The most conclusive evidence for using thyroid peroxidase antibody (TPO) is predictive in nature when evaluating possible subclinical hypothyroidism. If this test is positive, hypothyroidism occurs at a rate of 4.3% per year versus 2.6% per year when the antibody is negative. While this scenario does not cover all clinical indications for ordering TPO, there is no definitive evidence that repeat TPO testing provides additional information.1
Based on this information the ordering of TPO within Spectrum Health is being modified. If the test is ordered more than once on a patient, a screen will appear in EPIC indicating the following: “This test should typically only be resulted once per lifetime. The duplicate checking indicates that this patient has already had this testing performed. Please see chart review for results.” This is not a “hard stop” but providers will need to click “Continue” to proceed with the order.
In both the inpatient and outpatient settings, the laboratory has supplied 24 hour urine containers with preservative such as acetic acid, sodium hydroxide, and boric acid. Upon review of specimen stability requirements, it has been determined that a preservative is not needed prior to collection of most 24 hour urine tests as long as the 24 hour container is kept refrigerated or on ice during the collection period.
As part of the Choosing Wisely campaign, the American Association of Blood Banks (AABB) released five recommendations for transfusions:
When sending specimens collected in the office, place the Epic/Epic Care Link Lab Orders orange slip in the bag with the specimens. You no longer need to print the Order Requisition out of Epic.
At this time when Influenza prevalence is not widespread in the community, please order “Influenza A/B PCR” [LAB3255] when testing is needed. This applies to patients at all Grand Rapids and regional hospitals, and also system wide ambulatory patients.
Effective immediately, QuantiFERON®-TB Gold test (QFT), the industry-leading Interferon-gamma Release Assay (IGRA) for TB detection used at Spectrum Health Regional Laboratory is being replaced by the QuantiFERON-TB Gold Plus (QFT-Plus).
The QFT-Plus is now optimized with innovative tuberculosis-specific antigens that elicit both CD8 and CD4 T cell responses, enabling a more comprehensive assessment of cell-mediated immune response to TB infection. The test principle, procedures, and specimen handling will remain the same with the one exception being that the collection kit will now consist of four tubes instead of three. Three-tube collections can no longer be accepted and will thus be canceled.
If you have three-tube collection kits, please order new four-tube collection kits in Lawson (#54909) or via the Lab Supply Order Form.
Please direct urgent questions to the Laboratory Call Center at 616-774-7721 or for non-urgent inquiries use the “contact us” link above.
Spectrum Health Regional Laboratory is not validated to perform Chlamydia and Gonococcus testing on pediatric patients under the age of 14 years old. Testing for these patients must be sent to a reference laboratory. Please order a Reference Miscellaneous Test (#LAB848) and indicate complete test name when ordering.
Effective November 5, 2017, Spectrum Health Regional Laboratory will be implementing the Paris System for reporting Urine Cytology.
Effective November 5th, the following test order names will be modified. These changes have been made to enhance clarify regarding the testing performed. In all cases, prior Cerner names are set as aliases that direct to the new Epic order names.
Spectrum Health Regional Laboratory supplies purple priority bags for specimens that must be handled and processed immediately upon receipt in the laboratory. The purple color priority transport bag will be a visual cue to the receiving laboratory that the specimens inside the bag need to be handled or processed immediately at the time of arrival in the laboratory or the integrity of the specimen will be compromised.
Use these bags for transporting specimens to the laboratory when: