COVID-19 alert level two update
Screening of patients
Labtests continues to screen patients attending collection centres during alert level two. For the safety of both patients and staff, patients who respond ‘yes’ to the following questions will be asked to return home and contact their referrer for advice or instructions:
- Fever or felt feverish in the last 2 days?
- Currently have one or more of the following symptoms:
- Coughing Feeling breathless Sore Throat Cold Symptoms Runny Nose
- Have you tested positive for COVID-19 or been in close contact with a person with suspected or confirmed as COVID-19 positive in the 14 days?
- Have you travelled outside of NZ in the past 14days (i.e. returning air crew)
Screening will not be required when Auckland returns to at alert level one.
Skin Prick Testing
Skin prick testing remains on hold and we are not taking bookings for this test during alert level two. This is regrettable but necessary, because of the additional requirements involved in the procedure, and to assist in minimizing the length of time and number of patients in the waiting room during this alert level. Appointments for skin prick testing will be available after Auckland moves to alert level one.
Permanent closure of Quay West collection centre
The Quay West collection centre is now permanently closed. The nearest collection centres are located at:
CBD Level 2/280 Queen Street
Victoria Park (Union Street entrance) 95 Union Street, Auckland
Ponsonby White Cross Accident & Medical, 202 Ponsonby Road
For full listing of Labtests collection centres please refer to the website: www.labtests.co.nz
“Axe the Fax”
Replacement of Faxing
In June 2019 the Ministry of Health and the Accident Compensation Commission released a joint communique defining secure communication within the New Zealand health sector, specifically in regards to email and faxing.
The two recommendations are:
- All emails be transmitted using Transport Layer Security (TLS) no later than January 2020.
- All analogue faxing to be migrated to a fully digital security-assessed communications solution, such as email, no later than December 2020.
Labtests has complied with the first recommendation and has notified the Ministry of Health as requested.
In response to the second point, we have analysed the use of faxing within our business, what alternatives we currently have available, and what additional communication methods we may need to deploy.
Our preference is to remove faxing and re-evaluate the requirement for patient resulting outside of Health Connect South and PMS systems. We do not wish to simply swap faxing for email unless there is no better electronic alternative.
Faxing of Results
Urgent (Non-Critical) Results
All critical results are, and will continue to be, notified to referrers by phone.
Using TESTSAFE and PMS is the recommended safest way for a referrer to receive patient results. Faxing of results is not a routine method for the laboratory to send result reports. It is the referrer’s responsibility to create a workflow to ensure laboratory results are checked in a timely manner.
Many of the faxes we currently send fall into the category of abnormal but not critical, faxing these became our protocol because of historic delays in sending paper-based reports to referrers. Laboratory results are now available instantly in TESTSAFE and most referrers are sent results via HL7 messaging into their PMS on a frequent basis.
The majority of referrers (80%) receive 2 faxes per day or less. We propose to review the critical phone limits and remove the faxing option. This would result in referrers being called for results that were deemed critical and required immediate action, with all other results including abnormal results being available in TESTSAFE and the referrers PMS as soon as they are available. It is the responsibility of the referrer to check results on a regular and timely basis.
INR, DDIMER and TNI
Currently referrers can opt to have these tests automatically faxed on completion, however at the same time as these results are faxed they are sent to TESTSAFE and referrer PMS systems.
It would be possible to set these requests to auto email results, but we question if this is required and if it is the best workflow solution? In order to set up the (fax to) email of these results, we would first need to be supplied with the appropriate email address with the responsibility that it would be checked on a regular basis to provide appropriate and timely clinical action.
Referrers Unable to Access TESTSAFE or Electronic Reports
It is recognised that faxing is used by a very small number of referrers who do not have access to TESTSAFE or HL7 messaging into a PMS; for these referrers Labtests is able to arrange results to be emailed rather than faxed.
What do referrers need to do next?
If a referrer no longer requires faxes they do not need to do anything. Faxing will be phased out over the coming months.
If a referrer believes that previously faxed results need to be emailed, such as the examples provided, referrers must contact us on 09 574 7399 to arrange this. Any results that are sent via email must go to a dedicated results email address and must be checked regularly by the referrer. Labtests takes no responsibility for emailed results that are not checked by referrers.
Laboratory staff will be unable to enter email addresses on an ad hoc basis. To receive a result by email, all addresses provided must be verified and on record in our Laboratory Information System.
Faxing laboratory requests
Electronic ordering methods have replaced faxing laboratory request forms to individual collection centres. If you have any questions regarding electronic ordering, please contact us on 0508 373 783.
If you are unable to utilise an electronic ordering method, request forms can be emailed to email@example.com, the request will then be entered into our collection centre management system and will be available at all our collection centres as an electronic order.
Ordering of consumables
As of 1st October 2020 all consumables must be ordered via our online ordering system. The fax ordering system will be discontinued from that date. If you do not have an on-line order account number please phone 09 574 7282.
Correct Labelling of specimens is crucial
Specimen Labelling Policy
We continue to receive specimens collected by medical practices that are incorrectly labelled, necessitating recollection. This is very inconvenient to both the practice and the patient and causes delay in diagnosis. In April 2015, the Joint Advisory Group (JAG) endorsed the aligning of policies for specimen labelling across Auckland and the Northern region of the North Island. All laboratories in the region are expected to adhere to the labelling policy whereby two forms of the patient ID is a minimum requirement (e.g. two of the following three identifiers: the patient’s full name, date of birth, and NHI) and the identifiers on both the request form and the specimen must match.
Labtests is committed to ensuring the quality of the results we issue in the most timely manner, adhering to international best practice and complying with accreditation standards. Labtests has always contacted referrers when an incorrectly labelled / unlabeled specimen has been identified. In the first instance we strongly recommended a specimen recollect; however, we have also accepted written / verbal confirmation of patient identification in some instances. We note that other laboratories in the region have slightly different processes in dealing with these samples.
There are limited instances when it is not possible to recollect an incorrectly labelled / unlabeled sample (see table below for detail). For these samples we respectfully request written confirmation is provided to the laboratory in a timely manner. This will ensure that processing of the samples and the release of results is not significantly delayed.
Type of specimens that may be difficult to recollect
|Anatomical Pathology Requests||Renal Stones|
|Cytopathology Requests||Cerebrospinal Fluid|
|Requests for Children under the age of 5||Urgent requests|
|Aspirate requests||Urogenital Swabs|
|IUCD/IUD||24hr urine requests|
How does this affect you?
Labtests does not accept verbal confirmation on mislabeled/ unlabeled specimens. Confirmation of the identity of a specimen will only be sought if the specimen is classified as a difficult recollect and in these instances confirmation must be provided in writing; otherwise we will advise you that the specimen requires recollection.
If you would like any further details please do not hesitate to contact the Quality Manager:
Saad Mansour firstname.lastname@example.org .