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Barnsley & Rotherham Integrated Laboratory services Department: Pan PathologyFilename : Barnsley User Survey Report QMS No : DOC 135

Barnsley User Survey 2018 Report

Pathology would like to express their thanks to all those who were able to complete this year’s survey.

INTRODUCTIONISO Standards sub-clause 4.14.3 set requirements that the laboratory management shall seek information relating to user perception as to whether the service has met the needs and requirements of its users. This survey has been performed to comply with these standards, and in doing so, will bring to the attention of the laboratory management any areas of services provided by the laboratory that require improvement.

The user satisfaction survey ran between 23rd March to 20th April 2018 and its purpose is to obtain feedback from our users on the quality of the services provided by the laboratory.

The information gained from this survey will enable laboratory management to look at the service we provide and decide how to improve it to meet the needs and requirements of our users, as part of our commitment to continually improve quality.

METHODThe satisfaction survey was carried out using a questionnaire which was developed in consultation with BRILS Management Team, Clinical Heads of Department and the Laboratory Director, and comprised of 18 questions designed to elicit users’ general views on the quality of the services provided by Pathology. The respondents were asked to rate their satisfaction using the following response options: Yes or No, except in the case of questions relating to advice and assistance provided by pathology staff, where the response options were: Does not meet my needs, acceptable and excellent. Dissatisfaction was derived from the option ‘Does not meet my needs’ whilst satisfaction was derived from the levels ‘acceptable’, and ‘excellent’. A percentage distribution of responses was used to present the data and cumulative percentage dissatisfaction compared to cumulative percentage satisfaction. The respondents were also instructed to use ‘not applicable’ where appropriate. All questions asked were mandatory, except for question 2 & 3 which may leave the respondent identifiable. The final question asks users to provide any comments to improve the service. These have been collated and have been discussed at a feedback session to the BRILS Management Team and actions identified where appropriate. Responses are detailed at the end of the report. All responses received are duplications of the text received.

Separate user surveys have been completed for Community users (DOC 329), Phlebotomy (DOC 331), and Funeral Director (DOC 333).

Questionnaires were sent via survey monkey to Trust users – via the communications team, direct email lists and hard copies sent to Education

Centre Wednesday Lunchtime Lecture.

Version : 2018 Page 1 of 36Author : Natalie Holmes Approved by : Heather Da CostaActive Date : 14/06/2018 Review due : 14/06/2019


RESULTS OF SURVEYQuestion 1: Staff Group

A total of 41 responses were received from users within the Trust, these are broken down into Hospital Medical and Nursing staff as detailed above. Of the three respondents who answered “Other”, their responses were: clinical observer, clinical coder, community paediatric consultant. A wider variety of staff groups were captured in this user survey, compared to 2017.

Question 2: Name (Optional)

This question was optional and was included to allow for specific personal feedback to be given where relevant and to enable the incentive of a box of chocolate to be delivered to the winning participant in the draw. For the purpose of confidentiality, the names of participants will not be included in this report. 22 respondents gave their name, whilst 19 respondents opted to submit their response anonymously.



Question 3: Department/Ward (Optional)

Department/Ward Number of ParticipantsAnaesthetics & Intensive Care Medicine 4

AMU 2Surgery 531/32 1Paediatrics 4Rheumatology 1Ophthalmology 1Acute Stroke Unit 1Obstetrics and Gynaecology 2Gastroenterology 1Emergency Department 3Clinical Coding 1W19 1Haematology 1Urology 1Pharmacy 1Diabetic Clinic 1Student Support 1ENT OPD 1

33 respondents chose to include the department in which they worked, whilst 8 respondents chose to submit their survey anonymously. The above table shows that responses were received from a wide variety of clinical areas within the hospital, covering inpatients, outpatients and surgical areas.



Question 4: Are you satisfied with the usefulness of the Pathology Website as a source of information for each laboratory?

A substantial amount of user, 41.46%-51.22%, stated that they were not aware that there was a Pathology website. Given this response, the Pathology Department will begin to promote the website in collaboration with the hospital digital communications team. 2.44%-4.88% stated that they were not satisfied with the Pathology website. Where associated comments were left, responses are detailed in the table below.

Previous user surveys have only questions if the users feel that the website is acceptable or not, and have not addressed the awareness regarding the availability of the Pathology website. Enabling users to leave this responses has highlighted the need for promotion of the website.



Comment ResponseIs it the same as ICE? Given the lack of awareness regarding the

Pathology Website as a source of information, the Pathology Department will begin to promote the website in collaboration with the hospital digital communications team (QIN 365).

The Pathology Website is available via the following link: http://www.barnsleyhospital.nhs.uk/pathology/

Not used it.I only deal with certain software applications that gave us results of diagnosisI was told in induction about any websitesI did not need blood transfusion.Never had any information or induction about this service

Very difficult to find what you need If there is information that you are struggling to find, please contact the laboratory.

A direct link to Abx protocol would be good from main page.

The Antibiotic Policy is available on the Intranet via the Pharmacy Department. Microbiology will investigate the feasibility of adding an additional link to this via the Pathology Webpage (QIN 367).



Question 5: Are you satisfied with the range of investigations provided by the laboratory?

100% of respondents were satisfied with the range of investigations provided by the laboratory in Blood Transfusion, Cellular Pathology and Microbiology. In Blood Sciences, 95.12% of respondents were satisfied, however 4.88% were not. In 2017, all users were satisfied with the range of investigations. The issues that have been highlighted via associated comments that were left are in the table below and responses to each issue are provided.



Comment ResponseWe have had problems with 24h urine collections - often the repost states "citrate not available". 24h citrate is an important test for recurrent stone formers.

A referral laboratory has now been sourced, so we are able to provide this service. Please contact the laboratory for further details if needed.

Have to wait to many days for trace elements, toxicology, heavy metals

These tests are referral tests and as such samples are sent to other Trusts for processing. As soon as the report is available, it is input into the computer laboratory system and made available to our users. Should you wish to discus this further, please contact the Blood Sciences laboratory.



Question 6: Are you with the air tube system used to transport specimens to the laboratory?

81.48%-82.14% of respondents were satisfied with the air tube (pod) system used for transporting specimens to the laboratory. 12.50%-18.52% were not satisfied. Previous user surveys asked about the system used to transport the specimens to the laboratory and not the air tube system specifically. This question has highlighted that users feed that there are some issues with the air tube system. Where associated comments were left, responses are detailed in the table below.



Comment ResponseEquipment

However, a lot of times the system does not work or there not enough pods to use

The air tube (POD) system is managed by estates. We have passed on this feedback to the Estates department.We have delay in getting to the lab and have to

take it in person to labThe air tube system is not infrequently not working. In addition many wards have 1 or 2 pods which are rapidly used, meaning that results have to be hand delivered. There is no obvious or easy way to request more pods.Occasionally there are recurring issues in certain areas but these are fixed fairly rapidly.Sometimes the turkey system does not work and, for example when on amu, there are not enough podsUsually it's fine but often there aren't enough podsdoesn't always work. needs better signposting of dates etcIt is often out of service or purging

Air Tube System Availabilitynot installed in opd The air tube (POD) system is managed by estates.

We have passed on this feedback to the Estates department.

Not available in medical opd.

Other CommentsI've not used them Thank for your feedback. We hope that you are

satisfied with the air tube system if you use it in the future.

I rarely have the need to use it.I don't use it.



Question 7: Are you satisfied with the format/layout of the test request form for handwritten non-electronic requests?

86.21%-93.75% of users were satisfied with the format/layout of the handwritten request forms, whilst 6.21-13.79% were not satisfied. Fewer users were satisfied with this request form than in 2017. Where associated comments were left, responses are detailed in the table below.



Comment ResponseA tick box will help, though it may encourage over requesting.

Tick boxes are available for the most popular tests, however, the lab offers hundreds of tests and it would not be practical to put all tests on the request form.

Need for 2 G&S can cause surgical delays. The 2 sample rule is a national recommendation and is based on evidence from –

The BEST studies as referenced in BSH Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories. [Safety of transfusion begins with collection of the sample. It has been estimated that 1 in 2000 samples is from the wrong patient, commonly known as ‘wrong blood in tube’ (Dzik et al., 2003; Murphy et al., 2004). SHOT near miss data confirm that this ‐continues to be a serious problem (SHOT). The use of secure bedside electronic patient identification systems reduces this risk; however, in the absence of such systems, it is highly recommended that a second sample is requested for confirmation of the ABO group of a first time patient, where this does not impede the delivery of urgent red cells or other components.]

National data from the IBCT and the Near Miss chapters in recent SHOT reports (SHOT, 1996 to 2016)

Local audit data which confirms an unacceptable number of WBIT cases among patients where it can be detected due to having a historical group on record.

Wrong blood in tube (WBIT) is a 'never event', it should not happen, however on occasions it does. The consequences of transfusing somebody with blood of the incorrect blood group is very serious and can lead to death. In the 6 months prior to its introduction, there had been 4 WBIT incidents within the Trust, 2 of which would have resulted in a major ABO incompatible transfusion if blood products had been requested. WBIT is a SHOT (Serious Hazards of Transfusion) reportable incident. The two-sample rule is a national guideline to improve patient safety when receiving transfusions and has been routinely adopted by the majority of NHS Trusts across the UK.


https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-3148.2012.01199.x#tme1199-bib-0031

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-3148.2012.01199.x#tme1199-bib-0017


As a department we are sympathetic to clinical pressures and whilst we do not wish to add to clinical workload, the 2 sample rule is seen a necessary patient safety step that needed to be introduced by both those responsible for the Transfusion Service and the Trust. If you wish to discuss further please do not hesitate to contact the Laboratory Manager.

The (illegible word) for cross match easily missed.

Unable to comment.

Difficult to quickly see where to sign and which boxes to tick

We endeavour to make the request forms as clear and simple as possible, however, if you have any specific requirements, please contact Pathology and we will be happy to consider these for our next print run.

Should all be electronic. We encourage the use of electronic requesting as it helps to reduce errors when booking in and processing samples, alongside reducing the amount of paper used within the Trust. Thank you for using electronic requesting.

Not used.I have not used the hand written forms

Question 8: Do you use electronic requesting?Version : 2018 Page 12 of 36Author : Natalie Holmes Approved by : Heather Da CostaActive Date : 14/06/2018 Review due : 14/06/2019


97.14% of Blood Sciences Users and 94.44% of Microbiology Users use electronic requesting via ICE. Where associated comments were left, responses are detailed in the table below. This question has not been asked in previous surveys.

Comment ResponseIn out reach clinics eg Darfield I don't have access to a PC, therefore I give parents hand written forms.

If outreach clinics are held in locations where users have routine ICE access, there is no reason why you would be unable to get access through SystmOne or directly in to ICE.

Not got a password, don't know how to use the system

ICE training is available via the clinical systems department.

Not aware of it.

Question 9:Are you satisfied with ICE when requesting laboratory tests?



90% of Blood Sciences Users and 94.87% of Microbiology Users are satisfied with electronic requesting via ICE. Slightly fewer users are satisfied with ICE for requesting laboratory testing than in 2017. Where associated comments were left, responses are detailed in the table below.

Comment Response



It needs bulk requesting (i.e. multiple identical tests for the same patient)

Bulk/cumulative requesting is currently not supported due to poor usage in past. Could be looked into again in future if there is enough demand.

Due to IT system issues can't access ICE some days of every week

All IT systems inevitably have issues but we try to resolve as quickly as possible

Can be difficult to find which tests you need even with the search function. Clunky questions after the requests especially asking if you itu patients want out patient tests

“Clunky” questions and lack of simple list of tests are in place to minimise improper requesting of expensive tests. We appreciate that this can be cumbersome in an inpatient setting, happy to look into streamlining ITU requesting process. Suggest hospital wide consultation to standardise test nomenclature to simplify searching, or for us to match ICE test names with Pathology handbook names.

not got a password, don't know how to use the system


An interface from Dawn to ICE requesting would be a great benefit to the anticoagulant service and to the patients that attend phlebotomy thus reducing errors and the time that the patients have to wait when a request is not available

If you have the $$$, Sunquest/CliniSys have the interface. We are happy to assist implementation, advise departmental lead to contact Dominic Dunn ([email protected]) and liaise with him and Pathology to implement.

Not all dynamic endocrine function tests are available to request on ICE

Often done to minimise improper requesting, but we are open to any suggestions of new/missing tests that need to be put on ICE to improve ability to request.

Question 10: Are you satisfied with ICE when reviewing laboratory results?


mailto:[email protected]


Responses were consistent amongst users for Blood Transfusion, Cellular Pathology and Microbiology, where 83.33%-87.17% of users were satisfied with ICE when viewing results. However, in Blood Sciences, over a quarter of users (26.83%) were not satisfied with ICE when reviewing results. Fewer users are satisfied with ICE for reviewing laboratory testing than in 2017, however, this is to be expected given a recent LIMS system upgrade and ICE system upgrade leading to recent IT difficulties. Where associated comments were left, responses are detailed in the table below.

Comment ResponseResults now in very difficult format to read, having The linked reports section has now been removed,



to scroll down whole series of hidden reports. Ice filing cluttered with lots of pending reports. Please change it back! It was fine before. Makes admin much longer and more unsafe now.

which we hope will improve the presentation and accessibility of results. We are looking at a better solution for the issue of “pending” results, but this may require some time, as it will require changes to the function of our new reporting interface.As new results become available a (illegible word)

all tests reappear on ICE which is unnecessary.Following the last update, the layout has become very busy and its now very time consuming to scroll down to the result you are interested in.But the screen displays a long column of lists of result available. Every time to see results, you have to scroll down.The current formatting of the information is very poor. The initial section is a mess of reports that have been hidden, redacted or amended, and it makes for a poor experience particularly when using a mobile device. Also multiple reports are being re-issued as they move from pending to reported, which makes it very tiresome when trying to do ICE filing.Would be nice to be able to print off graphical trends on test results. Lately results have been preceded on the screen with a long list of information which slows down the ability to assimilate info mentally.The new layout is very poor. It has too many links at the top to scroll through every time.Not since recent update. New format of resultds very frustrating. Also, the "pending" on results is annoyingI do not like the new layout. To have the results first before the requests prior to the change worked better. Also I miss the recevied in lab part as sometimes if the bloods get lost we are unaware.Time of request is often incorrect. The time of a request should match up to the time

at which a specimen was marked as “collected” in ICE, either when the request form was printed or when a postponed event was activated.

ICE often down. Recently worked weekend 16-18/3 and had to ring through every blood result.

The Trust looking at purchasing 24/7 ICE cover which would significantly reduce disruption caused by IT/network problems.

When accessing a result there is a long list of previously overwritten reports (e.g. 'pending') meaning that one has to scroll down to see a result. This is an issue when trying to review results quickly using BDGH IT system (which is slow).

The linked reports section has now been removed, which we hope will improve the presentation and accessibility of results. We are looking at a better solution for the issue of “pending” results, but this may require some time, as it will require changes to



the function of our new reporting interface. Regarding the IT system, this is likely to be a hardware or VDI issue, as the ICE architecture is relatively new and a considerable improvement on previous performance. We are looking at further infrastructure and software version upgrades to improve functionality.

please can it be ensured that community paeds results are posted to new street HC.

Address corrected in lab system, but it would be preferable if it was possible to get an electronic (ICE -> SystmOne) link between our services, as I think this would improve things for both of us. If you’d like to progress this please contact [email protected] and we can get the ball rolling.

not got a password, don't know how to use the system


Question 11: Are you satisfied with the usefulness and availability of advice and assistance provided by laboratory staff in normal working hours?


2.44%




96.43% - 97.15% of users were satisfied with the usefulness and availbility of advice and assistance from laboratory staff in normal working hours, where acceptable and excellent responses denote satisfaction. In Cellular Pathology and Microbiology, over half of users felt that the usefulness and availability of advice was excellent, with 42.86% and 48.39% of users feeling that this was excellent in Blood Sciences and Blood Transfusion, respectively, also. 2.86% - 3.57% of users felt that this did not meet their needs. All departments received significantly increased “excellent” scores compared to 2017. Where associated comments were left, responses are detailed in the table below.

Comment ResponseI have not needed to ask for any clarification

Thank you for your feedback. We hope that if you do need to ask for advice, that you are satisfied with our service.



Sometimes difficult to get hold of microbiology advice

Thank you for response to the above question. We are very sorry to hear that you find difficult to get hold of a microbiologist. We try and answer the calls as much as possible. However when one microbiologist is on leave or busy with meetings the other microbiologist may find it hard to answer all the calls, as we have only two microbiologists on site and no junior support. If you leave a message with the laboratory to staff to call you back as soon as possibleThe on-call service, which extends from 5:00 PM to 9:00 AM the next day, and for the full 24 hours on weekends and public holidays done by a Consultant microbiology as the only 1 st on, is increasingly becoming very onerous which in many occasions is jeopardising our clinical duties during the day time. As you know we have no junior medical microbiologist colleagues and the calls come straight to the Consultant Microbiologists.We have found that a significant number of calls made between 11:00 PM and 7:00 AM are inappropriate and being made by junior colleagues. Examples include the following: Inadequate clinical review before the call is made, with it

appearing that the junior doctor is a go between the Consultant and Microbiologist.

Ineffective hand-over amongst clinical teams so that the medical team taking over is not aware of advice already given by Microbiologists earlier (mainly due to lack of documentation).

Not following the principles of SBAR when seeking for on-call microbiology advice, often making a second call necessary when full details have been acquired.

Requesting antibiotic codes when this is not necessary during on-call hours as the policy allows use of restricted antimicrobials for 24 hours initially if required.

The purpose of the call being defensive, i.e. double checking with the Microbiologist just in case.

We think in the setting of ITU call registrar is off good quality and will let the switch board allow calls from them

As you know all the Microbiologists are dedicated clinicians and more than happy to provide clinical advice and assist in any way they can. However, the increasing volume of calls needs to be addressed, as we cannot sustain the current demand.We thank you for your patience and glad to hear that you are satisfied with the advice and service you receive when you speak to the Microbiology Consultants.

Question 12: Are you satisfied with the usefulness and availability of advice and assistance provided by laboratory staff out of hours?



All users were satisfied with the usefulness and availability of advice and assistance provided by laboratory staff out of hours was satisfactory, with over half of users stating that this was excellent in every discipline. All departments received significantly increased “excellent” scores compared to 2017. Where associated comments were left, responses are detailed in the table below.

Comment ResponseMicro can be difficult to contact. Thank you for response to the above question. We



are very sorry to hear that you find difficult to get hold of a microbiologist. We try and answer the calls as much as possible. However when one microbiologist is on leave or busy with meetings the other microbiologist may find it hard to answer all the calls, as we have only two microbiologists on site and no junior support. If you leave a message with the laboratory to staff to call you back as soon as possibleThe on-call service, which extends from 5:00 PM to 9:00 AM the next day, and for the full 24 hours on weekends and public holidays done by a Consultant microbiology as the only 1st on, is increasingly becoming very onerous which in many occasions is jeopardising our clinical duties during the day time. As you know we have no junior medical microbiologist colleagues and the calls come straight to the Consultant Microbiologists.We have found that a significant number of calls made between 11:00 PM and 7:00 AM are inappropriate and being made by junior colleagues. Examples include the following: Inadequate clinical review before the call is

made, with it appearing that the junior doctor is a go between the Consultant and Microbiologist.




The purpose of the call being defensive, i.e. double checking with the Microbiologist just in case.

We think in the setting of ITU call registrar is off good quality and will let the switch board allow calls from them

As you know all the Microbiologists are dedicated clinicians and more than happy to provide clinical advice and assist in any way they can. However, the increasing volume of calls needs to be addressed, as we cannot sustain the current demand.

Not doing out of hours.Sometimes takes ages to contact the micro consultant

Micro sometimes not available



We thank you for your patience and glad to hear that you are satisfied with the advice and service you receive when you speak to the Microbiology Consultants.

Like to have robust urine microscopy for paediatric patients on request on weekends

Urine microscopy for all patients is available on weekends. All samples are routinely processed between 9am and 5pm on weekends. The new laboratory computer system allows for urine microscopy results to be released as soon as they are processed, however, if you find that they are not available and the microscopy will affect clinical management of the patient, please telephone Microbiology (or on-call Microbiology BMS out of hours).

I do not work out of hours at the hospital Thank you for your feedback. If you do need to ask for advice from laboratory staff, we hope that you are satisfied with our service.don't work out of hours

Question 13: Are you satisfied with the usefulness and availability of advice from clinicians in normal working hours?



All users were satisfied with the usefulness and availability of advice and assistance provided by clinicians in normal working hours was satisfactory, with over half of users stating that this was excellent in every discipline. All departments received significantly increased “excellent” scores compared to 2017. Where associated comments were left, responses are detailed in the table below.

Comment ResponseCompliments



Received very valuable reports from consultants when needed.

Thank you. The positive results have been fed back to Laboratory Managers to feed back to staff as part of staff meetings. The results have also been passed onto the Pathology Business and Service manager for inclusion in Staff Briefings.

It is always possible to contact a senior member of the above specialties to ask for telephone advice.

Turn-Around TimesSometimes Histology reports can be input into the system longer than it should be. Hope this is something that can be inputted soon as received from labs. Thanks much.

Reports from referral laboratory are inputted into the system as soon as they are received, and are authorised. As soon as the results are authorised, they are available on ICE. If you require any further information regarding sample turn-around times, please contact the Laboratory Manager.

Contacting ConsultantWhen the clinician is around the advice offered is excellent. Unfortunately when not around getting results can be difficult if they are not showing on ICE .

We are pleased that you are satisfied with the advice received from Pathology Clinicians. If you are waiting for a result, please contact the laboratory. If it is only waiting for Consultant authorisation, they will be able to give you the result without Consultant comment. Otherwise, laboratory staff may be able to advise you when the Consultant will be available.

Other CommentsNot needed histopathology or microbiology consultants yet.

Thank for your feedback. We hope that if you need to ask for advice from Pathology Clinicians, that you are satisfied with our service.



Question 14: Are you satisfied with the usefulness and availability of advice from clinicians out of hours?

All users were satisfied with the usefulness and availability of advice and assistance provided by clinicians out of hours was satisfactory, with over half of users stating that this was excellent in every discipline. This question has not been asked in previous surveys. Where associated comments were left, responses are detailed in the table below.



Comment ResponseIf required it is always possible to contact a senior member of the above specialties to ask for telephone advice out of hours.


Micro sometimes not available Thank you for response to the above question. We are very sorry to hear that you find difficult to get hold of a microbiologist. We try and answer the calls as much as possible. However when one microbiologist is on leave or busy with meetings the other microbiologist may find it hard to answer all the calls, as we have only two microbiologists on site and no junior support. If you leave a message with the laboratory to staff to call you back as soon as possibleThe on-call service, which extends from 5:00 PM to 9:00 AM the next day, and for the full 24 hours on weekends and public holidays done by a Consultant microbiology as the only 1st on, is increasingly becoming very onerous which in many occasions is jeopardising our clinical duties during the day time. As you know we have no junior medical microbiologist colleagues and the calls come straight to the Consultant Microbiologists.We have found that a significant number of calls made between 11:00 PM and 7:00 AM are inappropriate and being made by junior colleagues. Examples include the following: Inadequate clinical review before the call is

made, with it appearing that the junior doctor is a go between the Consultant and Microbiologist.




The purpose of the call being defensive, i.e. double checking with the Microbiologist just in

So microbiologists do not answer their ohine when working over the weekend and we struggle to get hold of one over the weekend sometimes.



case. We think in the setting of ITU call registrar is

off good quality and will let the switch board allow calls from them

As you know all the Microbiologists are dedicated clinicians and more than happy to provide clinical advice and assist in any way they can. However, the increasing volume of calls needs to be addressed, as we cannot sustain the current demand.We thank you for your patience and glad to hear that you are satisfied with the advice and service you receive when you speak to the Microbiology Consultants.

I have not had to use this service yet Thank for your feedback. We hope that if you need to ask for advice from Pathology Clinicians, that you are satisfied with our service.



Question 15: Are you satisfied with the report turnaround times?

100% of users were satisfied with the report turnaround times in Blood Transfusion and Microbiology. 3.33% were not satisfied with the turnaround times for Cellular Pathology reports, and 7.69% were not satisfied with the turnaround times for Blood Sciences reporting. This is a decrease on the 2017 user survey, where all users were satisfied with the report turn around tomes for all disciplines. Where associated comments were left, responses are detailed in the table below.



Comment ResponseBut I would like to be them quicker. We have KPIs for turn-around times all of the tests

we offer and locations requests are received from and we monitor these KPIs. Please note that some tests do take longer than others due to the nature of testing processes. Please phone the laboratory if you wish discuss further.

Waiting times for results in the afternoon are very hit and miss at certain times during the afternoonUrgent requests could come sooner

Not sure anything can be done to speed up reports for histology such as Bone Marrow biopsy.

This test is a referral tests and as such samples are sent to other Trusts for processing. As soon as the report is available, it is input into the computer laboratory system and made available to our users. Should you wish to discus this further, please contact the Blood Sciences laboratory.

Time limit in ED: therefore need some bloods urgently. Can sometimes be up to 2 hours to get results.

We have a KPI to achieve 90% of tests completed within an hour for A&E for the most frequently requested tests, and we monitor this KPI. There are occasions when depending on the test or other issues, such as analyser breakdown, requests will take longer. Please phone the laboratory if you wish discuss further.

If the consultant biochemist is not around the endocrine tests are not always made available and can cause delays in treatment

If you are waiting for a result, please contact the laboratory. If it is only waiting for Consultant authorisation, they will be able to give you the result without Consultant comment.

Question 16: Are you satisfied with the report content, clairty and interpretive comments?Version : 2018 Page 30 of 36Author : Natalie Holmes Approved by : Heather Da CostaActive Date : 14/06/2018 Review due : 14/06/2019


94.74% - 97.22% of users were satisfied with the report content, clairty and interpretive comments. Where associated comments were left, responses are detailed in the table below. This is a decrease upon the previous year whereby all users were satisfied in across all disciplines.

Comment ResponsePCR results are not predictable in paediatric cases We are unsure about what this comment means.



Please contact the laboratory to discuss further.It is not necessary to caveat every result with a warning regarding interpretation when a patient is on sulfasalazine (this is not common!)

The laboratory has an obligation to inform our users about potential results interpretation problems – e.g. interference due to some medication. Currently, we inform users by automated comments which accompany the results. However, we are currently reviewing method by which we inform our users.

Information from more specialist investigations such as bone marrow biopsies and aspirates seems to be slow for ICU patients. We are often not able to view the full report for ourselves - which would be helpful

Since the new laboratory computer system go-live (05/02/2018) full reports are now available for viewing in ICE. However, there was a delay due to the implications of go-live which is now resolved. Please also note that this is a referral test and samples are sent to another Trust for analysis, therefore results may not be available the same day.

Question 17: If you currently receive paper test reports, would turning off paper reports impact on your department?



This question was designed in order to gain an insight into the viability of ending the issuing of paper reports in favour of electronic reporting. It was found that 45.83% - 57.89% of users did not feel that ending paper reporting would impact upon their department. Where associated comments were left, responses are detailed in the table below.

Comment ResponseNegative Impact of Turning Off Paper Reports



Paper report provide a safety net and apparently normal result may be abnormal depending on the clinical context.

Thank you for your feedback. This question was designed in order to gain an insight into the viability of ending the issuing of paper reports in favour of electronic reporting. It is useful for Pathology to know how the paper reports we send out are used.

Sometimes it is the only trigger to remind us of a particular patient, eg notes may have been taken away but then the paper report will trigger the need to get the notes and make a planAccessing reports on limited functioning computers is a hold up and delay in patient care. If printed off by non medical staff (nursing) allows me to assess patients with little interruption or delay.

As we are based in community, we rely on paper copies of results in 90 % cases.bad idea

Positive Impact of Turning Off Paper ReportsAlready use ICE filing Thank you for your feedback. This question was

designed in order to gain an insight into the viability of ending the issuing of paper reports in favour of electronic reporting. It is encouraging to know that you are using and are satisfied with electronic reporting, and this helps to reduce the amount of paper used within the Trust.

Please stop sending paper reportsIn a very positive wayAlready use ICE filing to review results in ED. We review all microbiology results on a daily basis (M-F) and file, which works very wellIt is already all electronic.

USER FEEDBACK AND SUGGESTIONS



Users were asked to provide feedback or suggestions to improve the service. Each of the comments have been split into categories in the below table to allow appropriate action to be taken.

Comment Number

Comment Response

Compliment1 The service and support offered by lab,

haematology and microbiology teams have always in my experience been excellent. Generally the ICE reporting system is an excellent service.


2 I think the service works very well and all samples go to one place which helps. Out of hours I have had no issues and found it all very satisfactory. I have had quick turn around on samples of CSF.

3 So far, reports have been received well on time unless we know when we follow up that it is for genuine reasons. Well Done to Labs and those who put these records on the system for the good work that makes our work quicker and easier.

4 Overall a good service.IT

5 ICE is easy to navigate and access. Sometimes there are problems printing from ice and sometimes the tubing system does not work. These are the main problems

Printing is a notoriously problematic service for IT; we’re moving our ICE services onto new hardware and software later this year so we hope to see significantly fewer printing problems in the future.

6 we need better computer and printer , Please contact the IT department to arrange replacement of equipment.

7 I personally don`t like including the pending results, this increases the time it takes me to file results. I will prefer that only results that are ready to view are put on the system.

The linked reports section has now been removed, which we hope will improve the presentation and accessibility of results. We are looking at a better solution for the issue of “pending” results, but this may require some time, as it will require changes to the function of our new reporting interface.

8 Please, please get rid of hidden reports and pending reports to make results easier to read and file.

The linked reports section has now been removed, which we hope will improve the presentation and accessibility of results. We are looking at a better solution for the issue of “pending” results, but this may require some time, as it will require changes to the function of our new reporting interface.

9 Let's go paperless!! Thank you for your feedback. It is encouraging to know that you are using and are satisfied with electronic reporting, and this helps to reduce the amount of paper used within the Trust.



Comment Number

Comment Response

Communication10 Improvements overall needed to be made on

how very abnormal results are communicated to clinical staff consistently and reliably. This in itself is not just solely a lab problem but a wider hospital issue and I am aware of management trying to rectify some of these problems following a few serious incidents recently

Pathology is working with the acute response team to develop a robust procedure for escalating of abnormal results.

Turnaround Times11 I would like to have quicker turnaround times

to facilitate patient flow. I have observed times especially weekends up to few hours.

We have KPIs for turn-around times all of the tests we offer and locations requests are received from and we monitor these KPIs. Please note that some tests do take longer than others due to the nature of testing processes. Please phone the laboratory if you wish discuss further.

General Comments12 The main issue regarding delays in receiving

results is due to understaffing of the phlebotomy team (results taken late), poor IT infrastructure (very slow computer systems), and not infrequently unreliable pod system.

The Pathology department is responsible for the outpatient Phlebotomy team. Staffing levels mirror patient demand in this area. If this comment is regarding the inpatient phlebotomy team please contact Gary James, Ward 16 Discharge Unit.

Your comments relating to IT and Pod systems have been passed on to the Pathology IT department and Estates department.


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