Wednesday, September 17, 2008

Understanding Laboratory Test

It is the laboratory scientist's responsibility to make a test choice clear for the physician. We can be expected to reasonably interpret an order that doesn't match a menu name (AST for SGOT, for example). Other times, a questionable order is a methodology choice. A simple telephone call to the provider, a pathologist or a reference laboratory can clarify ambiguity.

The FDA and the Institute for Safe Medication Practices (ISMP) recognize the error potential of ambiguous abbreviations. Their education focuses on medications, but it isn't a stretch to apply this to the laboratory. Reference laboratory test menus, in particular, can create a bewilderment of choice.

Less often, a test report isn't clear or is difficult to interpret. There are even those times when the provider hasn't ordered what he thought he ordered. As one small study published in a British biochemistry journal suggests, not all physicians are equally up to speed on laboratory tests. Junior doctors--similar to American interns--order a majority of laboratory tests, but nearly one in six admitted not being able to fully interpret the results.

How can laboratories help? A proactive approach can help make a laboratory, regardless of size, an approachable and responsive resource. A laboratory newsletter is an excellent way to let providers know what the laboratory offers. Reference materials such as specimen collection charts, media guides and directory of service booklets are invaluable for providers and office staff.

Much of this material can be on a hospital Web site, emailed or distributed on a CDROM. Test synonyms in computerized physician order entry (CPOE) systems are helpful. Finally, it's useful to periodically survey providers to make sure a particular service responds to their needs. As engaged professionals we can help improve patient care. We need to build partnerships that help providers understand laboratory test menus and reports.

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