Please review the scenarios and specific workflows for outpatient blood draws at UNC Hospitals.
For outpatient collections where the patient is to go to the lab to have blood collected AFTER their CLINIC appointment on the SAME day:
1) Providers/Staff can place Lab orders from within the Clinic Appointment and they should be entered as Future/Lab Collect.
2) When the patient presents to the lab, the phlebotomist should choose the Clinic Appointment for that Day-of-Service (DOS) using the “Encounter” activity to release the lab orders to Soft. (Caveat: if encounter has been closed, they should use “Addendum” activity to release the orders).
3) If the patient does not come tho the lab on the same day, see next workflow starting at Step #2.
For outpatient collections where the patient is to go to the lab to have blood collected BEFORE their CLINIC appointment, OR they are having a BLOOD COLLECTION ONLY and no other appointment on that DOS:
1) Providers/Staff can use “Orders Only” encounter to put in lab oders. They should be entered as Future/Lab Collect.
2) On the day the patient comes in, they must stop at registration. Patient must have a registered encounter on the DOS.
(A registered encounter is something in addition to an “ORDERS ONLY ENCOUNTER”. The “Orders Only Encounter” is not a registered encounter. Examples of registered encounters are: Clinic Appointments, Lab Walk-In appointments, etc.)
3) If the patient does not have a registrable encounter in for the DOS, the Registration Staff will create a Lab-Walk-In appointment when they see the Orders Only Encounter/Future Orders and register it for the day.
4) When the patient presents to the lab, the phlebotomist must choose one of the registered encounters for the DOS using the “Encounter” activity to release the lab orders to Soft (Example; they can select the clinic appointment or a Lab Walk-In appointment to release the orders. (Caveat: if encounter has been closed, they should use “Addendum” activity to release the orders).
This is the scenario for patients requiring outpatient lab work prior to same day PROCEDURE (for example, EKG, Cardiac Cath, Bronchoscopy, Sleep Study, EEG, MRI, Mamogram, CATScan, VIR, etc.)
1) Provider/Staff schedules the procedure. The provider/staff should edit the Appointment Notes and include a comment that instructs the registration staff to send the patient to the lab for blood collection before they go to the procedure area.
2) Providers/Staff should use “Orders Only” encounter to put in lab orders. They should be entered as Future/Lab Collect. (Do NOT place the orders on the procedure appointment)
3) On the day the patient comes in, they must stop at registration.
4) The Registration Staff will see the Appointment Notes on the procedure appointment and the Orders Only Encounter and they will create a Lab-Walk-In appointment when for the DOS. They will instruct the patient to go to the lab first.
5) When the patient presents to the lab, the Phlebotomist will use the Lab Walk-In appointment to release the orders. (The Phlebotomist should never use the PROCEDURE ENCOUNTER to release these orders since this will release the orders to an inpatient collection list).