The Laboratory Information System (LIS) is a part of the University Hospital computer system. Access to the LIS is through computer terminals which are located throughout the hospital and clinics:
Inquiries pertaining to the operation of the laboratory computer should be directed to the following:
- Janet Liebl, MT(ASCP), Chief Technologists, LIS .................................................... Ext. 42883
- Digital Pager# 364-4868
- Peggy Wilkins, MT(HHS), Asst. Chief Technologist ................................................ Ext. 56100
- Pager# 713-4615
The Laboratory Information System (LIS) is a turn-key system comprised of Version 5.6 software by Medical Information Technology (Meditech). The system consists of the Laboratory Module for processing and resulting lab specimens, the Microbiology Module designed for the special requirements of microbiology cultures and sensitivities, and the Blood Bank Module which manages the specimen processing and crossmatching and assists in unit inventory. All inpatient and outpatient laboratory data is entered and stored in the Meditech Laboratory Information System by the Division of Clinical Pathology.
The laboratory system runs on a Data General AviiON 1400 multiprocessor with a CLARiiON Disk Array subsystem. This processor provides 64 megabytes of memory and EMC INTEL 995 MHz processing power. The lab disk configuration includes two 8 gigabyte data pack regions, essentially one master pack and one copies. Another 8 gigabyte pack for archive is provided and another 8 gigabyte pack as a spare for replacements. This is a total of four 8 gigabyte disk packs.
Stat broadcast printers enable the laboratory to automatically send all reports to areas with the Meditech printer capability. Label printers allow immediate identification of lab specimens by printing pertinent demographic and specimen information for placement on collection containers. Phlebotomy and some patient care areas are equipped with these label printers.
The system compiles a number of reports and summaries for patient's result reporting. The discharge summary is the final official copy of the patient data. This report is sent to Health Information Services for completing the patient charts.
All non-laboratory personnel must order tests through the SMS computer system, the Hospital Information System (HIS), which is interfaced to Meditech for orders and reports. Authorized lab personnel may place orders in Meditech. Telephone the Information System helpline at 41145 for information.
On the PATIENT INQUIRY/CENSUS OPTIONS screen
1. Locate patient by one of the options listed on the left side of the screen under
***Patient Inquiries***.
On the ORDER PROCESSING PATIENT MENU
2. Use the mouse to select !01 Enter Orders
Type in the line number, 01, in the space provided (on the right side of the bottom dotted line).
On the SELECT DEPARTMENTS screen
3. Use the mouse to select 01 Laboratory
Type in the line number of the desired department in the space provided.
On the SELECT SUBDEPARTMENTS screen (if applicable)
4. Use the mouse to select the desired subdepartment (See listing at end of section)
Type in the line number of the desired subdepartment in the space provided.
On the SELECT SERVICES screen
5. Use the mouse to select the desired test (See end of section for list of order screens)
Type in the line number of the desired test in the space provided.
On the ENTER INFORMATION screen
6. Complete required information by using the mouse to make desired selections or by typing in the required information. Use the Help Key(with the cursor in the first postition of the line, press F12 while holding down the shift key) to display allowable values for the required fields if acceptable values are not known.
7. Press enter. Then check the information displayed on the screen for accuracy. Make corrections if necessary.
8. Press enter again.
On the PRECONFIRMATION screen
9. Review, revise, delete, or add more orders as necessary by using the footer selections.
10. PRESS F12 TO COMPLETE the orders.
On the CONFIRMATION screen
11. Press enter to return to the ORDER PROCESSING PATIENT MENU.
There is a difference between “one time”orders and “continuing orders”.
For orders that are for more than one day, discontinue the orders, not cancel.
On the Patient Inquiry/Census Options Screen:
1. Locate patient by name or number inquiry.
On the Order Processing Patient Menu:
2. Select Option !10 Display/Revise Active Orders
On the Display/Revise Orders – Display Menu Screen:
3. Select the order to be canceled and
Select Option & F4 Cancel/DC
On the Cancel/Dc Options Screen:
4. Select Option !05 Cancel Order(s)
On the Cancel Order/Enter Order Screen:
5. Just Press Enter –Do not type in the order # because it comes across with the order.
On the Cancel Order/Comments Screen:
6. Select one of the provided reasons or type the reason for the cancellation. Press ENTER.
On the Cancel Order/Review Screen:
7. Review the information to confirm that this is the order to be cancelled. Press ENTER.
On the Cancel Order/Confirmation Screen: Press Enter
8. System will return to Display/Revise Orders/Display Menu screen and order will no longer be on the list, Select !F3 Display Options.
On the Display/Revise Orders/Select Display Criteria Screen:
9. Select Option !01 Display all orders +/- 90 days.
On the Display Orders/Display Menu Screen:
10. Verfy that the orders status in the status column to the right of the order that was canceled is now “CAN”.
(Abbreviated Instructions)
On the PATIENT INQUIRY/CENSUS OPTIONS screen
- Locate patient by one of the options listed on the left side of the screen under
******Patient Inquires******
On the ORDER PROCESSING PATIENT MENU screen
2. Use the mouse to select !12 Display Results.
OR
Type in the line number of the activity Display Results – 12.
On the LCR PATIENT MENU screen
3. The results are divided into time frames. If LAB is highlighted (in white), there are results behind it. Those not highlighted do not yet have results located behind them.
OR
Type in the line number of the time frame in the space provided.
On the DISPLAY RESULT screen
4. Use the mouse to select the desired result for viewing from the list
OR
Type in the line number of the desired result for viewing the the space provided.
Press ENTER.
5. View results. Use F8 to page down or F7 to page up.
6. If there is a TEXT message associated with the order, use the mouse to select it and choose the option !F10 Drill Down with the mouse.
OR
Type the TEXT message line Number and Press F10 on the keyboard
7. Press F2 to return to the previous screen and open another test from the same department.
8. Press F1 to return to the LCR PATIENT MENU screen and select another time frame if desired.
TO PRINT RESULTS
Select !F12 Options
Select !F8 Print Set
TO DISPLAY RESULTS IN SMS INVISION
(Abbreviated Instructions)
On the PATIENT INQUIRY/CENSUS OPTIONS screen
- Locate patient by one of the options listed on the left side of the screen under
******Patient Inquires******
On the ORDER PROCESSING PATIENT MENU screen
2. Use the mouse to select !12 Display Results.
OR
Type in the line number of the activity Display Results – 12.
On the LCR PATIENT MENU screen
3. The results are divided into time frames. If LAB is highlighted (in white), there are results behind it. Those not highlighted do not yet have results located behind them.
OR
Type in the line number of the time frame in the space provided.
On the DISPLAY RESULT screen
4. Use the mouse to select the desired result for viewing from the list
OR
Type in the line number of the desired result for viewing the the space provided.
Press ENTER.
5. View results. Use F8 to page down or F7 to page up.
6. If there is a TEXT message associated with the order, use the mouse to select it and choose the option !F10 Drill Down with your mouse.
OR
Type the TEXT message line Number and Press F10 on the keyboard
7. Press F2 to return to the previous screen and open another test from the same department.
8. Press F1 to return to the LCR PATIENT MENU screen and select another time frame if desired.
TO PRINT RESULTS
Select !F12 Options
Select !F8 Print Set
TO PLACE AN ORDER ON A PATIENT IN SMS INVISION
On the PATIENT INQUIRY/CENSUS Screen
1. locate patient by one of the options listed on the left side of the screen under
***Patient Inquiries***.
On the ORDER PROCESSING PATIENT MENU
2. Use the mouse to select !01 Enter Orders
OR
Type in line number, 01, in the space provided (on the right side of the bottom dotted line)
On the SELECT DEPARTMENTS screen
3. Use mouse to select 01 Laboratory
OR
Type in the line number of the desired department in the space provided.
On the SELECT SUBDEPARTMENTS screen (if applicable)
4. Use the mouse to select desired subdepartment (see listing at the end of section)
OR
Type in the line number of the desired subdepartment in the space provided.
On the SELECTED SERVICE screen
5. Use the mouse to select desired test (see end of section for list of ordered screen's)
OR
Type in the line number of the desired test in the space provided.
On the ENTER INFORMATION screen
6. Complete required information by using the mouse to make desired selections or by typing in the required information. Use the Help Key (with the cursor in first position of the line, press F12 while holding down the shift key) to display allowable values for required fields if acceptable values are not known.
7. Press enter. Then check the information displayed on the screen for accuracy. Make correction if necessary.
8. Press enter again.
On the PRECONFIRMATION screen
9. Review, revise, delete or add. more orders as necessary by using the footer selections.
10. PRESS F12 TO COMPLETE the orders.
On the CONFORMATION screen
11. Press enter to return to the ORDER PROCESSING PATIENT MENU.
LAB SYSTEM NOTES
All specimens sent to the lab must be labeled. The label must include all of the following information.
- a. Patient's name
- b. Patient's 12 digit case number, use addressograph plate when available
- c. Date
- d. Time collected
- e. Collected by (initials)
- f. Test(s)
- g. Requisition Number
- h. Requesting physician
(Lavender Card)
Outpatient Clinic
Collection Date Time By
Requisition # Requesting MD
Specimen Type Patient Location
Diagnosis/Medical Necessity
Test(s)
(Addressograph below)
Patient's Name
Complete Hospital#
Hosp. No. 1505
OR
(Yellow Card)
Inpatient Hospital
Collection Date Time By
Requisition # Requesting MD
Specimen Type Patient Location
Diagnosis/Medical Necessity
Test(s)
(Addressograph below)
Patient's Name
Complete Hospital#
Hosp. No. 1507
- Stat lab results will not be phoned back to the unit, except during codes or laboratory computer failure (note on label or 3 X 5 card CODE and extension number).
- If the Lab Computer is to have scheduled down time, a notification will be sent to all nursing stations with instructions for this period of time.
For unexpected computer failure, complete the following steps:
Check your computer, i.e., check computer plug, electrical outlet plug, on and off switch.
- If there is no computer response to the previous check, notify Computer Services, at extension 41145, that computer is down.
- Laboratory Computer Failure: If for any reason the laboratory computer is down, specimen entry into the laboratory requires completion of the 3 X 5 card available from the storeroom. This Manual Backup System is essentially implementing the 3 X 5 card system currently used when a laboratory test is submitted without the computer order from a clinic or nursing station.
- For specimens collected by non-laboratory-personnel (NLP), complete the 3 X 5 card with the addressograph imprinted on previous page. Complete the blanks on the card to include requesting physician, test requested, person drawing or collecting the specimen, and date and time collected. These specimens need to be delivered to the laboratory as usual. Please see example below.
- For Routine laboratory specimens requiring a phlebotomist, complete the 3 X 5 card as in item d above, and leave the card(s) at the nursing station. Normal phlebotomy rounds will be made to collect the routine lab work.
- For Stat laboratory requests (other than intensive care units/operating rooms, etc) stat phlebotomy from 0600 to 1800 hours will be provided as usual. Call extension 42350 requesting the stat phlebotomy. A phlebotomist will be dispatched to the location where the completed 3 X 5 card should be waiting with the added note to call back to the patients nursing station extension. It will be the responsibility of everyone to get the stat specimens to the laboratory as soon as possible during a computer failure. The phlebotomy personnel resources available at the time of the computer failure will determine the laboratories ability to draw and transport the specimens to the lab. Every attempt will be made to draw or pickup a STAT specimen. Obviously, this may not be possible at all times and physicians and nursing service assistance will be important to meet the patient's need. The laboratory will call back stat results as soon as possible.
- When the computer system becomes functional, the requested test results will be entered into the computer as quickly as possible
BLOOD BANK ORDERS
- Physicians, RNs and phlebotomists will draw specimens for blood bank. Labels must include all information except requisition numbers. (Blood Bank samples below).
- Send requisition card with specimen to the Blood Bank.
- Blood bank orders cannot be entered into the computer from the unit. Blood bank personnel will enter all requisitions into computer.
- If a physician cancels an order or a patient expires, call blood bank to release blood.
- Results inquiry function on the computer will provide information on blood products status (issued or available) for patients, alleviating the need to call the blood bank.
Department of Transfusion Medicine Requisition Card
PHLEBOTOMISTS DRAWING BLOOD BANK SAMPLES
Requisition cards are to be used for blood bank orders. They will be filled out by the ordering area with the following information: (see card on the bottom of Blood Bank Orders-page 64)- a. Patient's name
- b. Patient's 12 digit case number (use addressograph plate when available)
- c. Date
- d. Time collected
- e. Collected by (initials)
- f. Test
- g. Requesting physician
A label will also be prepared by the nurse or unit secretary with the following information:
- a. Patient's name
- b. Patient's 12 digit history number
- c. Requesting physician
- d. Room number
- e. Date
- f. Test
- g. Sample drawn by (initials)
These will be given to the phlebotomist when he or she checks in before rounds. If this is a STAT request, unit secretary or nurse will tell phlebotomist at this time. If STAT, floor personnel will deliver to the Blood Bank.
The Phlebotomist will follow standard patient identification procedures - verifying the armband of patient. The phlebotomist can draw blood for the Blood Bank only in the presence of the patient's nurse or physician.
The Phlebotomist will draw the appropriate specimens into the tubes, which will then be labeled.
The phlebotomist will put the draw time and identification number on the card and tube, then deliver the tube to the nurse's station or the Blood Bank (whatever will get the samples to blood bank immediately). If the phlebotomist is on rounds and will not return to the lab for an extended period, the floor may choose to deliver ASAP.
Do not order microbiology, transfusion services (blood bank), or special labs (Acute Lab and PeriNatal Lab) here.
STAT RESULTS
STAT lab results will not be phoned back to the unit, except during codes.
All test and procedure results are automatically printed back to the units once completed in the lab. The Stat Broadcast Result will be sent to the location of the patient in the Admission System at the time the test result is verified by the laboratory. For this reason, timely transfer and discharge of patients in the Patient Information System is vital to timely and accurate reporting of laboratory data.