Cerner specimen storage tracking

[ski390]

For those who use Cerner as their computer system in the laboratory, do you guys use storage tracking option? If so, can you please share how you're able to store two specimen (like a red and green tube) with one ordering label (one accession #)? I can order an extra tube orderable, but that will take too much effort and time. Trying to figure out a way to use the tracking system. Thanks!

[Nancy L.]

When there is more than one specimen container per accession number, cerner systems assigns a letter suffix to differentiate. For example, the green top tube would be Acc#A, red top Acc#B, and lavender Acc#C. In this way all containers of the same accession number can be placed in their own storage location. Letters assigned to containers can be seen in container details. We are in the process of switching to Cerner from Meditech (global organizational decision) and are also setting up specimen storage tracking. We look forward to not wasting ridiculous amounts of time searching through racks to find a specimen for add on orders et cetera. One key piece though...just like any other organizational system, it must be used in order to work. If someone removes specimen from rack without following through with tracking in computer it could get very aggravating. Good luck!

[Byfaith]

Just an FYI, we started using the tracking system a couple of years ago and love it! Wish we had done it sooner. I was not involved in setting it up so I have no special insight for you - but stick with it, it is worth it!

[ski390]

Thank you for the reply... but I'm still troubled at our facility because we receive multiple tubes for one test. For example, we receive a gold AND a green top for an order of CMP. There will only be one accession # for the CMP order, there fore, I am not able to log in two specimen for one test. Is there a solution to this that anyone can share with me?

[MARINA]

Where is the specimen storage on millenium? We have been using a simple excel spreadsheet and that works well, but it would be great to have it linked to our LIS! Does it print specimen locations on your pending list?

[lalamb]

We do keep an "extra" rack for specimens that are duplicates of the ones in the tracking system/day. We tend to get "exta" specimens mainly w/ER. If we have to go fishing for a tube, it's in a smaller pile ...

[joannef]

Our system is set up the same as Nancy's - if there is more than one tube for an accession, then each tube is automatically allocated an alpha suffix so that each tube can be managed individually. eg EDTA tube is usually ---A, heparin is ---B, etc. Extra tube records can be added easily if, eg, they send extra tubes, & system will give it the next letter available. The only issue we have is that if we do an unplanned aliquot then the label reprint will have the same alpha as the parent/primary tube. Maybe it's a request for the Cerner applications & configuration people?

For those who use Cerner as their computer system in the laboratory, do you guys use storage tracking option? If so, can you please share how you're able to store two specimen (like a red and green tube) with one ordering label (one accession #)? I can order an extra tube orderable, but that will take too much effort and time. Trying to figure out a way to use the tracking system. Thanks!

[cme]

You'll need to check the back end programming of your barcodes. When we decided to move forward on this, we were using code 39 without alpha, we had to revalidate all instrumentation (as a large system) to recognize code 128 with an alpha character. This format is shorter and fits on the labels. Some instruments did not like the longer barcode when the alpha was added or it would not fit on the label. So if you have a CBC, COMP and TSH ordered that go on three instruments, we would have for example, the following set up:

12-001-00001a CBC autoheme (serves as container and aliquot for the analyzer)

12-001-00001b COMP, TSH Container (pilot tube from pt)

12-001-00001c COMP autochem (aliquot for the analyzer)

12-001-00001d TSH immunochem (aliquot for the analyzer)

Once you do this the aliquots are not interchangeable between instruments.

There are six areas (background) where each analyte/tube type has parameters. So a CBC would be lav for us, COMP green autochem, etc. If there are common analytes with no special handling, they may all load to the same aliquot (label with alpha character). We have ours set up to have "container" or pilot tube labels which go on the primary tubes. The EDTA is defined as primary container and aliquot as the tube goes directly on the analyzer. It gets very complicated if things were set up to not be too particular.

Another system I have talked to in the area gives a new accession number to every container/pilot tube. While this works, in labbing specimens is probably much more complicated in more ways than one.

What we did with extra tubes is store them "bucket" wise. We always have at least one container label. We would store that in a "bucket" rack, then put all if its stragglers with it. Everything else is stored by the number on the tube.