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Critical and Priority Request Definitions for Anatomical Pathology Samples

October 10 , 2017

Key Messages:

Critical and Priority request definitions have been established for Anatomical Pathology samples for the province.  Anatomical Pathology sites within Edmonton Zone rolled this out to the endoscopy units in December 2016 and are now implementing these definitions to all areas.  The roll out will begin October 2, 2017.

Critical

Goal is to provide and initial report within 24 hours from received time in the laboratory (includes non-working days).  The requesting physician MUST contact the appropriate Pathologist / Resident verbally to rquest CRITICAL processing and reporting.  Size of tissue sample and other factors may require additional processing time.

This category is reserved for specimens such as

  • Rapidly progressive renal failure
  • Rapid decompensation following a previous biopsy or surgical procedure of Uterus, Heart or Gastro-intestinal tract
  • Extensive desquamating skin disease
  • Undiagnosed masses causing anatomical compormise of vascular or nerve function
  • Transplant or immunocompromised patients with rapidly deteriorating clinical findings
  • Pediatric Tumors with immediate clinical/therapeutic consequences
  • Life-threathening infections

Priority

For other urgent cases- the initial report will be completed in less than the standard turnaround time

Why this is improtant:

The terms and processes used for cases that require faster than routine processing and reporting (i.e. rush, priority, urgent, etc.) have previosuly been inconsistent.  This leaves the AP staff and clinicians unsure of how the case will be handled and expected date of the report.

Action Required:

When requesting a Critical

  • The requesting physician MUST contact the appropriate Pathologist verbally to request CRITICAL processing and reporting and the pathologist must approve the request
  • The requisition must be clearly labeled as a Critical
  • Must have supporting clinical history to indicate the reason for the request
    • Note: the approving Pathologist (or designate) can downgrade the request to priority if supporting medical information is not provided
  • Test request must include the physicians' direct contact information.

Site Contact Information

During laboratory working hours 0800 t0 1700 Monday to Friday (excluding Statutory Holidays):

Site Contact
RAH  Frozen Section Pathologist Pager: 780.445.2033
MIS  Frozen Section Pathologist Pager:  780.445.2947
GNH  Frozen Section Pathologist Pager: 780.445.7992
SGH  Pathologist Pager: 780.445.7466
CCI  Pathologist Administrative Staff 780.432.8506
UAH

Monday to Friday 0800-1700 with the exception of Tuesdays 0800-1200:

  • UAH Locating Physician will ask to be put into contact with the UAH Pathology Resident on call (via pager)

Tuesdays 0800-1200:

  • UAH Locating UAH Pathologist on Call (subspecialty dependent)

 

After laboratory working hours 1700 to 0800, Weekends and Statutory Holidays:

Site Contact
RAH, MIS, GNH, SGH, CCI Pathologist on call for the Edmonton Zone
UAH UAH Locating Physician will ask to be put into contact with the Pathology Resident on call (via pager)

 

When requesting a Priority

  • The requisition must be clearly labelled as a Priority - the new Anatomical Pathology Requisition has a check box for this
  • Must have supporting clinical history to indicate the reason for the request
  • Note: the approving Pathologist (or designate) can downgrade the request to routine if supporting medical information is not provided
  • The request may be approved by a Pathologist (or designate) upon receipt in the laboratory
  • Test request must include the physicians' direct contact informnation

Inquiries and feedback may be directed to:

  • Site Anatomical P)athology Tech IIs
  • Jenny Zadunayski- EZ Anatomical Pathology Quality Assurance Tech II email or 780.407.8481

 

 

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