Freestanding ED/UC sites

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For anyone out there who has freestanding ED/UC sites, how are you handling critical calls? Our sites are extremely busy, and the testing is done by non-laboratory staff, using a POCT model. In our system, POCT results are not called by our call center, and we have comments in our procedures that state that the if the person doing the test is the patient caregiver, then we don't need to call any critical results. Because the labs are run by dedicated lab staff, they are not caregivers. They run far too many tests in their shift and also are not laboratorians so aren't familiar with critical values. Since our lab isn't running the tests, we are concerned for the liability of calling/reporting lab values that we're not performing. So, we are looking for a solution that will best serve our patients and providers. Has anyone out there looked at this issue? Any thoughts on how to move forward? I appreciate any feedback.

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I am assuming these are charted electronically via an interface. 
Depends on device and middleware, but can you do a comment or entry that acknowledges the results as critical? 
For iSTAT with Telcor QML, a numerical comment can be created. 
Attachment.
image.png
in DE customization - Test tab - Patient Test comment code choose Prompt for comment code and then drop down of require comment
·   Press (1) for repeat (do new sample /new cartridge as could be in error)
·   Press (2) acknowledge critical/provider will be notified – must document in EPIC 
The middleware can be configured to "not send" if press 1 and send if press 2
So then you can say - they acknowledged result as critical - thats first step anyway. Then in review POCC filter for comment 2 and send a report to site (or review yourself) for documentation in chart. 

Thanks for this. We are looking for something that will indicate that a result is critical and immediately catch the attention of the provider. Right now, the results are sent directly to the patient chart, with an indication of high, low, or critical. We want something, maybe electronic, similar to the boards we have in the lab that will indicate a STAT and turn red after a certain period of time. Since the sites are staffed by non-laboratorians, they don't always know when results are critical and often don't even look at the results since they automatically cross to the patient record.

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Kathleen David
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