I was wondering if anyone partially auto releases the hemogram part of the CBC that contains a flag? An example would be if there was an Immature Gran flag or an anisocytosis flag that required a smear review. The hemogram part of the CBC would auto release but the differential part would be held pending the smear review. Thanks in advance for your input.

We use SoftLab and we do not do this.  It is an all-or-nothing type of autovalidation.  In the past, techs used to manually release the hgb, hct, and plts for ER and nursery patients if a differential needed to be done.

We try not to release any suspect results until they have been checked out, in the case of a CBC/Diff, this would be a smear review. 

 

But I see no reason not to release partial results in many critical cases.  For example, an automated analyzer may have trouble with a differential on a leukemia or chemo patien. (where you may end up releasing only the manual diff.)  However, if the same patient has an unflagged critical low Hbg or Plt count, it would be irresponsible to not release those results ASAP.

 

Scott

We do a partial release after reviewing the flag and it is determined that the flag is not one that interferes with the WBC,RBC or PLT count. For instance a suspect platelet clump which may or may not be due to actual platelet aggregation, NRBC's, giant platelets, or even dwarf megakaryocytes. We would NOT do a partial release until a smear is reviewed for verification.

 

In the case of flags for morphology review or suspect immature cells, we would manually release (like nziegler in the past) the hemogram portion of a CBC and "hold" the differential for smear review. 

We have been partialy validating / releasing results for many years.

We automatically release all technically valid key parameters (WBC, Hb, MCV, RDW, Plts and WBC differential) and if not complete

ly autovalidated, will review for Clinical review / commenting.

We use Remisol, so have complete control over this process.