Want to Simplify PT Result Reporting? Consider Direct Transmission

Julie McDowell:

Submitting quantitative PT results manually can be time-consuming, can drain laboratory resources, and is subject to human error. CAP customers can now simplify this process by using direct transmission. In this CAPcast interview, Tim Aukerman, Corporate Quality Assessment Manager at Quest Diagnostics, discusses his experience with directly transmitting PT results to the CAP via the data innovations instrument manager. Tim has oversight of quality initiatives, including PT, across Quest Diagnostics, and led the switch to using direct transmission across more than 100 Quest regional and rapid response labs.

Tim, can you tell us how Quest Laboratories was reporting PT results to the CAP prior to implementing direct transmission?

Dr. Timothy Allen:

Sure. Prior to implementing the direct transmission process, the old process was a much more manual and labor-intensive process for both entering and reviewing. data. Results were manually transferred from the instrument printout to the result form, then results were reviewed by a supervisor and then either faxed or entered manually into the eLab system, which would then require secondary review. For the large surveys like the C surveys, this was a huge time commitment requiring several hours of work for both the technologist and supervisor, and of course added the possibility of clerical errors. As you can imagine, this was not a process that anyone looked forward to having to perform on a regular basis with the huge number of surveys that are performed at Quest.

Julie McDowell:

Now, what made you decide to implement direct transmission in your laboratory?

Dr. Timothy Allen:

Ultimately, it was the PT failures that involve clerical errors that became the driving force to implement this process at Quest. We had tried other processes without huge success to prevent these clerical errors, like additional reviews. But these processes took a lot of extra time and resources and were difficult to standardize throughout our organization. We felt that the only way to reduce the clerical errors would be to implement a process that's similar to the way we report and review patients in our LIS system. Direct transmission seemed to be the best option to make this process much more similar to how we report our patients. And again, the time savings alone for the larger surveys made this a very attractive option based on the huge number of surveys that are performed across our regional labs and our rapid response labs.

Julie McDowell:

Now, how many Quest laboratories currently utilize direct transmission to report PT results?

Dr. Timothy Allen:

We have roughly 30 of our regional laboratories, our larger laboratories, and roughly 75 rapid response laboratories currently utilizing the direct transmission process. So you can imagine how much time that saves our techs and supervisors and allows them to be performing other tasks.

Julie McDowell:

Well, you touched on this a little, but how else has using direct transmission to report your PT results impacted you in your laboratories?

Dr. Timothy Allen:

Obviously, the time savings alone has been huge for Quest. We have also seen a reduction in the clerical errors related to entering quantitative results. This won't stop all your clerical errors, because qualitative results are still being manually entered, but the majority of clerical errors are around transposing numbers when entering quantitative results.

Originally, labs were kind of reluctant to use this process because they were worried that once the results were sent to CAP, that they would not have an opportunity to review the results that had been sent. Basically, it is the same process that they currently use for manually entering into eLab, but when you get into the eLab, the results are already there to be reviewed and you still have the opportunity to change the result or enter a result that did not cross. Here at Quest, we have it set up to not transmit greater than or less than results so that the correct code can be entered if the results are above or below the analytical measurement range.

What I really noticed was that once Labs began using it, the word spread as to how much easier this was than manually entering every single result. And then the labs began coming to me wondering how they could get started. And we are still adding our rapid response labs currently, but obviously the biggest bang for our buck was to get the larger regional labs on board first because they run many more surveys than the rapid response labs.

Julie McDowell:

Finally, Tim, do you have any advice for laboratories considering using direct transmission to report PT results?

Dr. Timothy Allen:

You need to look at the time you're taking for your manual entry processes and the number of PT failures that are related to clerical errors, and it becomes really a no-brainer for most labs to use this direct transmission process. If you already use Data Innovations Instrument Manager, it's really easy to make this transition because you already have your test menu in Data Innovations. It was a little more difficult for us because we were not using Data Innovations, and so Instrument Manager had to be matched to the test codes in CAP to get the testing across to the CAP. But once we had one lab set up with all the correct codes, it became as simple as just copying that original set to each individual lab. If you don't have Data Innovations Instrument Manager, you can purchase Instrument Manager and run this direct transmission process through one Instrument Manager, which is what we currently do at Quest.

I'd say the biggest challenge was getting the results from Instrument Manager through the firewall at Quest and then onto CAP. Once we got the right IT team involved and worked closely with CAP and data innovations, we were able to make it happen. And then the other thing we did here at Quest was to create an SOP around this process so that it was easier to train subsequent labs as to some of the differences the technologists might face in relation to the manual process. And then finally, I'd like to mention that we still have the manual entry process as a backup to the direct transmission process.

Julie McDowell:

Thank you, Tim, for discussing direct transmission of PT results on this CAPcast. For more information, please visit cap.org and click Laboratory Improvement from the main menu.

Thank you for listening to this CAPcast. Be sure to listen to our other CAPcasts from the CAP on our SoundCloud channel by downloading the SoundCloud app on your mobile device. And we're also on Apple Podcast and the Stitcher app. To find this podcast search for the word CAPcast on these apps. Once you find our podcast, be sure to click the subscribe button so you don't miss new CAPcast episodes.

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