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 The NANOGRAM

Martha Jefferson Hospital Laboratory Services

Summer 2010

Quarterly Newsletter on MJH Website

This newsletter is from the Laboratory and will be distributed on a quarterly basis. It contains important information and news briefs concerning laboratory services. In addition to normal distribution, each issue will be posted at www.marthajefferson.org/healthcare/laboratory. Go to www.marthajefferson.org on the Healthcare Professionals menu and select Laboratory Medicine.

Congressman Tom Perriello Visits MJH Lab

In preparation for National Medical Laboratory Professionals Week at Martha Jefferson Hospital, Congressman Tom Perriello who represents the 5th District of Virginia visited MJH for a tour of the pathology and clinical laboratory on April 13, 2010. The Congressman received a guided tour headed by the four pathologists of Charlottesville Pathology Associates, Drs. Laura Spinelli, R. Hunt MacMillan, David Rowe, and Thomas Dudley. During the tour, the Congressman observed the process of how a pathology slide is prepared and spoke to many of the lab technologists that take part in that process. The visit ended in the clinical lab where the group toured the MJH Blood Bank, Microbiology Lab, Contract Office, and Central Receiving. The NBC news affiliate interviewed the Congressman in the clinical lab and aired the spot on the evening news.

Sara Hoffman, MT: Menk Award Winner

The Menk Award was established in honor and memory of Dr. Karl Menk who was an esteemed Pathologist in central Virginia from 1951-1981. The recipient receives funding to attend a professional meeting or conference of their choice. This award is given out during Martha Jefferson Hospital Laboratory Service’s Lab Week (the third week of April) every year. This year’s winner is Sara Hoffman, MT. Sara received a BS degree in biology from University of Mary Washington. She joined Martha Jefferson and has served as a phlebotomist where she excelled and demonstrated the desire to further challenge herself by returning to school for her Medical Technology (MT) degree. After completing the MT program at Augusta and passing her ASCP exam, Sara returned to the lab as a technologist. She demonstrates excellent customer service, can be called on for assistance without hesitation, and remains calm under pressure. Sara most recently accepted the role of Blood Bank Section Leader. Join us in recognizing Sara as a crucial part of the MJH Laboratory Team.

NOTE: Serum Osmolality Tests

Martha Jefferson Hospital will be sending serum osmolality tests to UVA to improve turn around-time.

MJH is a Certified Primary Stroke Center

In preparation for the Joint Commission to visit Martha Jefferson Hospital for a survey, the Stroke Program Team met to review performance measures. The laboratory results were outstanding. The average turn-around-time for “stroke alert” patient testing is 18.7 minutes! The requirement set by the committee was 45 minutes.

On June 10, 2010 the survey was completed with no findings and MJH was noted for several best practices. Martha Jefferson Hospital is now a Certified Primary Stroke Center!

Another Free Screening Day Success

Martha Jefferson Women’s Health Services combined efforts with Martha Jefferson Laboratory Services once again to offer free breast health screenings, blood glucose tests, and cholesterol level tests. The free testing was offered on Saturday, April 24th, 2010 and approximately 40 blood tests were completed.

If you have patients that are interested in this free screening in the future, please contact Health Connection at 654-7009. A patient may qualify if they:

• Don’t have insurance or their insurance doesn’t cover mammograms and the cost is a concern,

• Are 40 years old or older, and

• It has been more than a year since the last mammogram.

HPV Testing: Basic Information on Ordering

Since HPV was first discovered to infect the female genital tract and subsequently certain types (termed “High Risk” linked to 70% of cervical cancers, testing for High Risks HPV has become an important tool used in conjunction with the Pap test in assessing patients’ cervical cancer risk. Liquid-based Pap specimens can be tested for HPV along with being processed as a Pap test (HPV ordered “Regardless” of Pap diagnosis), can be submitted to the laboratory for Pap and “Reflex” HPV (specimen is only tested for HPV if the Pap result is Atypical Squamous Cells of Uncertain Significance- “ASCUS”), and can be submitted for HPV testing only (no Pap). In addition, HPV testing can be requested as add-on testing (up to 30 days past date of collection), if the practitioner determines after the fact that the HPV result is needed. HPV testing cannot be done on conventional Pap smear slides.

Persistent High Risk HPV infection past the age of 30 significantly increases a patient’s risk for developing cervical cancer precursors. Many practitioners request Reflex HPV testing on Pap specimens from their patient under 30, and Regardless HPV testing on patients 30 and older. Patients over 30 who have negative Pap and HPV results may not need repeat screening for 3 years, if no lifestyle changes or symptoms occur. If you have specific questions on ordering, feel free to contact Cytology at 434-654-7775.

HIPAA Patient Privacy Regulations

Due to HIPAA patient privacy regulations, any request form that has missing, indecipherable, or uncertain ordering or “copy to:” physician information will result in a delay of laboratory processing and reporting. To avoid this please insure all lab requisitions identify ordering and copy to physicians by first and last name.

Rh Immune Globulin

Rh Immune Globulin should be given to D-negative women within 72 hours of delivery, performing an amniocentesis (or any procedure that may cause fetomaternal hemorrhage), or termination of pregnancy. If more than 72 hours elapse, the dose should still be given. If patients do not receive RhIG within this recommended time frame, the patient is at greater risk for alloimmunization.

REMINDER: HPV and MEDICARE

HPV was added to the list of tests that fall under the Medicare Medical Necessity rules. Orders for HPV as a screening test on Medicare cases always require an Advance Beneficiary Notice (ABN). And, remember it is always better to err on the side of getting an ABN signed for Medicare patients if there is a question.

Important Telephone Numbers

o Need lab results from the Clinical Lab call 654-7170 or fax 654-7164.

o Outreach Department, call 654-7183

o Need lab results from the Anatomic Pathology Lab 654-7955 or fax 654-7944.

o AP Client Services Representative, Noel Jorgensen, at 654-5525.

The next Nanogram newsletter will be fall 2010 distributed in October.