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Good morning,

I am a lab person experimenting with OE and "add-on" lab orders for inpatients 
in an attempt to reduce phone calls and phone tag.  My OE knowledge is quite 
basic.  Very frequently as docs make rounds the nursing units will call to see 
if certain other lab tests can be performed on specimens already collected.  We 
then have to verify that we have an appropriate specimen, that it is not too 
old, or has not been stored in a way that won't work for the add-on, then call 
the unit back to let them know we can or can't do it, document the phone order, 
including a "read-back" from the person on the unit, and THEN do the test.  A 
significant time sink for both lab and nursing.

I set up an add-on procedure according to Knowledge Base #2166, specifically 
addressing added orders.  Category AOT and procedure AOT with a CDS asking 
which tests.  It's a process by care area category. This prints in the lab.  We 
can then look for the specimen, add the requested test if appropriate and be on 
our way.  No phone calls.  However, I have two questions:

1.  Is it necessary for the AOT procedure to be completed in OE?    It would be 
easy enough to give lab a shortcut to complete the order.

2.  If the AOT was for a few tests, and not all of them can be done, what would 
we do then?  It looks like cancelling the AOT would not print back at the 
nursing unit, but would instead just print again in lab.  And, we would not 
want to mark it complete if it wasn't.  I know we would call the unit to tell 
them what tests can't be done, but how to handle the order and how to document 
completing only part of the order has me stumped.

If anyone has a good streamlined process for handling add-ons, especially for 
inpatients, I would appreciate your suggestions.

Thanks, Judy Hill


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