POCT Emergency 99999999 numbers when MRN not available

ED unregistered patient form FINAL.doc

ED unregistered patient form TRAINING colors.doc

We have forms in the Emergency Department with a unique number that the lab generates.  There is a space on the form for them to place a label with all of the patient's info, after the patient has been registered.  They send that form to the lab and we match the result up to the correct patient.  I hope this helps.

Mary Wrenn

Hi Gayle!

I send the user an email and copy their leader on it. The email is rather generic... What can you tell me about this test? Who does this belong to? Did it get manually entered into the EMR?

Our waived testing is Joint Commission, using terms like JC standards or accreditation standards seams to make my likelihood of a response greater.  Depending on the response, we have a tip sheet from IT on how to manually enter 999s into the EMR and we request a Patient Safety Report get filed.

If I don't hear back, I bug them again.

Our EPIC team issued an edict stating that no emergency numbers would be used going forward once we were live on EPIC.    Staff were to register the patient in a timely manner so the wristband were available for scanning on the devices (glucose meter and I-STAT).  This has made life in our POC world much easier.

Andrea Spence

Point of Care Testing Coordinator

Hartford Hospital

Hartford, CT

I track down the operator that used the device and ask them to tell me a name of the patient.  From there I am able to look up the patients name and medical record number and link the results to my emergency patient.  Some of the staff call and leave me messages with a patients name of account number. 

I've worked really hard to let nursing staff know that they can always use an emergency ID on a patient when it is need but it is their responsibility to let me know who it belongs to so it can be resolved.  They've done a pretty good job at my facility letting me know what they've done.

We use a very similar process to Mary Wrenn.  If we don't get a form, we report the lack of follow-up in our hospital event reporting system.  We try to limit it to the ED and NICU, but we do occasionally get a generic number from another unit.

The glucometer middleware RALS gives the who, what, time and where the test was performed.

• ED adds the patient's name or last name/DOB as a comment.


• I can either find the information in the EMR and complete the loop.


• If I can't ,I send a copy of our ID Correction Form and a printout from RALS to the operator and the Clinical Lead in the ED.

They are given 4 weeks to address the issue before it becomes an unmatched patient result for our QI report.

Procedure: The only place an alternate ID can be used is the ED (unresponsive pt.), LDR (newborn not registered yet) or the CrashCart911 barcode on all of our crash carts (visitor, staff member or vendor who becomes acutely ill). Staff are required to send me an email as to the situation and "patient's name".

This works well at our institution but I have occasionally had to chase a staff member or manager! 

We create specific ID numbers for each of our satellites and for our Transport, ED and PICU.  Since we have manual entry locked out (as much as possible) they have to scan a barcode in order to enter  patient information.  I use the location plus sequential numbers to differentiate between the areas and it's mostly used for codes on parents.  They do a good job at registering patients and having ID for them.  Even our Transport now has the patient registered before they go to pick them up.  The operator fills the form out with the name and DOB of the non-registered patient and then either tubes or faxes the form to me.  If I don't received it within a few days of the result being in QML I send an email to them and cc their manager.  One of them will get back to me with the info.

We also use a process similar to Mary Wrenn but we just use a Dymo label printer to print sequential barcode numbers so they have something to scan into the meter and we can match it up from RALS when they attach the registration label and tube to the lab.

We allow use of fake numbers in the glucose meter and iSTAT and allow manual entry for these. It's almost solely used by transport and labor and delivery. I have been trying to get a group together to talk about the reg process but it's low on their list.

Respiratory has been doing this so long that we don't really have an issue. They send me an email with the patient info - email is preferred for tracking. I still have a couple that leave voicemails. If I haven't receive the info, I email the operator and management the next day. After 5 days, they get another email flagged as urgent and "2nd notice". I rarely do not get a response.

I have had an issue with staff testing themselves when they aren't feeling well thus using a fake number. Does anyone else have this problem and how are you handling it?

Anytime I have a result on an emergency use ID and do not receive patient information I send a request to both the operator and their director for the information.  The second offense I ask again and give them a warning that a 3rd occurrence will result in the loss of their ability to use the point of care testing.  I have only had one operator who got to the point of having their access revoked.