Laboratory Services Guide

Locum physicians are required to add a copy to for the physician, and fax number, and the location of the clinic they are covering for proper follow-up of patient care after they are gone.

Learn more about the guidelines for ordering urgency so that results are available when you need them in the Turn Around Time section.

Please refer to page 2 of the IH Laboratory Requisition for some common patient instructions.

Consult the IH Lab Test Directory or contact your local lab for more information on requirements for specific lab tests. Out of province test orders require BC Agency for Pathology and Laboratory Medicine approval. Please refer to their webpage for further information and forms to complete.

Patients may be asked to return at a later date if:

• The test ordered must be shipped outside of Interior Health
• The sample will not be stable until the next shipping opportunity

View patient collection instructions

Complete the IH Laboratory Requisition following the job aid to prevent delays and errors.

• IH Laboratory Requisition
• Outpatient Cardiac Diagnostic Requisition

Additional requisitions from a referral testing facility may be required. Please refer to the Test Directory for information and links.

Requisitions from other accredited laboratories or pre-approved requisitions from IH Specialty programs (i.e. Renal Clinic, etc.) are accepted at any IH Laboratory site.

Standing orders are accepted for routine testing only for a maximum duration of two years. Standing orders are discontinued immediately when a physician leaves his/her practice. Patients affected by this must see a new physician for a new standing order request.

IH Lab Requisition must include:

• Complete patient information
• Stated start date and expiry date
• Clear frequency of testing
• Any additional practitioners for copy to results

Requests to collect standing orders outside of the original stated frequency require a separate requisition.

Standing order requests by locum physicians are permitted for the duration of the locum and must include the name of the practitioner they are covering for. Patients must obtain a new standing order request once the locum has left.

The following will not be processed as standing orders. A requisition is required for each visit:

• Urine culture requests
• Renal and transplant orders presenting on an IH renal/transplant requisition
• PRN (Pro re nata)/As needed orders*

 *PRN orders for INR testing will be accepted if ordered in conjunction with a specified frequency, i.e. INR monthly and PRN as requested by physician.

Guidelines for standard non-blood sample collection

Patient-collected samples

Collection containers are available from your local lab. Learn about sample collection information for samples collected by the patient.

Body fluids/CSF

Body fluid samples require strict collection and transportation criteria to maintain sample quality. 

• View the guidelines for body fluid sample collections
• View the guidelines for CSF collections

Bone marrow

Bone Marrow requests must follow clinical guidelines determined by an IH Pathologist or Specialist with expertise in Hematology.

Complete the Request for Bone Marrow Aspiration and Biopsy Form. The request form is reviewed by a pathologist to ensure appropriate ancillary tests are ordered before an appointment is booked.
 

Review the resource for COVID-19 sample collection.

Anatomical Pathology

Refer to the Department specific page for information about sample identification, collection and handling.

Microbiology

Refer to the Department specific page for information about sample identification, collection and handling.

Transfusion Medicine

Refer to the Department specific page for more information.

Specimens must be transported to the laboratory in a manner that ensures the sample integrity and packaged according to the Transport of Dangerous Goods (TDG) legislation.

Guidelines for handling and transporting samples to the lab

• Check sample container lid is tightened and place into a secondary leak-proof container such as a biohazard sealable bag to contain spillage or breakage in the event of damage to the container. Include samples from only one patient and one testing department in each biohazard bag.
• Do not put Microbiology and Anatomical Pathology or Cytology samples in the same bag.
• One requisition per patient must accompany all samples collected at the same time. For Anatomical Pathology, Cytology or Microbiology samples, clearly indicate site or container number (for multiple samples from the same site) on the container. Place requisitions accompanying the specimen in the pouch of the biohazard bag (separate from the specimen) to prevent contamination.
• Specimens transported to another facility must be in a sturdy puncture-proof outer container and packaged according to the Transport of Dangerous Goods (TDG) legislation.
• Transport specimens within the acceptable time frame for analysis and at the required temperature. Blood specimens should be delivered to the lab within 2 hours of collection.

Refer to Anatomical Pathology or Cytology for more information regarding transportation and handling requirements for those specimens.

Test results will be available based on order priority (STAT, urgent or routine). Select the appropriate test priority based on the patient's clinical need.

Turn around time by department:

• Chemistry and Hematology STAT/Urgent TAT availability
• Anatomic pathology Turn Around Time Information
   

STAT

• Reserved for those situations of life-threatening (life and limb) medical emergency
• STAT orders will be given priority and collected immediately after order received
• Results will be available within 60 minutes of ordering for tests performed on site
• Blood cultures will be drawn STAT and are monitored continuously for positivity.
• STAT Microbiology cultures will be set-up immediately, only at facilities providing Microbiology testing services. Preliminary culture results will be available within 24 hours.
• STAT Gram stain results will be available within one hour during Microbiology Technologist work hours. After hours STAT gram stains require a Microbiology Technologist to be called in.

Urgent

• Collected as soon as possible after the order received and results will be available within 3 hours of ordering for tests performed on site

Timed

Collected at time indicated.

• Refer to the Test Directory to determine the proper sample collection time for your patient
• Outpatients must know date and time of last dose of medication

Routine

• Collect at routine collection times
• Most results will be available within 24 hours of receipt of the specimen in the lab for testing performed on site

Unexpected delays in results reporting

Occasionally the lab experiences difficulties that affect its ability to provide results within the stated timeframes. Physicians/wards will receive notification in the event that a STAT or Urgent order cannot be processed in time. The lab will try to communicate when the results might be expected to be available.

Results will only be available to the ordering physician as well as any other healthcare providers listed on the patient requisition/LIS order.

• It is the physician’s responsibility to provide results to their patients at their request.
• Patients requesting access to their lab results through MyHealthPortal
• Patients can also request a copy of their own results under the Freedom of Information and Protection of Privacy Act (FIPPA) by submitting the completed Request for Access to Records – Lab form to your local IH health records department.

Physicians are able to access their patient’s results electronically from their office through the Physician Office Integration (POI).

• Results will only be faxed to secure fax machines that are separate from public access
• Ensure that your fax number is listed correctly on the requisition. To make a change please call the Service Desk at 1-855-242-1300.
• Fax numbers are validated for accuracy prior to use

• IH Laboratory Service will issue verbal laboratory results to the health care practitioner when indicated or requested on the requisition. The identity of the person receiving the result must be verified at the time of the call for authenticity in order to maintain patient confidentiality.
• Requisition must have the phone number and the name of the specific person or site to which the call is to be made.

All critical test results are immediately communicated to the attending physician or appropriate clinical personnel responsible for that patient’s care.

In the event that the physician is unavailable to receive the result, the Laboratory Medical Director will be notified in order to take the next steps to ensure that the patient receives the proper care in a timely manner.

• Chemistry critical result list
• Hematology critical result list
• Microbiology critical notification list
• Transfusion Medicine critical notification list

Inpatient critical results will be phoned to nursing staff on the patient’s unit to relay the result to the ordering physician immediately

Outpatient critical results will be called to the physician’s office during their regular working hours.

• If the physician is not available, the result will be given to the office RN and that the physician must be notified immediately
• After hours, if the patient has been discharged or is an outpatient, the lab staff will call the ordering physician’s on-call number

An IH Pathologist is always available for consultation. 

Monday to Friday 8am-4pm contact your local Anatomic Pathology department:

• East Kootenay Regional Hospital 250-489-6441
• Kootenay Boundary Regional Hospital 250-364-5189
• Kelowna General Hospital 250-862-4407
• Penticton Regional Hospital 250-492-9014
• Royal Inland Hospital 250-314-2669
• Vernon Jubilee Hospital 250-558-1342

After hours, contact the switchboard operator at the desired facility to page the Pathologist on-call or consult the Oncall Scheduling system.
 

All laboratory tests requested by an authorized health care provider are tested and reported. If a test is not performed for any reason, the reason is documented and the physician is notified.
Missing laboratory reports could be due to a variety of reasons. If no results are available after the expected time, please contact the lab by email or by phone for further investigation.
 

Reference ranges for individual tests are stated on the patient report, specific for the age and birth sex of the patient, taking into account biological variation. As test methodologies vary, the reference range will reflect the current appropriate range for that test. All results must be interpreted in conjunction with the patient’s individual presentation.

This Measurement Uncertainty (MU) Table provides estimates of MU for all quantitative methods. The MU estimate provides a range of values within which the true value is believed to lie with an approximate confidence level of 95%. MU is estimated for each analyte using precision data obtained from observed quality control results prior to the implementation of a new method and 6 months after any method change. 

Contact ihlabquality@interiorhealth.ca to request site specific and/or date range specific values if needed.