The Spectrum Health Lab Coagulation Department has the following changes that will be occurring on 1/12/21 as a result of new instrumentation:
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Laboratory Services
Effective December 9, 2020, the following insect allergen components will be available:
◊ Allergen Honey Bee Component Panel – EPIC #LAB1230747, Interface #1230747, CPT 86008
◊ Allergen Common Wasp (Yellow Jacket) Component Panel – EPIC #LAB1230752, Interface #1230752, CPT 86008
◊ Allergen Paper Wasp Component rPol d 5 – EPIC #LAB1230754, Interface #1230754, CPT 86008
◊ Cross-reactive Carbohydrate Determinant (CCD) – EPIC #LAB1230755, Interface #1230755, CPT 86008
To maintain optimal specimen integrity, Spectrum Health Laboratory requests that you load your outdoor lock box properly for winter weather temperatures. Please follow the diagram on the right to prevent freezing of specimens.
Frozen specimen should never be left in the lock box for after-hours pickup. These tests may be better preserved in the office freezer until the next day’s courier pickup.
Request for specimen pickup should be made to the Laboratory Call Center at 616.774.7721.
Effective immediately there has been an update to scheduling breath testing. Both the Bacterial Overgrowth and Lactose Intolerance breath tests must be scheduled through Epic or via Spectrum Health MyChart app.
Compliance & Safety, General Information, Immunochemistry, Main lab
Serum Kappa/Lambda Free Light Chain Assay Update
Effective September 28th, 2020, a new generation of the serum kappa/lambda free light chain assay has been implemented.
With the implementation of the new generation of the assay there is an approximately 20% negative bias for kappa free light chains in serum containing >20 mg/dL kappa free light chain. This may affect the trending for patient who are serially monitored by this assay.
As of August 26, 2020, the following tests will be obsoleted or made as lab orderables only. This was implemented to streamline protein electrophoresis orders and ensure that patients receive the recommended testing for the assessment of plasma cell proliferative diseases.
In addition to streamlining protein electrophoresis orders, order questions have been implemented to the available tests to access the reason for ordering to ensure that the proper reflex testing is applied.
For more information, see the lab test directory under the available tests for a protein electrophoresis orders tip sheet entitled “Orders- Protein Orderable Changes”
Leaky specimen containers may cause compromised test results and it is also a hazard to lab couriers and registration personnel. Leaky specimen containers are not acceptable and may be rejected.
In order to prevent leaky containers, please be sure to:
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Pay close attention to the lid, making sure the screw-cap lids are fastened evenly and securely, with the threads aligned. If a patient has challenges with tightening the lid, please have them notify lab staff when they return to drop off their container.
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Containers should be upright at all times, with lid on the top during transport. If container is placed in a biohazard bag, please maintain in the upright position by gripping the cup or the handle and not by the top of the bag.
The Laboratory provides a brochure “Laboratory Specimen Home Collection” for patient collection instructions. Internal offices (i.e. SHMG) may order these from Document Services using the order number X17776 (X19611 for the Spanish version). External offices may order these from Laboratory Courier Services using the Supply Order Form.
Beginning September 8, at approximately 2PM, Spectrum Health Laboratories will go live with their new lot of APTT reagent. This lot change triggered a new therapeutic curve resulting in new heparin nomograms for the system. The standard heparin therapeutic range will change from the current 45-65 seconds to a new range of 37-52 seconds based off the new curve. Reference ranges for the APTT assay will also be updated. Grand Rapids APTT reference range will be 21-27 seconds and the Regional Hospitals will be 21-31 seconds.
APTT specimens that are unable to reach an endpoint (no clot is detected), will reflex to the Unfractionated Heparin (UFH) (Test Code LAB3389) anti-Xa assay. To accommodate this change, UFH values have been added to heparin nomograms. The UFH anti-Xa assay is currently only performed in the Grand Rapids labs and valid only for unfractionated heparin. Any questions concerning these changes may be directed to the Spectrum Health Regional Laboratory Coagulation department at 616-267-2740.
Test manufacturer supply chains continue to be disrupted due to COVID-19. Currently, there is a shortage of supplies for the Group B Streptococcus PCR test. Orders for this PCR test may continue to be placed, however, the SHRL Microbiology Department will perform a culture method until PCR supplies are available with appropriate charging and a reporting comment indicating that the culture was performed. The PCR test is normally resulted within 24-48 hours of specimen receipt in lab, whereas the culture method turnaround time may be 48-72 hours. An update will be posted when these PCR supplies are received, however, there may continue to be intermittent supply issues for this test. Additional test information can be found here.
Advanced Technology Laboratory, Compliance & Safety, Education & Training, General Information, Main lab, Microbiology, Molecular Diagnostics, Test Utilization
REMINDER: Herpes Simplex Virus (HSV) PCR and HSV Culture Orders
As of January 13, 2020, the Spectrum Health Microbiology Laboratory will switch any viral culture orders placed on cutaneous or mucocutaneous lesion specimens to molecular PCR testing as the preferred diagnostic method.
Please refer to these documents for specimen collection information and appropriate ordering codes: