SUMMARY The use of a laboratory computer system to deal with specirn m proble-m is described. Problems such as 'insufficient material' or 'haemolysis' are entered by reception staff or by bench workers so that resolution of the problem will not be overlooked; problems are then listed and dealt with by the duty biochemist. Specimens on printed worksheets are annotated 'urgent' where appropriate. Results obtained on-line, which are above top standard, automatically cause the specimen to reappear on the next worksheet marked 'dilution required'. Data relating tD its use over a threemonth period are presented together with some comments on the causation of specimen problems and their prevention.In days gone by, when laboratory workloads were a lot smaller than they are today, it was not difficult for the person supervising the analytical work of a clinical chemistry laboratory to deal personally with all problems relating to specimens. When a plasma sample for an electrolyte estimation was found to be haemolysed, he either rang up the house officer or sent one of the laboratory staff to obtain another specimen. He then wrote 'haemolysed' on the report form opposite potassium.With many staff in the laboratory and a division of labour, lines of communication have become much more complicated, and, as a result, there is a much greater risk of their breaking down. Someone reading a printed result sheet from a multichannel instrument may, unless an appropriate message appears on the result sheet, issue a result that is incorrect because, for example, there was a delay in separating plasma from cells. A sample fed into an automatic analytical instrument and found to be of insufficient volume may be detected at the bench, but resolution of the problem as far as the patient is concerned requires that another specimen is obtained, and, with a chain of persons involved, this may be delayed or even overlooked.In recent years computers have started to take over much of the clerical and communication work within laboratories, such as registering work to be done, compiling worksheets, and producing reports. It seems sensible, if a computer is being used in this way to communicate between different sections of the laboratory, that it should also handle specimen problems. This paper describes a method for handling specimen problems, which was incorporated into an existing laboratory computer system. Laboratory staff were instructed how to use it in dealing with specimen problems but no effort was made after its introduction to enforce its use. This was done quite deliberately on the argument that helpful aspects of the scheme would be adopted and unhelpful aspects would be dropped. After a settling-in period the system was automatically monitored over a threemonth period to provide data on its usage: some statistics from these data are presented.
Laboratory organisationSpecimens are collected by a venepuncture team, by medical or nursing staff, or by medical students and arrive at the laboratory reception bench accompanied by a req...
