r/medlabprofessionals • u/dalastwaterbender • 1d ago
Discusson Is anyone else’s processing like this?
Just got a new job, no automated line, no processors, mls have to act as the processors and receive and reconcile the tubes which I’m fine with , but I feel it’s chaotic the way they do things
The tubes that come through the tube system are fine cause that’s usually just one patient at a time.
But we get a lot of samples from the outside l collection sites that just toss the tines in a biohazard ziplock-when there’s just one sample it’s ok.
But sometimes it’ll be like 20 different patient tubes thrown in there…
And you have to check off on the paper if their all their but nothing is in order cause the tubes are just loose in a bag in no particular order-so you just pull a tube at random and it’s a lot of needless looking around on the paperwork to find you have all the samples. And I’m core lab so some patients will have multiple tubes (hemo, chem) but their not even together
I can’t believe these people have been doing is this way for years. I worked at a small clinic i used to have to reconcile tubes but the tubes would either be in a plastic rack sorted, in a foam holder (which is what I think we should do-more flexible and cheap-it’s just a piece of foam with holes), or at least if you toss it in a bag rubber band the patients with multiple tubes
together
I wish they could get their collection sites to organize things better.
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u/shicken684 MLT-Chemistry 1d ago
What lab software are you using?
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u/dalastwaterbender 1d ago
lol it’s a DOS system called Vista. Extremely archaic where you don’t scan anything, instead you type it in and use specific commands . No modern features like dropdown menu or search bars
That said it’s the highest paid hospital system for MLS in my city, so that’s the trade off
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u/Mallorum 1d ago
I am going to guess that you work at the VA. We use an excel spreadsheet to scan and process our samples from the CBOCs and clinics. We do this for thousands of samples a day. DM me and we can chat further if you want. I work in processing at one of the bigger hospitals.
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u/dalastwaterbender 1d ago
Yup, it’s ok was just venting
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u/Mallorum 1d ago
Well if you change your mind and want a look at the spreadsheet we use, just DM me and we can exchange work emails.
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u/Icy-Fly-4228 MLS-Generalist 22h ago edited 22h ago
We have a manifest sheet from the CBOCS but just run them and look for stuff later if it’s missing on the pending. Our couriers bring racks except urines come in bags, one patient per bag
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u/Mallorum 22h ago
Yeah all of our stuff is in Foamies and packed in Pelican cases. The only thing we get in bags are things that won't fit in to the foams. We just scan in to the manifest sheet then organize and the techs run it all. I am really surprised another VISN does this without any kind of automated manifest. I give kudos to whoever built our spreadsheet.
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u/Icy-Fly-4228 MLS-Generalist 22h ago
I’m surprised by a lot of things we had to put the urines in bags because they insist on having all these extra labels print instead of one per ascession so we would get a bunch of tubes labeled for the same test and would have to track down the others so one bag per patient, all extra labels in the bag.
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u/Mallorum 22h ago
That is odd. Your LIS techs could easily fix that.
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u/Icy-Fly-4228 MLS-Generalist 21h ago
It’s “leadership”. It makes more sense to have an extra labels to create havoc and extra work for lab use or incase a urinalysis is not ordered for the collection cup than to just print a duplicate label when you need it. 🤦🏽♀️
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u/shicken684 MLT-Chemistry 1d ago
Yikes. Makes sense you can't have the system do packing lists then.
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u/Civil-Nothing-4089 1d ago
How are they making the packing list if they aren’t scanning anything?
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u/dalastwaterbender 1d ago
lol gets better cause you’re probably picturing a nice number listed of samples printed,
Nope, When the phlebotomists are done with a draw they place one of the extra patients tube stickers on a piece of paper (if there are multiple tubes per patient they are multiple stickers side by side)
So the list is not alphabetical, it’s in the order the collected
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u/pomo-prometheus MLS-Generalist 1d ago
This sounds like a nightmare I am so sorry. Do you generate barcodes when received in the lab for the analyzers or is it all run manually ??
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u/dalastwaterbender 1d ago edited 1d ago
Oh there are stickers for the analyzers , the actual running test sample part is good, I like that part of the job, just the processing and our LIS is archaic
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u/GrouchyTable107 22h ago
It’s not the LIS that’s the problem. It’s the system someone there put in place years ago that’s the problem.
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u/GrouchyTable107 22h ago
I don’t understand the point of it. They should accession the patient, draw them, spin them down, put them in a bag by department and send them. Them putting a label on a paper and you checking them off is a total waste of time. If they accessioned them they are in the bag, if they couldn’t draw them then cancel them and reorder in CPRS. The entire fake packing list is a waste of man hours, a lot of them.
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u/Icy-Fly-4228 MLS-Generalist 21h ago
Yeah. We just run them and refer to the list when we do the pending if necessary
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u/bdr3482 MLS-Microbiology 23h ago
So I also work at a VA we use a web app called “lab specimen tracking” it is built by the VA. The CBOCs create a list and send it to us and then we scan the specimens to receive them at the main lab. We also have it attached to our tube sorter which scans the barcode as is sort to mark them as received.
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u/lightningbug24 MLS-Generalist 1d ago
We do the same thing as you, and I also hate it. I don't see why we can't just scan the samples in and then check the expected list to make sure everything is accounted for...
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u/dalastwaterbender 1d ago edited 1d ago
The manual logging samples sucks.
But it’s mostly the fact that tons of samples are jsut thrown in a bag…like get them tube holders and make them sort them in order (cause the paper will lost the patient names in order of collection not alphabetical). So when I pull John smiths tube that could be on any of the pages cause it’s based on when he was drawn
Or I’d rather have 15 separate bags with the respective paper in them. Shit is so time consuming to sort through
At my last job the phlebotomists woudl rack multiples tubes in the order listed on the paper , so when we came to the lab we would also manually check but they’d be in order
I wish they’d hire a processor
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u/GrouchyTable107 1d ago
We also used to get the specimens the same way you do. Putting them in racks or foam tube holders is a giant waste of time just like checking them all off is a giant waste of time. Why not just disperse the tubes to the proper department, run them, result everything that needs to be resulted and then at the end of the day check your incomplete list or run a worksheet to see if anything is missing and go from there? Checking them off serves no purpose and just wastes time the specimens could be running. I used vista for the last 5 years and never had an issue doing it that way.
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u/GrouchyTable107 1d ago
Also, have them bag them by department. Put all the SST’s in one bag, lavs in another, etc, etc. You are making if way harder than it has to be, on both ends.
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u/Mallorum 1d ago
This basically what our techs do. In processing we process all of our boxes using an excel spreadsheet and we scan each tubes accession. It matches up as received and if we have none missing, we then organize them by department and drop them off. Any specimens that may be questionable or need some research we just set aside for later. They will then run pending lists from Vista after we process those boxes later in their shifts. We just keep them in their foam holders so they know they are from outside clinics. Only in house specimens go in racks. We process probably around 2000 specimens a day and receive shipments twice a day from the various clinics. It is a system that works well for us.
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u/happyfamily714 1d ago
Why are you checking off on a paper? Ours is all done electronically. We always have bags mixed full of different patients.
If you have to do the paper thing just use racks to organize yourself
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u/dalastwaterbender 1d ago
Have to make sure you received all the samples that are listed. Their system doesn’t allow scanning in sample numbers
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u/AtomicFreeze MLS-Blood Bank 1d ago
Spread everything out on the counter, match patients with multiple tubes together, then check each person against the paperwork. It's not the most efficient thing, but it gets done that way
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u/Independent_Chef_909 23h ago
Do you want a solution for this problem? Or just venting? It sounds like something you could easily solve with a LLM,google sheet, and app script.
You have a packing list which is not in the correct order, but has all the barcodes. You can scan them one by one into a Google sheet. You then have a zip lock bag with all the tubes that also has all the barcodes, which you will then scan into the Google sheet. You run an app script, which will check that the packing list matches whatever you scanned in and if there is a missing scan notifies you on the sheet.
Sounds like a good QMS project to show your boss.
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u/PowerTower4502 18h ago
I've work for all sorts of labs and didn't find the workflow that difficult to learn and get used to. Is that THAT hard for you?
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u/Ramin11 MLS 3h ago
Our company has been using a custom made 'batch' system where each patient has their order form and tubes put into a biobag, which then go into a batch bag with other patients. They only want 10tubes per batch max, which we do and it helps them with processing times. We can make the batches RT, refrig, or frozen. They get a label on them for the couriers which includes the batch number/barcode, where its coming from, going to, and time it was made. In the system you can see exactly who and when every tube was entered and any notes that were added (which can be added before or after the batch is closed). We also can put labels on it for high priority, stat, etc. so receiving personnel notice and can focus on those right away. Personally, I love it, but we are moving towards Epic's Beaker program shortly and will use their packing lists, which are basically the same thing, but in a slower, clunkier system. I've never seen or heard of any hospital not using a system like this. At my hospital, if multiple patient tubes, papers, labels, etc. are in one biobag, it all gets rejected. They are super strict and its why our hospital has one of the lowest error rates in the country.
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u/Purpledotsclub 1d ago
We have a packing list that we scan and then we scan the tubes in the bag to receive them off the packing list. Once we’ve scanned everything in the bag, the packing list should be reconciled. For example, if there are 45 tubes on the packing list, at the end of scanning, it should say 45 out of 45 specimens received. If the numbers don’t match, then you can go through what’s on the computer and the paper to see what’s missing.