The following information was updated in the Spectrum Health Laboratory Catalog.
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General Information
Compliance & Safety, General Information
Pathology Narratives Release Hold Removed for Weekends and Holidays
Effective July 1, 2021, Pathology and Radiology Result Narratives will no longer be held on weekends and holidays. All finalized result narratives will be released at 6 a.m. and 12 p.m. daily. This adjustment aligns with the 21st Century Cures Act and corresponding CMS mandate to allow data to flow freely and securely between providers, payers, and patients.
Of note, patients may be able to see results in MyChart prior to a provider seeing the results. Ordering providers should consider discussing potential outcomes with patients to prepare patients for results. Results should only be held if releasing the result puts the patient at risk of physical harm, or the patient requests the information not be shared.
More information related to the 21st Century Cures Act and established interoperability requirements can be found on the Information Governance Insite page (Internal). Contact Information Governance at InformationGovernance@spectrumhealth.org with any questions or use the Contact Us link above.
Blood Bank, Compliance & Safety, General Information, Hemostasis/Coagulation, Referral/Sendouts, Test Utilization
Coagulation Blue Top Tube Shortage
Update 9/1/2021:
September 1, 2021
There continues to be a global shortage of sodium citrate (“blue top”) blood collection tubes used for coagulation testing as a result of unprecedented demand, in part due to COVID-19 surges, vaccine and treatment development. This was anticipated to last through August 2021, but now, due to continued unprecedented demands, there is no end date in sight. Please take this into consideration when ordering coagulation testing (i.e. Protime, aPTT, Fibrinogen, D-dimer, Lupus Screens, Factor Assays, Mixing Studies, von Willebrand testing, etc.).
Chemistry, Compliance & Safety, General Information, Hematology, Hemostasis/Coagulation, Microbiology, Referral/Sendouts
CSF Priorities on QNS Specimens
When a Cerebrospinal fluid (CSF) specimen arrives into the laboratory and is deemed Quantity Not Sufficient (QNS) for ordered testing, the ordering provider is contacted to identify testing priorities. Occasionally, the laboratory is unable to secure these priorities.
If the lab is unable to secure priorities from the ordering provider within an hour of collection, the following will occur:
1. We will move forward with the Cell count with differential, Culture, and Protein/Glucose
2. The rest of the ordered testing will hold until we can clarify the priorities
Laboratory is partnering with Epic Beaker to discover if a prioritization of orders, upon CSF order entry, is possible.
If you have questions or concerns, please use the “Contact Us” link above.
If you are collecting COVID-19 swabs in your office or clinic, please order and collect using the saline swab kits (“liquid media” or “wet collection”) instead of the tube with no liquid media (“dry collection”).
• Liquid media swab kits will provide a faster turn-around time.
• Dry collection kits supplies are low.
Please refer to the COVID-19 PCR test in the Lab Catalog for the most up-to-date information on COVID-19 collection.
The 21st Century Cures Act and Office of the National Coordinator for Health Information Technology (ONC) Final Rule states that Spectrum Health cannot engage in practices that interfere with access, exchange, or use of electronic health information (EHI), otherwise known as Information Blocking, unless a specific Information Blocking exception applies.
Spectrum Health Regional Laboratory is committed to the safety of our patients, and the accuracy and quality of the testing we provide. In order to do that, we need your help to ensure that patient specimens adhere to our internal policies and quality checks.
THE DETAILS
To that end, we are asking for your help in the process of labeling specimens before they are sent to our laboratory. It is our policy at Spectrum Health Regional Laboratory that the routine labeling of laboratory specimens MUST INCLUDE FULL LEGAL NAME and DATE OF BIRTH, and if possible, additional identifiers such as medical record number, specimen number, etc. If this information is missing, incomplete or incorrect, the specimen is considered a mislabeled specimen, and will be canceled upon receipt. (The only exception to this is “precious specimens,” ex. cerebrospinal fluid or surgical specimens, which can sometimes be given an opportunity for relabeling after correct identification).
If a patient specimen is labeled with a NICKNAME instead of the FULL LEGAL NAME, this specimen would be considered a mislabeled specimen and have to follow the above process, which will delay patient care and/or employee eligibility to work.
EXAMPLES
| “Alli” Smith Unacceptable | Allison Lynn Smith Acceptable |
| “Johnny” D Parker Unacceptable | John David Parker Acceptable |
| “Dan” Stevens Unacceptable | Daniel Stevens III Acceptable |
WHAT WE NEED YOU TO DO
Please review this notice with your collecting/labeling staff as soon as possible to ensure proper labeling practices. Though not new, this policy has been reviewed by our team members in central specimen processing, and will be strictly adhered to going forward. Please feel free to forward this notice to anyone involved in the collecting or labeling of laboratory specimens that are sent to Spectrum Health.
Thank you for continuing to trust Spectrum Health Regional Laboratory for your testing needs, and thank you for partnership in attention and commitment to quality and safety!
For questions or concerns regarding this policy, please use the “Contact Us” link above.
RESOURCES
Spectrum Health Labeling Guide
The Joint Commission 2021 Patient Safety Goals
Clinical Laboratory Standards Institute
Spectrum Health Laboratory Policy #9955
Self-collected vaginal swabs may be used for testing as opposed to provider-collected swabs. Self-collected swabs are supported by current clinical guidelines as recent studies have shown their equivalence, if not superiority, in quality and their association with increased patient satisfaction.
NOTE: Self-collection must still take place in a healthcare setting and is not approved for at-home collection.