The right test, on the right patient, at the right time Submitted by: Cindy Johnson, Laboratory Operations Director

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December 2014 Laboratory Test Utilization The right test, on the right patient, at the right time Submitted by: Cindy Johnson, Laboratory Operations Director The rising cost of health care in the United States has prompted many of us in the laboratory profession to evaluate the appropriate use of laboratory and pathology tests. The surge in expensive molecular and genetic tests is one of the driving forces to develop a test utilization program that provides high quality, cost-effective patient care. CentraCare Health recently formed a Laboratory Utilization Review Committee (LURC), chaired by time pathologist Matthew Zieske, MD, comprised of primary and specialty ons Director providers and health system leadership. The LURC is responsible has prompted many of us inofthe for the establishment standards use of laboratory and pathology tests. and guidelines for laboratory test sts is one of the driving forces towithin availability and ordering gh quality, cost-effective patient care. CentraCare Health. mary ship. ability Pathologist Matthew Zieske, MD g and utilization. of new tests, identify opportunities for The primary functions of the LURC are to: Identify system-wide trends in test ordering and utilization. Evaluate appropriateness and availability of new tests, identify opportunities for in-house laboratory testing and evaluate whether referred laboratory testing should be performed by Services. Remove/replace obsolete tests and procedures. Review test ordering trends for proper provider utilization. Review and determine appropriate ordering criteria for select tests. Develop educational materials/ algorithms for optimal patient management. Over the next few months, LURC members will be partnering with our information systems teams to develop tools within the Epic electronic medical record to assist with test utilization strategies. System-wide recommendations will be communicated through appropriate channels. Volume 10, Issue 2 Inside this issue: Laboratory Test Utilization 1 Seeing Sepsis: Early Identification Saves Lives 2 Laboratory Accreditation Inspections 3 CCLS Laboratory Information Systems Team 4 Holiday Greeting 5 Mission Statement As part of CentraCare Health, we are a team of dedicated health care professionals whose mission is to provide quality service, expert consultation and comprehensive medical laboratory information to Central Minnesota.

P a g e 2 Seeing Sepsis: Early Identification Saves Lives Submitted by: Kristi Enerson, Technical Coordinator Severe sepsis can be associated with a mortality rate of up to 50 percent in hospitals that do not utilize an early detection and treatment bundle. The Minnesota Hospital Association (MHA), funded by the Centers for Medicare and Medicaid Services Leading Edge Advanced Practice Topics (LEAPT), has coordinated the development of the Seeing Sepsis tool kit to facilitate the adoption of severe sepsis early detection tools and the Surviving Sepsis Campaign three- and six-hour care bundles by hospitals of all sizes. These bundles have helped St. Cloud Hospital decrease mortality due to severe sepsis and septic shock by 49 percent. Additionally, making early identification of sepsis in the emergency department a priority helped Ridgeview Medical Center decrease mortality due to severe sepsis and septic shock by 60 percent. St. Cloud Hospital and Ridgeview Medical Center are two of the LEAPT mentor hospitals, contributing content and helping create the tool kit. Services is thrilled to have played a role in developing this tool kit. In the Seeing Sepsis Part 3 video created by Minnesota Hospital Association (MHA), Meghan Pearson s (Senior Laboratory Assistant) phlebotomy skill and Nicole Hirsch s (Clinical Laboratory Scientist) lactic acid testing expertise are highlighted (Minutes 0:55-1:09). Visit the MHA website to learn more about sepsis and view the entire Sepsis tool kit: http://www.mnhospitals.org/ patient-safety/ current-safety-quality-initatives/ severe-sepsis-and-septic-shock

P a g e 3 Laboratory Accreditation Inspections Services accredited by College of American Pathologists CentraCare Health announced that has received a two-year reaccreditation by the College of American Pathologists (CAP) after an unannounced visit May 15. The accreditation covers both St. Cloud Hospital and the CentraCare Health Plaza location. The College of American Pathologists is acknowledged by the federal government as being equal or more stringent than the government s inspection program. Services is proud to be recognized for the excellence of the services being provided. In the course of an on-site inspection, designed to ensure the highest standard of care for all laboratory patients, inspectors examine the laboratory s records and quality control of procedures for the previous two years. CAP inspectors also scrutinize the education and qualifications of the staff, the adequacy of the facilities, the equipment, laboratory safety and laboratory management to determine how well the laboratory is serving the patient. CAP is an advocate for high-quality, cost-effective care. St. Cloud Hospital achieves Joint Commission accreditation St. Cloud Hospital departments and nursing units that perform point-of-care laboratory testing underwent a Joint Commission site survey Nov. 4-5. CentraCare Laboratory Services provides technical consultation to these departments and nursing units performing laboratory testing. Joint Commission surveyor, Vicki Livingston, was very complimentary, stating the point-of-care testing program was well developed and executed. Notification of reaccreditation is expected to occur in early 2015. FDA inspection of transfusion services Kellie Thommes, Food and Drug Administration Investigator, performed a routine inspection of the transfusion services department Nov. 25-26. There were no major findings that require follow-up action with the FDA. The success of this survey is due to the dedication of our transfusion services team who are available to assist you with any questions or concerns.

P a g e 4 CCLS Laboratory Information Systems Team Services would like to introduce the newest members of the Laboratory Information Systems (LIS) team, Renae Wirkkula and Karen Kiffmeyer. Renae and Karen s roles on the LIS team are to provide integrated training, implementation, and ongoing support for all users of the Sunquest information system. Please feel free to contact them for any questions or concerns you may have. Renae Wirkkula Application Specialist Medical Laboratory Technician Hibbing Community College Previous position: Generalist & LIS Administrator CentraCare Health Paynesville Karen Kiffmeyer Application Specialist Medical Laboratory Technician St. Catherine University Previous position: Laboratory Supervisor St. Cloud Medical Group E-mail: renae.wirkkula@centracare.com Phone: (320) 251-2700, ext. 51482 E-mail: karen.kiffmeyer@centracare.com Phone: (320) 251-2700, ext. 77444 Happy Winter!

V o l u m e 1 0, I s s u e 2 P a g e 5 CCLS CONNECTION Editor: Jeremy Angell Contributors: CCLS Leadership Cynthia Johnson Kristi Enerson Services - River Campus 1406 Sixth Ave. North (320) 255-5999 Services - River Campus Clinic Collection Site 1200 Sixth Ave. North (320) 240-2211 Services - Health Plaza 1900 CentraCare Circle (320) 229-4903 The holiday season is a time of reflection. It is a time of celebration and joy. It is a time to be thankful for all that we have. At Services our greatest achievement and that for which we are most grateful is our role in providing high quality health care to the communities that, with your partnerships, we are able to serve. CCLS CONNECTION DISTRIBUTION LIST If you know someone who would like to be added to our distribution list, or if you would like to be removed from the list, please let us know. E-mail us at: cclabser@centracare.com From the staff of CCLS we offer our appreciation for your collaboration and extend to you and your families a blessed holiday season and continued success in the New Year ahead.