Laboratory report formats can be cluttered with interpretive comments. While useful for the sake of providing complete and accurate information specific to the test, they can easily become a distraction.
At a recent lab manager meeting the group discussed how to attach interpretive ranges for pediatric patients to a lipid panel report. We examined reports from several labs. Is this new information on the report in addition to the adult interpretive comments or does the information system add the correct information based on patient age? The former creates a report too long to be useful; the latter is possible but potentially cumbersome. Any modification to an information system needs maintenance, too. The more complicated a format, the more difficult the upkeep and the more likely the reason for it will be forgotten in six months. What should the comment be?
I raised my hand and joked, “Maybe, ‘You Should Know This.’”
Physicians are trained to interpret our test results. So as long as they understand what is normal in a given population, the only other information they need would be something uniquely related to the test, such as a gray zone related to analytical sensitivity, therapeutic ranges that overlap a critical limit, etc. Lipid panel and other testing guidelines (e.g. glycated hemoglobin) are well established so to be universally understood.
I asked physicians during rounds one morning about an interpretive comment recommending a repeat test depending on a value. One said candidly, “I don’t like those comments that tell us to do this or that! I don’t want to be held accountable when the chart is audited and the question is asked, ‘Why wasn’t that repeat test done?’ when it may not be needed. That’s my decision.” He’s right, of course.
In other words, doctors are doctors and lab techs are lab techs. We need to have a firm understanding of what they need from us to treat their patients and how to give it to them with the least interference. We don’t like requisitions that specify the tube, instrument methodology, incubation temperature, and so on. Just saying.
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