on the Artery, several solutions were found to questions ranging from “when should a lab perform ioPTH measurements?” to “who should collect sweat chloride specimens?” Read on for our editor’s picks of the best discussions on the Artery in September.

How Late Does Your Laboratory Offer ioPTH Measurements?

Initiated by @Joe Wiencek, PhD

The majority of respondents say their labs don’t restrict when they perform intraoperative PTH, but that almost all requests they receive come in during the day shift. One respondent added that his lab is informed about ioPTH testing the day before, while another respondent said her lab has access to the surgery schedule. A couple respondents also elaborated that at their institutes, ioPTH specimens are hand-carried directly to the chemistry lab and processed STAT with a 23-30 minute TAT.

Who Collects Sweat Chloride Specimens at Your Facilities?
Initiated by @Seetharam Chittiprol, PhD, ASCP, DABCC, NRCC

The original poster’s lab uses specially-trained lab assistants, but due to high staff turnaround, they can’t keep up with training new staff and their Quantity Not Sufficient rates are too high. They are therefore thinking of switching to using nurses or respiratory therapists and want to know what is standard at other institutes. 9 respondents also use lab staff, 6 use phlebotomists, 4 use nurses, and 2 use respiratory therapists. Most respondents also use a small group of collectors, since this makes it easier to maintain their competency.

Medical Director’s Name on Patient Reports/EPIC?
Initiated by @Seetharam Chittiprol, PhD, ASCP, DABCC, NRCC

After witnessing a regulatory agency cite a lab for not listing their medical director’s name as part of a patient report, an Arterian is now wondering if other labs indicate the lab medical director name on patient reports/EPIC. Respondents say that CLIA, CAP, and the Joint Commission don’t require the medical director name to be on a patient report. However, labs should still check their state regulations, because some states such as Massachusetts and California require this by law.

Curbing Inappropriate Utilization With Clinical Consults
Initiated by @Charles Beavers, MD

The providers in a large health network tend to have difficulty figuring out who to contact for test guidance, so the network’s lab is looking for a way to make it easier for providers to order a formal lab consult. One respondent suggested monitoring send out tests and initiating consults whenever a red flag pops up (rather than expecting providers to initiate). Another respondent shared a study detailing the creation of a test consultation tool that providers can access in the electronic health record system—which the original poster says is very close to what he was envisioning for his own lab.