Compliance & Safety, General Information

Expired Order Cleanup in Spectrum Health’s Epic

Effective, Friday, August 12, at 1700 (5 p.m.), a batch job will be run in Spectrum Health’s Epic Production to cancel any historical expired lab orders.

· After this job is completed, providers and clinical users of Spectrum Health’s Epic, will begin receiving daily messages alerting them of lab orders that are set to expire within the next 30 days (this includes Epic Hyperspace, Epic Community Connect, and EpicCare Link). Non-Spectrum Health Epic users (i.e. interfaced clients or paper order users) will not be notified.

· Once the lab order reaches the expiration date or reaches 400 days from the order date, the order will be cancelled by the system because it is no longer considered a valid order by the lab. (Per Policy 11101, Laboratory Orders Policy-Outpatient)

· If the order is still desired by the provider, a new order will need to be placed.

· This change will not impact point of care testing.

The following types of lab orders will be impacted by this change:

· Advanced Diagnostics AP

· Advanced Laboratory Diagnostics

· Blood Bank

· Blood

· Body Fluid

· Cytology

· Microbiology

· Stool

· Urine

· Orders placed into our version of Epic and through eShare

· Orders placed into EpicCare Link

Why make this change?

This change will help to limit lab order clutter in the patient’s chart. This will help clinicians, like phlebotomists, by streamlining the outstanding orders that are available on a patient so accurate draws can be completed.

Hematology

Result Reporting Change of Nucleated Cells in Cerebrospinal Fluid (CSF) Counts

Cell Count w/ Differential if indicated, Cerebrospinal Fluid [LAB2111025] and Cell Count with Differential, Cerebrospinal Fluid (Pediatric Oncology) [LAB212] currently result nucleated cell counts as a White Blood Cell (WBC) count.

Effective Tuesday, August 16, 2022, the WBC component will be removed and instead reported as a Total Nucleated Cell (TNC) Count for CSF.

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Chemistry

Reference Range Update: ALT and AST

After consultation with our clinical partners, Spectrum Health West Michigan Laboratory will be adjusting the pediatric reference ranges for our new ALT and AST reagents in an effort to better serve our population.  Numerous academic studies were reviewed, and the values listed below were adopted on August 3, 2022: Continue Reading

Chemistry

Updates: Chemistry Reference Ranges

Effective August 2, 2022, reference ranges for the below tests will be updated to better align with the vendor’s recommendation and with Spectrum Health Lakeland Laboratory. Please click on the links below and scroll to the Reference Range field to see the updated ranges.

Lithium Level [LAB29]

PTH Intact [LAB108]

IgM Level [LAB72]

IgA Level [LAB73]

CA 125 Level [LAB155]

C4 Complement Level [LAB151]

C3 Complement Level [LAB152]

Albumin Level [LAB45]

Transferrin Level [LAB133]

Questions or inquiries may be directed to the “Contact Us” link above.

Microbiology, Test Utilization

Enteric Pathogens PCR Panel: New Order Criteria

The Enteric Pathogens PCR test performed by Spectrum Health Laboratory may be used to detect common pathogenic bacteria and viruses in stool collected from individuals with symptoms of gastrointestinal infection. Specifically, this test detects Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Norovirus, Rotavirus, and the Shiga toxin virulence factor. Effective August 17, 2022, Spectrum Health’s Epic EMR will contain new ask-at-order questions to help improve the clinical decision support and appropriate utilization of this testing. Continue Reading

General Information, Toxicology

Updates to Blood Lead Reporting

As of July 19, 2022, in alignment with recommendations from the Center for Disease Control and Prevention (CDC) the reference range for blood lead testing has been updated from 5 mcg/dL to 3.5 mcg/dL.

This applies to both: Lead, Blood Level [LAB98] and Lead Screen Filter Paper [LAB2111119].

In addition, at this time the low end of reporting for Lead Screen Filter Paper [LAB2111119] has increased from 1 mcg/dL to 2 mcg/dL. Continue Reading