A True Who - “Dunnit” Mystery

1. Laboratory Package for Small Sites without a Laboratory Professional Resource Patient Management System A True Who - “Dunnit” Mystery

2. Crime Scene: Nothing is showing in PCC • Police Report: • The provider reports that no labs are in PCC. • This can be solved after the maintenance section of the class

3. Solution: PCC Link not running Go into CORELAB—>BLR—LS Is the Link running? If not run STP and start the link Ask yourself why was it down to begin with? System reboot? Check for errors? Crime Scene: Nothing is showing in PCC (cont.)

4. Crime Scene:Labs are not showing in the TIU objects • Police Report: • While investigating the PCC problem, it was reported that TIU data objects for lab were also empty

5. Most lab data objects TIU come from PCC. You just fixed both problems by checking the link Crime Scene: TIU Objects (cont.)

6. Crime Scene: Only SOME TIUs Have Stopped • Most providers are happily entering notes now but they seem to not be able to add the TIU only for the Glucose…

7. Crime Scene: Only SOME TIUs Have Stopped (cont.) • TIUs link by Test Name… • You just remembered you changed the Glucose name from “Glucose” to “Glucose, Random” • You need to have the CAC or Consultant update the TIU for the new name • You need to update your Lab procedures to remember to change TIUs if test names change

8. Crime Scene: Orders are coming to lab but the lab can’t accession • Police Report: • lab contacted you about orders in EHR that are not showing up in RPMS. They were not aware of any problems until stats were not getting done on time • They don’t understand why the orders are not showing up in OERR and request your help in solving this mystery.

9. Crime Scene: Why don’t I see orders in RPMS OERR and I see it in EHR? • Roll over has not completed and this can prevent accessioning • Use taskman to restart rollover • Ask why did it stop? • Reboot • Error---check for errors

10. Crime Scene: The inspector has arrived • Police Report: • The inspector arrived. It is the same day you had a fire drill and a code-adam. As you re-entered the building the inspector signed in…. • She wants to see • Training records • Remediation of problems records • Competency proof • List of orderable tests with dates last modified

11. Crime Scene: Inspector (cont.) • The best way to solve this is prior preparation • Have your training records properly filed • Make sure you back up training with competency • Make sure you add site/date notes to file 60 tests • In order to print the test dictionary consult with your area consultant and use fileman print • When you are prepared, you can great the inspector with calmness

12. Crime Scene: Quest has called Quest called and is attempting to send results but can’t.

13. Crime Scene: Quest has called (cont.) • Check GIS, what color is it? • Check the four jobs that need to be running • Where is this? • But wait---I do not have an interface. What is wrong? Turn on your fax, make sure it is not out of paper.

14. Crime Scene: New Test! • Dr. Jones has discovered a new test kit that she wants to use in the clinic. What do you need to do?

15. Crime Scene: New Test (cont.) • Solution: • Check the mfg web site and literature to assure you have the skills and authority to run this test. Is the test Waived, Moderate, or High complexity? Does your certificate cover it? What will the results be used for---is it within the scope mentioned by the mfg? • Get a product insert from the MFG

16. Crime Scene: New Test (cont.) • Solution: • Read it and extract---Units, Ranges, limitations, procedures, collection samples • Consult with your Lab consultant to assist with the building and TESTING—DataName, file 60, Quick orders, TIU, patient reports, PCC • Consult with medical staff for placement on an menu

17. Crime Scene: POC Test • Crime Scene: A new RMA has called and can’t use the POC button. She sees the button, is able to bring up a test, but can’t enter results.

18. Crime Scene: POC Test (cont.) Crime Scene: The RMA is missing the LR VERIFY key

19. Crime Scene: Reference Ranges • Crime Scene: No reference ranges are showing in Lab or E.HR. The results are not flagged either!

20. Crime Scene: Reference Ranges (cont.) • Crime Scene: Two causes possible • File 60 has no site/specimens • Or the site/specimen is missing units/ranges • Go into Fileman • Inquire • Enter file number 60 • Enter test name • Display the test • Make sure units/ranges/specimens exist • If they do exist, do an order/test status and see if the specimen used to collect matches the specimen found in item 3.

21. Crime Scene: Tests Not Completed • Crime Scene: Second shift is complaining that first shift is leaving tests undone

22. Crime Scene: Tests Not Completed (cont.) • Crime Scene: Every shift needs to run an incomplete test list prior to end of shift!

23. Crime Scene: Reference Lab Test Missing • Crime Scene: The Drs are missing tests that were sent out to Quest!

24. Crime Scene: Reference Lab Test Missing (cont.) • Crime Scene: Incomplete test log will show what is pending and you can then followup with quest

25. Crime Scene: System is Slow or Hangs • Crime scene: You accession orders and the system hangs or is very slow to assign an accession

26. Crime Scene: System is Slow or Hangs(cont.) • Crime scene: You accession orders and the system hangs or is very slow to assign an accession • Solution is to make sure your background tasks are scheduled to run…. This keeps the package squeaky clean! • Schedule the LRTASK ROLLOVER for 1 minute past midnight to run every night • Schedule the LRTASK NIGHTY to run 5 minutes after midnight every night • Schedule the BLRTASK Lab Log Cleanup 1 hour past midnight every night • Schedule LA7TASK NIGHTY 1 hour 15 minutes past midnight every night

27. Questions & Discussion