Requesting & Reporting

For RUH Trust staff : we are now live with Millennium OCS! Please use Millennium for all electronic ordering of Pathology and Radiology. Trust users will still be able to view existing requests and all previous results within ICE.

Current position: To ensure samples are processed successfully please ensure that you mark as "Collected" with a tick for each container required, followed by "Sign" and write date and time on sample label. Otherwise sample will not be processed and reported as "Samples have been received with Millennium barcode labels that have already been received and processed in the laboratory. These samples will be held pending confirmation of appropriate tests and date and time of collection information."

For all other users, please continue to use ICE as you have previously, nothing should have changed for you.

Request tests

ICE Desktop

Inpatient Requests

Each request accepted by the laboratory for
examination(s) shall be considered an agreement.

For all RUH inpatient tests (for Haematology, Chemistry and Microbiology samples), electronic requests should be made through Millennium. For other locations requests for tests can be made electronically via Sunquest ICE or via paper requests.

For inpatients, upon completion of a request barcode labels will be produced and samples must be taken and labelled with the printed labels. This should be done immediately. The correct date and time should be handwritten on the labels, then the samples placed in a bag and sent to the lab.

Millennium can be used for requesting a G&S but not ordering blood components. A Millennium printed label for a G&S can be used for the demographics on the Transfusion form. All labels are available from Pathology stores.

Secondary (Primary) Care Requests

For tests requested by secondary care but taken in primary care please follow attached guidance. ICE should be used to request a postponed order so that the GP can print off the request at a later date. For housebound patients or those that may require district nurses to take the blood consider using a paper form or print of the ICE request and give to the patient.

Blood Transfusion Requests

Important: Blood transfusion samples must be fully labelled by hand and signed by the person obtaining the sample. The sample must be accurately labelled with:

Essential for Bloodbank
(handwritten or demand printed from BloodTrack tx system only)

NHS Number / Hospital Number /
Medical Record Number (MRN)

Patient's Surname and Forename

Date of birth

Gender

Signature of person who took sample (unless using demand printed BloodTrack tx label)

These must match on both the sample and the request form. Failure to do so can result in rejection of the blood sample and a delay in providing blood components.

Using ICE

Guides and tutorials on using ICE are available, please email Clinical Comms.

User Set up

For primary care users requests are made through ICE.
Any issues please contact ruh-tr.ClinicalComms@nhs.net

Using Millennium

Guides and tutorials on Millennium are available, please discuss with the IT training team. A guide to ordering on Millennium can be found here:

How to manage Bloods

User Set up

This should be arranged during Trust induction as part of your Millennium access.
Any issues please contact ruh-tr.ITServiceDesk@nhs.net

Order Comms (Millennium & ICE) Downtime Procedure

Completing a paper request

The only time paper requests forms will be accepted is when the Order Comms systems are down, or, for example, if the test is unavailable on the Order Comms system. There are emergency packs available to each ward for this occurrence, please contact the laboratory bleep via switchboard.

Please complete all sections of the correct form (see table below) using a ball point pen (addressograph labels can be used on forms only).

It is essential that you include a summary of the relevant clinical details and therapy, as the laboratory may initiate further appropriate tests on the basis of the results obtained and clinical information provided.

There should be at least three matching pieces of information between the form and the sample and they should be as listed below:

Surname and Forename and Registration or Hospital number or Date of Birth (unique identifier)
Registration number and Surname and any other from list (a) below
NHS number and Surname and any other from list (a) below

List (a):
- Registration number
- NHS number
- Forename
- Surname
- Date of birth
- Location
- Address

Failure to complete forms correctly results in delay and inefficiency. If a report is required, you must include the correct hospital, ward and consultant codes or GP codes. A properly addressed report cannot be issued without this information.

Urgent requests must still be phoned to the laboratory by following the usual procedure on the Urgent Requests page.

Labelling of samples

It is essential that all tubes/specimens are carefully labelled and dated to ensure that the correct analysis is attributed to the correct patient. Samples should always be labelled as described on the Sample Labelling page and include the date and time of collection.

The essential and desirable labelling information for specimen identification (see above for Bloodbank) is:

Essential	Desirable
NHS or CHI number (see Note 1)	Nature of sample, including qualifying details, e.g. left, distal etc. especially if more than one sample per request is submitted (see Note 3)
Patient's Surname and Forename or unique coded identifier
Date of birth and/or hospital number
Date and time of collection (see Note 2)

Note 1:	GP electronic requests through ICE and by paper requests should use the NHS number.
Note 2:	Date and time are Essential for some Biochemistry examination procedures and therefore have been classed as such for Pathology. They are classed as Desirable according to the IBMS.
Note 3:	Nature of the sample is Essential for Histology samples and should be written on the form and pot.
Note 4:	Microscope slides, e.g. FNAS must have the patient's forename, surname and date of birth written in pencil.
Note 5:	In the event of a Major Incident the 10 digit Majax number must be used in place of an NHS or Hospital number.

Receipt of specimens in the lab - Acceptance & Rejection Policy

On receipt of specimens at the Pathology reception, the Request and the Sample are checked to confirm that the essential information has been provided and that the data match.

For details about completing the form and labelling of samples, click here.

If the minimum requirements for identification have not been met or the identification of the specimen and the request do not match, they will be rejected and reported as so.

There are some specific occasions when samples or request forms are referred back to the requesting practitioner for amendment or irreplaceable samples may be processed under the discretion of the Consultant and in accordance with local laboratory procedures. They will be reported showing a clear disclaimer detailing the shortcomings of the sample and/or request and alerting the requesting practitioner to take responsibility for the results, and for any action taken as a result of the report.

Laboratory staff will not amend details on the sample.

Staff are aware of the importance of relevant clinical information when validating and authorising results, especially when cumulative records are available. An unexpected test result can highlight the possibility of an incorrectly labelled sample or request form and should be investigated immediately.