Clinical Laboratory Workflow
Clinical laboratory testing is always a go-to resource for physician and healthcare providers to accurately diagnose and treat their patients. Below is quick overview of the specimen life-cycle.
Patient Draw
When laboratory work is ordered on a patient, a phelbotomist or nurse will draw the specimens needed for testing. Each test ordered has different draw requirements. Each type of collection tube or method has different qualities that affect the integrity of the specimen. For example, a CBC (complete blood count) must be drawn in a lavender EDTA tube to prevent the blood from clotting.
Received in Laboratory for specimen processing
Once the samples are received in the laboratory, they are processed based on the orders associated with each sample. Some blood and urine specimens are spun down, some are poured off into seperate tubes, and some are left to be tested as-is. The samples are checked for labeling accuracy as well before they are approved for testing.
Send out complex testing
Most laboratories cannot complete all of the testing required for a patient. There are many complex tests that are cost-prohibitive for the lab to have the equipment and staff to complete the testing. These specimens are prepared to be sent out following very strict preparation guidelines. The laboratories that complete this testing are called reference laboratories.
Perform in-house testing
The tests that can be done “in-house” are sorted based on the testing that will be done. In general, the main types of testing are Chemistry, Hematology, Urinalysis, Immunohematology, and Serology. Each type of testing has it’s own set of instrumentation. These instruments can be as small as a desktop computer, to as big as a car to handle the many different types of testing performed.
Result Review
After the samples are run through the instruments, the results are uploaded to the laboratory information system (LIS) for review by a licensed laboratory technologist. The technologist reviews whether the testing was successful, and can be approved for release, or if the sample integrity was not sufficient. For example, a potassium result reporting as 5.5 will be checked for hydrolysis. It is the technologist’s job to ensure accurate result reporting to the physician.
Physician Review
The physician will receive the results through an electronic medical result interface (EMR), where he/she will review and make their medical decisions based on the results. Laboratory results make up 70% of a doctor’s information that a diagnosis is based off of.
Patient Review
Many times the patient is able to review their results through an online portal or have the results printed through their physician’s practice.
Summery
The workflow of the laboratory is complex with many safety checks along the way. Laboratories are under strict guidelines from national and state inspection bodies to ensure that patient safety is never compromised.
