S02 ATTACHMENT D.15 - LAB_INFORMATION_MANAGEMENT_5_VISTA_CLINICAL_PATHOLOGY.pdf

Lab Information Management 5 VistA ADP Basic VistA Operations for Clinical Pathology

Copy of version 2.0 (approved and current)

Last Approval or Periodic Review Completed

2/27/2023

Next Periodic Review Needed On or Before

2/27/2025

Effective Date 2/27/2023

Controlled Copy ID 26038

Location No Physical Location

Organization Veterans Health System of the Ozarks

Comments for version 2.0 Combined procedures. Revised and changed font to comply with Media Lab.

Approval and Periodic Review Signatures

Type Description Date Version Performed By Notes

Approval Lab Director 2/28/2023 2.0 Constantine Theoharis

Approval Lab Director 2/27/2023 2.0 Constantine Theoharis

Approval Review 2/17/2023 2.0 Jenifer Welsch

Approval Lab Director 6/20/2022 1.0 Constantine Theoharis

Periodic review

Designated Review er

3/10/2022 1.0 Patricia Gregg

Periodic review

Designated Review er

2/28/2022 1.0 Jennifer Horton Recorded w hen document added to MediaLab

Approval Lab Director 3/25/2016 1.0 Dr. R Levy Recorded w hen document added to MediaLab

Approvals and periodic reviews that occured before this document was added to the MediaLab Document Control system may not be listed.

Version History

Version Status Type Date Added Date Effective Date Retired

2.0 Approved and Current Major revision 2/16/2023 2/27/2023 Indefinite

1.0 Retired First version in Document Control 2/28/2022 3/25/2016 2/27/2023

Basic VistA Operations for Clinical Pathology

Table of Contents

PURPOSE

SCOPE

PROCEDURE

VERIFYING RESULTS ANALYZED ON AN INTERFACED INSTRUMENT

ENTERING/VERIFYING DATA MANUALLY

RESULTING AN ACCESSION NUMBER WITH MULTIPLE PERFORMING LABORATORIES

ADD TESTS TO A GIVEN ACCESSION

LAB ADD TEST(S) TO AN EXISTING ORDER

DELETE TESTS FROM AN ACCESSION

REMOVE AN ACCESSION

ORDER/TEST STATUS

REVIEW BY ORDER NUMBER

LIST OF LAB ORDERS NOT COLLECTED

BUILD AND PRINT A LOAD/WORK LIST

INCOMPLETE STATUS TEST REPORT

LONG FORM ACCESSION LIST

WORK SHEET ACCESSION LIST

SPECIAL REPORTS

Approved and current. Effective starting 2/27/2023. Lab Information Management 5 VistA ADP (version 2.0) Basic VistA Operations for Clinical Pathology

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PURPOSE

The purpose of this procedure is to describe the process for performing basic VistA functions in clinical pathology. Refer to department-specific procedures for additional functions. Refer to anatomic pathology procedures for anatomic pathology functions. This procedure includes:

Verifying results analyzed on an interfaced instrument Manually entering and modifying results Add and delete tests from an accession Build and print a Load/Work List View Order/Test Status Review Test by Order Number Generate a List of Lab Orders Not Collected Generate an Incomplete Status Test Report Generate a Long Form Accession List Generate a Work Sheet Accession List Special reports

SCOPE

This procedure applies to Medical Technologists assigned to Clinical Pathology.

PROCEDURE

VERIFYING RESULTS ANALYZED ON AN INTERFACED INSTRUMENT

1. Data is transmitted from the instrument through the Data Innovations Instrument Manager (DIIM) to the VistA computer system. VistA is prompted by the load list sequence number.

2. Utilizing the Enter/Verify data (auto instrument) [LRVR] option to verify electronically transmitted data, data from a load list can be reviewed/edited individually by the sequence defined in the load list. If the LRVERIFY key is owned, the data may also be verified. Once verified, the data is not available for viewing with this option.

A. Select Lab Tech Menu Option: Process Data in Lab (Local)

B. Select Process Data in Lab (Local) Option: EA Enter/verify data (auto instrument)

C. Select LOAD/WORK LIST NAME: Enter the Load/Work List name (i.e., BECKMAN, COULTER, COAG, URINALYSIS, etc.)

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D. Select Performing Laboratory: FAYETTEVILLE AR//It is very important to enter the correct performing laboratory here.

E. Select PROFILE: This field may not always be displayed, but if it is, enter the LOAD/WORK LIST PROFILE (i.e., CHEMISTRY, STAGO, etc.)

F. Work Load Area: BECKMAN//Press enter to select the default Work Load Area or enter a new one. This prompt references the electronic “Work Load Recording/Reporting System” or LMIP WKLD. It is important that the correct Work Load or LOAD/WORK LIST is entered here so that the lab area doing the work is properly credited.

G. Would you like to see the list? No//Press Enter to select the default or select Y to see the list. If you select “YES” all of the tests in the LOAD/WORK List profile will be displayed.

H. Do you wish to modify the test list (i.e., would you like to add or subtract ATOMIC tests? Enter Yes or No: No//Press Enter to choose the default.

I. You have selected ## tests to work with.

J. Do you want to review the data before and after you edit? Yes//Press enter to choose the default.

K. Select one of the following:

1. Accession Number

2. Unique Identifier (UID)

L. Verify by 1//Press Enter to choose the default of Accession Number or select 2 to enter results by UID.

M. Accession Date: TODAY//Select date, or press Enter for TODAY

N. Accession NUMBER: 9//(The smallest working number from the date selected that has not been verified will be the default prompt) Press Enter to select the default number or enter the desired number and press Enter.

O. The computer will list the patient’s name, SSN, order, and specimen information. Be sure to check the validity of all patient information.

P. If the data from the automated instrument has reached the VistA computer system, all test results will be displayed. Review all results for accuracy. If any delta checks

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Q. If data from the automated instrument is not displayed, first exit using “Shift 6” (^).

Wait a few minutes and then try reentering the accession number. The following prompt will be displayed if data from the automated instrument has not reached VistA and manual data entry may be needed:

“What tray:” Press Enter

Enter manually? Yes//Press Enter

The computer will not display each test one by one allowing manual entry of results.

On occasion, the computer will not allow entry of decimal points carried to more than one or two places. If this occurs, round off to the next decimal or whole number.

R. Select COMMENT: Enter any department-specific comments. This is also where you enter comments for calling a critical value.

S. The Order information, accession information, and test results are again displayed for review. Always double check any results entered manually!

T. SELECT (‘E’ TO EDIT, ‘C’ FOR COMMENTS, ‘W’ WORKLOAD). Select E, C, or W to edit results. Or select enter to verify.

U. Approve for release by entering your initials: Double check all data (patient name, SSN, results, etc.). If all data is correct, the person doing the verifying enters their initials. If the report is not being verified, enter “Shift 6” (^) and these results will not be reported. Only verified results are reported. If anything else is entered, the following prompt will be displayed two time:

Approve for release by entering your initials:

Pease enter your correct initials Approve for release by entering your initials:

Nothing verified!

V. The next accession number will appear. If you wish to continue, enter the appropriate accession number. If you do not wish to continue, type “Shift 6” (

Select Process data in lab menu Option: ^EA Enter/verify data (auto instrument)

Select LOAD/WORK LIST NAME: COULTER

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Select Performing Laboratory: FAYETTEVILLE AR VAMC// AR VAMC 564

Work Load Area: COULTER// Would you like to see the test list? No// NO

Do you wish to modify the test list? NO// You have selected 55 tests to work with.

Do you want to review the data before and after you edit? YES//

Select one of the following:

1 Accession Number 2 Unique Identifier (UID)

Verify by: 1// Accession Number Accession Date: TODAY// (FEB 15, 2023) Accession NUMBER: 9// 79

ZZTEST,DANNY D 000-00-1961

ORDER #: 549823

Seq #: 50 Accession: HE 0215 79 Results received: Feb 15, 2023@09:01 UID: 1230460079 Last updated: Feb 15, 2023@09:03

Sample: BLOOD Specimen: BLOOD

ZZTEST,DANNY D SSN: 000-00-1961 LOC: FAVNON

Pat Info: Sex: MALE Age: 62yr as of Feb 15, 2023 Provider: THEOHARIS,CONSTANTINE Voice pager:

Phone: 65270 Digital pager:

ACCESSION: HE 0215 79 [1230460079]

CBC 2/15 08:54d WBC (FV) 6.7 K/cmm RBC (FV) 3.30 L M/cmm HGB (FV) 13.0 g/dL

HCT (FV) 36.3 L %

MCV (FV) 110.0 H fL MCH (FV) 39.4 H pg MCHC (FV) 35.8 g/dL

RDW (FV) 14.6 H %

PLT (FV) 195 K/cmm

MPV (FV)

NE% (FV) 63.8 %

LY% (FV) 28.7 %

MO% (FV) 4.3 %

EO% (FV) 2.1 %

BA% (FV) 1.1 %

NE# (FV) 4.2 K/cmm

PRESS ANY KEY TO CONTINUE, '^' TO STOP

LY# (FV) 1.9 K/cmm MO# (FV) 0.3 K/cmm EO# (FV) 0.1 K/cmm BA# (FV) 0.1 K/cmm

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SELECT ('E' to Edit, 'C' for Comments, 'W' Workload):

Approve for release by entering your initials: ARB

Accession NUMBER: 80//

3. To modify the data before verification, you can use the same methods used to enter the data originally. Any of the following options may be used:

Enter/Verify/Modify data (manual) Enter/Verify data (Load list) Enter/Verify data (Worklist) Enter/Verify data (Auto Instrument)

ENTERING/VERIFYING DATA MANUALLY

1. This option is used to enter results for analytes not tested on an interfaced instrument.

This option can also be used to modify (edit) results that have already been verified.

2. Use the option ^EM (Enter/verify/modify data (manual).

Select Process Data In Lab (Local) Option: EM Enter/verify/modify data (manual)

Do you want to review the data before and after you edit? YES// Do you wish to see all previously verified results? NO//

Select one of the following:

1 Accession Number 2 Unique Identifier (UID)

Verify by: 1// 2 Unique Identifier (UID)

Unique Identifier: 1160890002 (CH 0329 2) Select Performing Laboratory: FAYETTEVILLE AR// AR VAMC 564

Work Load Area: BECKMAN

ZZZTEST,TEST TEST 709-12-0155P LOC:LABF

Sample: BLOOD Specimen: SERUM

1 GLUCOSE (FV)

ZZZTEST,TEST TEST SSN: 709-12-0155P LOC: LABF

Pat Info: Sex: FEMALE Age: 60yr as of Mar 29, 2016 Provider: THEOHARIS, CONSTANTINE Voice pager: 585 Phone: 479-443-4301 (65270) Digital pager:

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ACCESSION: CH 0329 1 CH 0329 2 [1160890002]

3/29 10:18d 3/29 10:22d *** Comments for Previous Accession CH 0329 1 *** COMMENTS: For eGFR: Race unknown, if African American multiply result by 1.210 COMMENTS: GLUCOSE (FV) reported incorrectly as 126 by [1451-VA564].

COMMENTS: Changed to 162 on Mar 29, 2016@10:19 by [1451-VA564].

GLUCOSE (FV) //162

Select COMMENT:

ZZZTEST,TEST TEST SSN: 709-12-0155P LOC: LABF

Pat Info: Sex: FEMALE Age: 60yr as of Mar 29, 2016 Provider: THEOHARIS, CONSTANTINE Voice pager: 585 Phone: 479-443-4301 (65270) Digital pager:

ACCESSION: CH 0329 1 CH 0329 2 [1160890002]

3/29 10:18d 3/29 10:22d GLUCOSE (FV) 162 162 H mg/dL *** Comments for Previous Accession CH 0329 1 *** COMMENTS: For eGFR: Race unknown, if African American multiply result by 1.210 COMMENTS: GLUCOSE (FV) reported incorrectly as 126 by [1451-VA564].

COMMENTS: Changed to 162 on Mar 29, 2016@10:19 by [1451-VA564].

SELECT ('E' to Edit, 'C' for Comments, 'W' Workload):

Approve for release by entering your initials: SFB

LAST IN WORK LIST

3. If the result was previously verified, VistA will automatically enter a comment that the appropriate test was incorrectly reported, who entered the incorrect result, what the results were changed to, the date time results were edited, and the tech who did the editing.

A. Laboratory personnel are coded by DUZ number.

B. The laboratory ADPAC has the ability to look-up individuals by their DUZ number.

Example:

COMMENTS: GLUCOSE (FV) reported incorrectly as 209 by [1451-VA564].

COMMENTS: Changed to 205 on Mar 23, 2016@14:48 by [1451-VA564].

RESULTING AN ACCESSION NUMBER WITH MULTIPLE PERFORMING LABORATORIES

1. Occasionally an accession number will contain tests that have different performing laboratories. It is important to make sure each test is verified using the appropriate

Approved and current. Effective starting 2/27/2023. Lab Information Management 5 VistA ADP (version 2.0) Basic VistA Operations

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2. To result the in-house test:

Select Process Data In Lab (Local) Option: EM Enter/verify/modify data (manual)

Do you want to review the data before and after you edit? YES// <Enter> Do you wish to see all previously verified results? NO// <Enter>

Select one of the following:

1 Accession Number 2 Unique Identifier (UID)

Verify by: 1// <Enter to select 1 or enter 2> Accession Number Select Accession: CH 1 <Enter Accession Number or UID>

CHEMISTRY (MAR 21, 2016) 1

Select Performing Laboratory: FAYETTEVILLE AR//<For in-house test enter>

Work Load Area: <Enter the correct Work Load Area> MISC. CHEMISTRY

ZZZTEST,TEST TEST 709-12-0155P LOC:LABF

Sample: PLEURAL Specimen: PLEURAL FLUID

1 PH (BODY FLUID)

2 GLUCOSE (FV)

3 LDH (FV)

4 TOTAL PROTEIN (FV)

TEST #(s) (or "ALL"): <Select ONLY the test to be resulted> 1

ZZZTEST,TEST TEST SSN: 709-12-0155P LOC: LABF

Pat Info: Sex: FEMALE Age: 60yr as of Mar 21, 2016 Provider: LEVY,ROBERT M Voice pager: 585 Phone: 479-443-4301 (65270) Digital pager:

ACCESSION: CH 0321 1 [1160810001]

3/21 09:01d COMMENTS: ~For Test: GLUCOSE

COMMENTS: ~TESTING PERFORMING LAB

PH (BODY FLUID) //7.835

Select COMMENT: ~TESTING PERFORMING LAB // COMMENT: ~TESTING PERFORMING LAB Replace Select COMMENT:

ZZZTEST,TEST TEST SSN: 709-12-0155P LOC: LABF

Pat Info: Sex: FEMALE Age: 60yr as of Mar 21, 2016 Provider: LEVY,ROBERT M Voice pager: 585

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Phone: 479-443-4301 (65270) Digital pager:

ACCESSION: CH 0321 1 [1160810001]

3/21 09:01d PH (BODY FLUID) 7.835 pH units COMMENTS: ~For Test: GLUCOSE

COMMENTS: ~TESTING PERFORMING LAB

SELECT ('E' to Edit, 'C' for Comments, 'W' Workload):

Approve for release by entering your initials: SFB

3. To result the send out tests once they are received, follow the steps below. It is very important not to select a test that has already been verified. If you do select a test that has already been verified, the performing laboratory will change to the current performing laboratory which may not be correct. It is important to only select the tests that have new results.

Select Process Data In Lab (Local) Option: EM Enter/verify/modify data (manual)

Do you want to review the data before and after you edit? YES// <Enter> Do you wish to see all previously verified results? NO// <Enter>

Select one of the following:

1 Accession Number 2 Unique Identifier (UID)

Verify by: 1// <Enter or enter 2> 2 Unique Identifier (UID)

Unique Identifier: <Enter Accession # or UID> 1160810001 (CH 0321 1) Select Performing Laboratory: FAYETTEVILLE AR// <Enter Performing Lab> LAB

1 LABCORP BURLINGTON NC

2 LABCORP DALLAS, TX TX

3 LABCORP HOUSTON TX

4 LABCORP OF AMERICA NC

5 LABCORP RTP CMBP1 NC

CHOOSE 1-5: <Select appropriate> 2 LABCORP DALLAS, TX TX

Work Load Area: MISC. CHEMISTRY

ZZZTEST,TEST TEST 709-12-0155P LOC:LABF

Sample: PLEURAL These results have been approved by FETZER-BOVA,SUSAN L on Mar 21, 2016@09:02:44 Specimen: PLEURAL FLUID 1 PH (BODY FLUID) verified

2 GLUCOSE (FV)

3 LDH (FV)

4 TOTAL PROTEIN (FV)

TEST #(s) (or "ALL"): <Select ONLY the tests to be resulted> 2,3,4

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ZZZTEST,TEST TEST SSN: 709-12-0155P LOC: LABF

Pat Info: Sex: FEMALE Age: 60yr as of Mar 21, 2016 Provider: LEVY,ROBERT M Voice pager: 585 Phone: 479-443-4301 (65270) Digital pager:

ACCESSION: CH 0321 1 [1160810001]

3/21 09:01d COMMENTS: ~For Test: GLUCOSE

COMMENTS: ~TESTING PERFORMING LAB

If you need to change something, enter your initials: SFB

For test GLUCOSE (FV) UNITS: mg/dL

REFERENCE LOW:

REFERENCE HIGH:

CRITICAL LOW:

CRITICAL HIGH:

Result's Abnormality: Calculate from entered values//

GLUCOSE (FV) //135

For test LDH (FV)

UNITS: IU/L

REFERENCE LOW: ^

LDH (FV) //211

For test TOTAL PROTEIN (FV) UNITS: g/dL

REFERENCE LOW: ^

TOTAL PROTEIN (FV) //2.9

Select COMMENT: ~TESTING PERFORMING LAB // COMMENT: ~TESTING PERFORMING LAB Replace Select COMMENT:

ZZZTEST,TEST TEST SSN: 709-12-0155P LOC: LABF

Pat Info: Sex: FEMALE Age: 60yr as of Mar 21, 2016 Provider: LEVY,ROBERT M Voice pager: 585 Phone: 479-443-4301 (65270) Digital pager:

ACCESSION: CH 0321 1 [1160810001]

3/21 09:01d GLUCOSE (FV) 135 mg/dL

LDH (FV) 211 IU/L

TOTAL PROTEIN (FV) 2.9 g/dL COMMENTS: ~For Test: GLUCOSE

COMMENTS: ~TESTING PERFORMING LAB

If you need to change something, enter your initials:

Approve update of data by entering your initials: sfb

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4. The interim report should look similar to the one below. Note the institution numbers to the right of each result.

Select Results menu Option: Interim report for an accession Print address page? NO// Select Accession or UID: CH 1

CHEMISTRY (MAR 21, 2016) 1

DEVICE: HOME//

ZZZTEST,TEST TEST Report date: Mar 21, 2016@10:30 Pat ID: 709-12-0155P SEX: F DOB: Dec 01, 1955 LOC: LABF

Provider: LEVY,ROBERT M Specimen: PLEURAL FLUID Accession [UID]: CH 0321 1 [1160810001] Report Released: Mar 21, 2016@09:06

Specimen Collection Date: Mar 21, 2016@09:01 Test name Result units Ref. range Site Code GLUCOSE (FV) 135 mg/dL [12288] Eval: Semi-quantitative compare to serum/plasma value. This test has not been Eval: approved of cleared by the FDA for use on such fluid.

TOTAL PROTEIN (FV) 2.9 g/dL [12288] Eval: Semi-quantitative compare to serum/plasma value. This test has not been Eval: approved of cleared by the FDA for use on such fluid.

LDH (FV) 211 IU/L [12288]

Eval: Semi-quantitative, compare to serum/plasma value. This test has not Eval: been approved or cleared by the FDA for use on such fluid.

PH (BODY FLUID) 7.835 pH units [564] Eval: Pleural fluid pH: 7.3-7.4 Benign Eval: <6.0 Suggests esophageal rupture Eval: <7.3 Indicates empyema, loculated effusions,or TB Eval: >7.4 Suggests malignancy Comment: ~For Test: GLUCOSE

~TESTING PERFORMING LAB

KEY: "L"=Abnormal low, "H"=Abnormal high, "*"=Critical value

ADD TESTS TO A GIVEN ACCESSION

This option is used to add tests to the same accession number.

Select Accessioning menu Option: Add tests to a given accession.

Select Accession or UID: <Enter Accession # or UID to add to>

HEMATOLOGY (MAR 16, 2016) 1

AAA,FHXUFH W 101-15-5673

Nature of Order/Change: SERVICE CORRECTION// <Enter> S

TESTS ALREADY ON THE ACCESSION:

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CBC (FV)

Select Original Ordered Test: CBC (FV)

Add LABORATORY TEST: DIFF <Enter test to add> DIFFERENTIAL ...OK? Yes// <Enter> (Yes) Select URGENCY: ROUTINE// ...OK? Yes// <Enter> (Yes)

Select one of the following:

1 Add On 2 Reflex

Type of test order being added: 2 Reflex

DIFFERENTIAL ADDED

Add LABORATORY TEST: <Can add another test or Enter to exit>

LAB ADD TEST(S) TO AN EXISTING ORDER

This option is used to add tests to an existing order. It is used when the accession areas are different.

Select Accessioning menu Option: ^LAB ADD test(s) to an existing order

Order Number or UID: 1323001573

LISTING OF DATES

1 2/13/2023

ORDER #: 548425 PAT: ZZTEST BURIS,BURIS SSN: 000-00-7111

WHO ENTERED: BOUXSEIN,ALISON R TYPE OF COLLECTION: SP

COLLECTION STATUS: C

DRAW TIME: Feb 13, 2023@14:17 ORDERING LOCATION: FAV EMERGENCY DEPART LAB ARRIVAL: Feb 13, 2023@14:17

SPECIMEN: BLOOD PROVIDER: THEOHARIS,CONSTANTINE

TEST: GLYCO HGB A1C ROUTINE

TEST: Glyco Hgb A1C ROUTINE SPECIAL HEMATOLOGY 1573 <1323001573> Order has already been accessioned.

Is this the one? Yes// (Yes)

WANT TO ENTER COLLECTION TIMES? Y//

Select ACCESSION TEST GROUP:

Select one or more tests from which you will be generating your entries.

Select LABORATORY TEST NAME: REFERRAL A1C Is SEND BLD (BLOOD) LAV/BLD the correct sample to collect? Y// Same specimen/source for the rest of the order? No// (No)

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Select LABORATORY TEST NAME:

Select one of the following:

LC LAB COLLECT(INPATIENTS-MORN. DRAW)

SP SEND PATIENT

WC WARD COLLECT

I Immed COLLECT

Specimen collected how ? : SP// SEND PATIENT PATIENT LOCATION: ED// FAV EMERGENCY DEPARTMENT (enter the correct location from the original order) PROVIDER: THEOHARIS,CONSTANTINE (enter the correct provider from the original order) Other tests? N// Nature of Order/Change: SERVICE CORRECTION// S

You have just selected the following tests for ZZTEST BURIS,BURIS 000-00-7111 entry no. Test Sample

1 REFERRAL A1C SEND BLD (BLOOD) BLOOD

All satisfactory? Yes// (Yes)

LAB Order number: 548425

Collection Date@Time: NOW//T@1000 (FEB 13, 2023@10:00:00) (date/time specimen was collected) ~For Test: REFERRAL A1C SEND BLD (BLOOD) BLOOD Enter Order Comment:

ACCESSION: LC 23 1739 <5623001739>

REFERRAL A1C SEND BLD (BLOOD) BLOOD

LAB PROCESSING INSTRUCTIONS : This test is for referral testing of A1C specimens that will not result on VAMC-Fayetteville's instrumentation. This test can only be ordered by laboratory personnel.

CONTAINER: Lavender-top EDTA whole blood tube. STORAGE: Refrigerate.

(Stable for 7 days at room temp.) METHODOLOGY:Roche Tina Quant

DELETE TESTS FROM AN ACCESSION

This option is used to delete specific tests from an accession number.

Select Accessioning menu Option: Delete test from an accession

Select Accession or UID: HE 1 <Enter Accession # or UID>

HEMATOLOGY

HEMATOLOGY (MAR 16, 2016) 1

AAA,FHXUFH W 101-15-5673

Order Test Urgency Status Accession -Lab Order # 22010 Provider: THEOHARIS, CONSTANTINE

BLOOD

CBC (FV) ROUTINE Collected 03/16/2016@10:51 HE 0316 1 DIFFERENTIAL ROUTINE Collected 03/16/2016@10:51 HE 0316 1 : Added by 1451 on Mar 16, 2016@10:52

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AAA,FHXUFH W 101-15-5673

TESTS ON ACCESSION: HE 0316 1 UID: 1260760001

CBC (FV)

DIFFERENTIAL

Change which LABORATORY TEST: DIFF <Enter test name> DIFFERENTIAL Select another test: <Can select another test or Enter>

Change Accession : HE 0316 1 UID: 1260760001

DIFFERENTIAL

Cancellation Reason: OTHER CANCEL REASON// ?

Answer with ORDER REASON NAME, or SYNONYM, or CODE Do you want the entire ORDER REASON List? Y (Yes) Choose from:

CLOTTED SPECIMEN

DUPLICATE TESTS

HEMOLYZED SPECIMEN

INSUFFICIENT SPECIMEN

OTHER CANCEL REASON

Obsolete Order

PATIENT UNAVAILABLE

Purged Order

REQUESTING PHYSICIAN CANCELLED

SERVICE CORRECTION

This order/change will be recorded in the patient’s electronic record.

Depending of the nature of this activity, a notification may be sent to the requesting clinician to electronically sign this action, and a copy of this action may be printed on the ward/clinic to be placed in the patient’s chart.

Cancellation Reason: OTHER CANCEL REASON// <Enter appropriate reason>

Select NP comment Lab Description screen: <Enter>

Not Perform Reason: NOT REQUIRED <Enter appropriate reason>

(NOT REQUIRED)

Satisfactory Comment? Yes// YES [ DIFFERENTIAL ] Marked Not Performed

REMOVE AN ACCESSION

This option is used to delete all tests within an accession number.

Select Accessioning menu Option: Remove an accession

The ability to DELETE an entire ORDER/ACCESSION has been REPLACED. The test(s) will now be marked as Not Performed and a reason for 'NP' will be stored with each test. Accession numbers can't be reused after it has been assigned to a specimen.

Select Accession or UID: HE 1

HEMATOLOGY (MAR 16, 2016) 1

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Controlled copy ID 26038. Printed on 3/14/2023 10:23 AM (EDT). Page 14 of 22

AAA,FHXUFH W 101-15-5673

Order Test Urgency Status Accession -Lab Order # 22010 Provider: LEVY,ROBERT M

BLOOD

CBC (FV) ROUTINE Collected 03/16/2016@10:51 HE 0316 1 DIFFERENTIAL ROUTINE *Not Performed 03/16/2016@10:59 HE 0316 1 : OTHER CANCEL REASON: *NP Reason: NOT REQUIRED : *NP Action: Mar 16, 2016@10:59 : Added by 1451 on Mar 16, 2016@10:52 DIFFERENTIAL *Canceled by: FETZER-BOVA,SUSAN L : OTHER CANCEL REASON: *NP Reason: NOT REQUIRED : *NP Action: Mar 16, 2016@10:59 : Added by 1451 on Mar 16, 2016@10:52

AAA,FHXUFH W 101-15-5673

TESTS ON ACCESSION: HE 0316 1 UID: 1260760001

CBC (FV)

DIFFERENTIAL *Not Performed Mar 16, 2016@10:59 by 1451

Change Entire accession to Not Performed? NO// YES Cancellation Reason: OTHER CANCEL REASON// <Enter appropriate reason>

Select NP comment Lab Description screen: <Enter>

Not Perform Reason: DUPLICATE <Enter appropriate reason>

(DUPLICATE)

Satisfactory Comment? Yes// YES

All accessioned test(s) changed

ORDER/TEST STATUS

1. This option is useful when trying to determine exactly what has been ordered on a patient and the status of the test(s) ordered. After selecting a patient, for each day prompted, the status of each test for that day is given. The report will output for a specified patient, order number, urgency, status (test complete, on collection list, collected), provider, and accession number.

Select Phlebotomy menu Option: Order/test status Select Patient Name: ZZZTEST,TEST TEST 12-1-55 709120155P **Pseudo

SSN** NO NON-VETERAN (OTHER)

DATE to begin review: TODAY// <Enter for today or select date> 3.16 (MAR 16, 2016)

Test Urgency Status Accession -Lab Order # 40671 Provider: THEOHARIS, CONSTANTINE

EYE

CULTURE, EYE ROUTINE Collected 03/16/2016@13:44 MIC 16 1 No orders for 03/15/2016

No orders for 03/14/2016

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REVIEW BY ORDER NUMBER

1. The option provides information related to the order. If the order number is not known, you can look it up in ^Order/Test Status.

Select Accessioning menu Option: Review by order number

Order Number or UID: <Enter order #> 40671

ORDER #: 40671 PAT: ZZZTEST,TEST TEST SSN: 709-12-0155P

WHO ENTERED: FETZER-BOVA,SUSAN L TYPE OF COLLECTION: WC

COLLECTOR : FETZER-BOVA,SUSAN L COLLECTION STATUS: C

DRAW TIME: Mar 16, 2016@13:30 ORDERING LOCATION: FAV LAB FASTING LAB ARRIVAL: Mar 16, 2016@13:44

SPECIMEN: EYE PROVIDER: LEVY,ROBERT M

TEST: CULTURE, EYE ROUTINE MICROBIOLOGY 1 <6816000001>

Order has already been accessioned.

LIST OF LAB ORDERS NOT COLLECTED

1. This option lists orders indicated as not collected by the phlebotomists after routine collection by lab on the ward. This list, which can be generated after receipt of specimens from a routine scheduled collection, can also be consulted when trying to find a missing specimen. If during the “receiving” process, a specimen or group of specimens from a single ward collection are overlooked, the system will not “release” those accessions, but leave them with a status of “on collection list” or with a status of “cancelled.”

Select Phlebotomy menu Option: List of lab orders not collected DATE: <Select date> T (MAR 21, 2016)

You may enter 'ALL' as a response

Select PATIENT LOCATION: ALL// <Enter> DEVICE: HOME// <Enter or enter printer name> Linux Telnet/SSH

LIST OF PATIENT LAB ORDERS NOT DRAWN 03/21/2016 MAR 21, 2016@15:24

ZZZTEST,TEST TEST 709-12-0155P

LOCATION: ICU NON-DRAW Order: 40704

TESTS: CBC (FV)

REASON: NOT ON LIST YET **

Finished

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Controlled copy ID 26038. Printed on 3/14/2023 10:23 AM (EDT). Page 16 of 22

BUILD AND PRINT A LOAD/WORK LIST

1. The formatting of these lists is determined by the field entries for each load/work list name in the Load/Work List file.

Note: If you are running an interfaced instrument, you must have a load/work list defined for it and associated with that instrument in the “Auto Instrument” file. This version will allow load or work lists to be built by a specified urgency or range of urgencies, as well as allowing accessions to be bought onto a list only when the tests ordered exactly match the tests defined in the list’s profile.

Example: A load list profile consists of two tests – FREE T3 and FREE T4. The list may be specified to build only accessions which have both ordered onto the list. (Accessions having only a FREE T3 ordered would not be built onto that list).

2. The load or work list that has been created may be used to find the appropriate specimens. The lists may also be manipulated in order to allow you to insert, move, and remove samples onto and off of the lists as originally built, if desired.

3. Options to use:

A. Build a load/work list [LRLL]: This creates a load or work list for an instrument or manual test(s).

Select Process Data In Lab (Local) Option: Build a load/work list

Select LOAD/WORK LIST NAME: <Enter Load/Work List Name> MISC. CHEMISTRY ALL PROFILES? No// Y (Yes) <If no, will ask which profile> (C)ondensed or (E)xpanded list ? (req. 132 column format):C// All urgencys? Yes// (Yes) 1 Allow splitting tests from each accession between load/worklists.

2 Require all tests to build or build none at all (for each accession).

Choose: 1// <Enter> HOW MANY ENTRIES TO BUILD: ALL// <Enter>

ACCESSION LIST: CHEMISTRY

USE DEFAULT SETUP? Yes// N (No) <Can also say yes. Yes will not unload> WANT TO UNLOAD THE WORK LIST FIRST? No// Y (Yes) Select ACCESSION AREA: CHEMISTRY// <Enter Accession Area if not correct.> Accession DATE: T// <Enter, or select date> (MAR 17, 2016) ACCESSION NUMBER: FIRST// <Enter> GOTO: LAST// <Enter> SEQUENCE # TO START WITH: 1// <Enter> Queue build and print:? No// <Enter> (No)

STARTING PROFILE MISC. (FLUID) SCAN

SCAN DONE. BUILDING

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B

BUILD DONE

STARTING PROFILE MISC. (BLOOD) SCAN

SCAN DONE. BUILDING

B

BUILD DONE

STARTING PROFILE MOUNT VERNON CBOC SCAN

NO ENTRY FOUND!

STARTING PROFILE FORT SM SCAN

NO ENTRY FOUND!

STARTING PROFILE BRANSON SCAN

NO ENTRY FOUND!

STARTING PROFILE JAY CBOC SCAN

NO ENTRY FOUND!

STARTING PROFILE OZARK CBOC SCAN

NO ENTRY FOUND!

LOAD LIST IS NOW SET UP

LOAD/WORK LIST NOT SETUP FOR THIS DATE

SEQUENCE # TO START WITH:1// <Enter> END WITH: LAST// <Enter> DEVICE: HOME// <Enter printer name or print to screen> Margin: 80//

WORK-LIST FOR MISC. CHEMISTRY (Profile: MISC. (FLUID))03/17/2016 15:31 Name ID# Acc # UID Collection Date/Time Provider Order #

SEQ: 1 INACT*IRISPEC CB 22112

CH 0317 13 1160770013

MAR 17, 2016 00:36 Unknown #:75047

------------------------------- ROUTINE

UA PROTEIN URINE

B. Print a load/work list [LRLLP]: Prints a load or work list. You can start printing from any entry and it will reflect revised and new current status of specimens.

Select Process Data In Lab (Local) Option: print a load/work list

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PRINT LOAD/WORK LIST

Select LOAD/WORK LIST NAME: MISC. CHEMISTRY

(C)ondensed or (E)xpanded list ? (req. 132 column format):C// SEQUENCE # TO START WITH:1// <Enter> END WITH: LAST// <Enter> DEVICE: HOME// <Enter printer name or print to screen> Right Margin: 80//

WORK-LIST FOR MISC. CHEMISTRY (Profile: MISC. (FLUID))03/17/2016 15:38 Name ID# Acc # UID Collection Date/Time Provider Order #

SEQ: 1 INACT*IRISPEC CB 22112

CH 0317 13 1160770013

MAR 17, 2016 00:36 Unknown #:75047

------------------------------- ROUTINE

UA PROTEIN URINE

C. Unload Load/Work List [LRLLCT]: This option will remove entries from the specified tray(s) and make the accession(s) available again for adding to a worklist or load list.

Select Process data in lab menu Option: Unload Load/Work List

This option will remove entries from the specified tray(s) and make the accession(s) again available for adding to a worklist or loadlist.

Select LOAD/WORK LIST NAME: FS CHEMISTRY

STARTING SEQUENCE #: FIRST//

LAST SEQUENCE #: LAST//

UNLOADING THE FOLLOWING ACCESSIONS

(List of Accession Numbers)

INCOMPLETE STATUS TEST REPORT

1. This report will display incomplete tests by test name, patient name, social security number, location, order urgency, and accession number, as well as status of the incomplete test(s). The report may be requested for a given accession area or for a selected group of tests within an accession area. This report should be run several times during the day, especially at the end of a shift, to check for incomplete/delinquent tests.

This report may be sent to a printer or printed to the screen.

Select Process Data In Lab (Local) Option: Incomplete test status report

Select ACCESSION AREA: IM/UR IMMUNO/URINALYSIS Accession Date: TODAY// <Enter or enter date> (MAR 17, 2016)

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First Accession number: 1// <Enter, or select accession #> Last Accession number: LAST// <Enter, or select accession #>

Select ACCESSION AREA: <Can enter an additional accession area> Specify detailed sort criteria? NO// <Enter> Do you want an extended display? NO// <Enter> DEVICE: HOME// <Enter or enter printer number>

INCOMPLETE STATUS REPORT *** NOT FOR WARD USE *** 03/17/2016 15:43

Accession Area(s): Page: 1 IMMUNO/URINALYSIS For Date: 03/17/2016 From: 1 To: 9999999 Sorted by Accession Area; Controls Excluded: NO; Specific Tests: NO Exclude Specific Tests: NO; Required Tests Only: NO

Test Urgency Accession Date/time Location SSN Patient Status

URINALYSIS CONTROLS ROUTINE IM/UR 0317 11 03/17/2016@00:36

021-16 IRISPEC CA (iChem10 Load/work list

URINALYSIS CONTROLS ROUTINE IM/UR 0317 12 03/17/2016@00:36

021-16 IRISPEC CB (iChem10 Load/work list

URINE SSA PROTEIN*IN ROUTINE IM/UR 0317 11 03/17/2016@00:36

021-16 IRISPEC CA (iChem10 Load/work list

LONG FORM ACCESSION LIST

1. This list gives a detailed printout of all the pending accessions for a given accession area.

It may be requested by a specific date or range of dates, specific tests, and/or by incomplete tests only. This list may also be used as a worklist or as a replacement for manual logbooks or worksheets. It can also be useful to use as a “checklist” at the end of each shift for finding any specimens that have not been run, or determining the work that is leftover and will be run during the next shift.

Select Misc. Processing Menu - Local Option: Long form accession list Select ACCESSION AREA: <Enter Accession Area> Accession Date: TODAY// <Enter, or select different date> (MAR 17, 2016) First Accession number: 1// <Enter or select different number> Last Accession number: LAST// <Enter or select different number> Do you want a specific test? NO// <Enter> Do you want only incomplete entries? YES// <Enter> DEVICE: HOME// <Enter to print to screen or enter printer name> Linux Telnet/SSH

LONG FORM NOT FOR WARD USE

Approved and current. Effective starting 2/27/2023. Lab Information Management 5 VistA ADP (version 2.0) Basic VistA Operations

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Accession Area: IMMUNO/URINALYSIS 03/17/2016@15:49 ACCESSION: IM/UR 0317 11 PATIENT: IRISPEC CA (iChem100)

ORDER #: 75056 SSN/ID: 021-16

UID: 0560770011 DOB:

LOCATION: DATE ORDERED: Mar 17, 2016 COLLECTED: Mar 17, 2016@00:36 PROVIDER: UNKNOWN LAB ARRIVAL: Mar 17, 2016@00:36

SAMPLE: URINE

TEST: URINALYSIS CONTROLS ROUTINE LIST: URINALYSIS 1;6

TEST: URINE SSA PROTEIN*INACT(4-29-11)ROUTINE LIST: URINALYSIS 1;6

WORK SHEET ACCESSION LIST

1. This prints an ACCESSION list in the format of a worklist. The CBOCs print this list to accompany the specimens that are sent to the Fayetteville lab for processing.

Select Misc. Processing Menu - Local Option: Work sheet Accession list Select ACCESSION AREA: <Enter Accession Area> Do you wish to list by date (rather than by accession number)? Yes// <Enter> Enter earliest date received at lab to list: T (MAR 17, 2016) Enter latest date received at lab to list: T (MAR 17, 2016) Do you want a specific test?? No// <Enter> (No) Do you want only incomplete entries?? Yes// <Enter> (Yes) Do you want a long list?? No// <Enter> (No) DEVICE: HOME// <Enter printer name> Linux Telnet/SSH

LAB ONLY WORK-SHEET FOR Accession area SEND FAY (OZARK) 03/17/2016 @16:03 Accession Name ID Urgency UID Collection Time Doc Loc

FAYOZ 16 1019 HOWDY,DOODEY TIME 6318 ROUTINE

3616001019 MAR 17, 2016 08:06 GUYER,GERALD LAWRE OZKFAS

--------------------------------------- SERUM

LIPID PROFILE (FV), RENAL+LIVER PROFILE (FV), eGFR

FAYOZ 16 1020 HOWDY,DOODEY TIME 6318 ROUTINE

3616001020 MAR 17, 2016 08:06 GUYER,GERALD LAWRE OZKFAS

--------------------------------------- BLOOD

CBC (FV), Glyco Hgb A1C

SPECIAL REPORTS

1. Various “specialized” reports exist for quality control, quality assurance, and daily review and summary purposes. They include, but are not limited to:

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A. Accession List – List of accessions by UID, tests, patient name, SSN, location, and technicians’ initials.

B. Short Accession List [LRACC2] – Printed by accession area, test, or specified date(s).

C. Search for abnormal and critical flagged tests [LRSORD] – finds any test results that are outside of the established or defined critical (“panic”) value ranges or are otherwise “abnormal” (have failed a delta check, etc.) within a specified time span.

D. Search for critical value flagged tests [LRSORC] – finds any test results which have exceeded the critical value limits defined in the LABORATORY TEST file within a specified time span.

E. Search for high/low values of a test [LRSORA] – finds any results equal to, less than, or greater than the value you specify for a given test or group of tests, within a specified time span.

F. Quality control display (levey-jennings) [LRQC] – will display the quality control data for a test or group of tests by given lab control name, for a set number of time points. This is a highly specialized format that indicates the actual value of the control sample and plots it against the established mean and ± 1, 2, and 3 standard deviations on the display.

G. Summary lists – various reports which summarize large groups of data include:

a. Supervisor’s report [REACS MANUAL] – generated with a format similar to the daily cumulative reports, by date.

b. Summary list (supervisors’) [LR SUP SUMMARY] – generated with a format similar to the long form accession list, with or without verified test results, by date. All results for a given accession area (or areas) for a given date and range of accession numbers. This report can serve as an “audit trail” for a specimen.

Includes information on person placing order, person performing test, verifying person, LOINC code(s) and dates and times of specimen collection and test completion. The report can be sorted by accession number or by patient, and can be printed in long form, which includes the above-mentioned information plus test results.

2. Contact the LIM/ADPAC for additional information regarding report templates.

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