Starting November 29th, 2022, Corewell Health West, Hematology Laboratories will begin reporting absolute counts for white blood cell (WBC) manual differentials, in addition to relative (percentage) counts. The WBC differential count determines the number of each type of white blood cell present in the blood. It can be expressed as a percentage or as an absolute value. Of these, the absolute value is much more important than the relative value, given that clinically relevant WBC elevations and declines are defined by their absolute numbers, not by their relative proportions, and there is potential for error if this conversion is performed outside the laboratory.
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Pediatrics
Effective November 21, 2022, the following changes will be made to Meconium Drug Testing (LAB479).
- The cutoff for positivity for the opiate drug class (codeine, morphine, hydrocodone, hydromorphone, oxycodone, and oxymorphone) will increase to 20 ng/g from 10 ng/g.
- The format of reporting will be updated to include discrete reporting fields for all tested analytes. Positive results will no longer be denoted via comments.
Effective immediately, the following Regional Hospital Laboratories have the 4-Plex (COVID-19, Influenza A, Influenza B, RSV) test available for ordering and testing:
- Big Rapids Hospital Laboratory
- Blodgett Hospital Laboratory
- Gerber Hospital Laboratory
- Ludington Hospital Laboratory
- Pennock Hospital Laboratory
- Reed City Hospital Laboratory
- United/Greenville Hospital Laboratory
- Zeeland Hospital Laboratory
At the beginning of the COVID-19 pandemic Spectrum Health Laboratory implemented a protocol to call providers and patients to notify of positive COVID-19 PCR testing. The pandemic has shifted to an endemic phase and a positive COVID-19 test is no longer considered a critical value. Effective Friday, August 26, 2022, Spectrum Health Laboratory will no longer call positive COVID-19 PCR testing, for inpatient or outpatient specimens.
Results for COVID-19 PCR will still file to the patient’s chart in Epic and reported to the ordering provider through usual means of receiving results (fax or electronic) and to the Michigan Department of Health and Human Services (MDHHS). Patient’s will still be notified via their MyChart as well.
If you have any questions or concerns, please use the “contact us” link above.
After consultation with our clinical partners, Spectrum Health West Michigan Laboratory will be adjusting the pediatric reference ranges for our new ALT and AST reagents in an effort to better serve our population. Numerous academic studies were reviewed, and the values listed below were adopted on August 3, 2022:
The Enteric Pathogens PCR test performed by Spectrum Health Laboratory may be used to detect common pathogenic bacteria and viruses in stool collected from individuals with symptoms of gastrointestinal infection. Specifically, this test detects Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Norovirus, Rotavirus, and the Shiga toxin virulence factor. Effective August 17, 2022, Spectrum Health’s Epic EMR will contain new ask-at-order questions to help improve the clinical decision support and appropriate utilization of this testing.
As of July 19, 2022, in alignment with recommendations from the Center for Disease Control and Prevention (CDC) the reference range for blood lead testing has been updated from 5 mcg/dL to 3.5 mcg/dL.
This applies to both: Lead, Blood Level [LAB98] and Lead Screen Filter Paper [LAB2111119].
In addition, at this time the low end of reporting for Lead Screen Filter Paper [LAB2111119] has increased from 1 mcg/dL to 2 mcg/dL.
Compliance & Safety, Education & Training, Microbiology
Update: Swabs for Cultures without a Source and Order
Effective May 9th, 2022, Spectrum Health Laboratory’s Microbiology Department will no longer be preemptively setting up cultures on swabs without a source and order, when received on Thursdays through Sundays and Holidays. Note: The specimen will still be held, but cultures will not be set up in anticipation of the order.
Advanced Technology Laboratory, Cytogenetics
Discontinuation of Low-Volume and Individual Fluorescence in situ Hybridization (FISH) Probes
Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the following FISH tests will no longer be offered:
• Prader-Willi/Angelman (15q11-q13) by FISH
Recommended test is Angelman/Prader-Willi mPCR
• Smith Magenis (17p11) by FISH
If need arises for this test, please place an order for a Send out Genetics Miscellaneous and enter requested test in the comments. The testing will be sent out through Spectrum Health.
Any questions about referral testing may be directed to the Referral Department. Any questions or concerns regarding these changes may be directed to Dr. Salah Ebrahim in the Cytogenetics Laboratory.