syngo® Lab Data Manager Investigate Held Results Online Training

Welcome to the syngo® Lab Data Manager Investigate Held Results Online Training course.  By effectively investigating and managing results held for review in Result Manager you can: Optimize workflow Increase productivity Reduce turn around time Note:  In this training course, we will discuss managing results that are held due to either instrument errors or through the use of autoverification rules.  Since rules used for autoverification are often unique to each laboratory and can be complex, there are no default rules that can be enabled.  Autoverification for syngo Lab Data Manager can be implemented by the local support team through the purchase of professional services. Select Next to continue. Demonstrate actions that can be performed on held results Investigate QC and previous results Locate held samples Navigate to the Sample Review Screen Recognize why results are held Upon successful completion of this course, you'll be able to: Select Next to continue. Most acquired cardiovascular diseases are degenerative in nature - they develop over a lifetime as a result of chronic damaging effects on the heart and vascular system. The main culprit is a western lifestyle, which is often characterized by a diet rich in animal fats, overweight, cigarette smoking, lack of physical activity, stress, arterial hypertension and a high incidence of diabetes mellitus. These factors favor the development of atherosclerosis. The dramatic rise the number of overweight adolescents means that the prevalence of atherosclerotic diseases is expected to rise significantly in the coming decades.  Several cardiovascular diseases are attributable to atherosclerosis. The most common clinical manifestations include coronary artery disease (CAD), peripheral arterial occlusive disease (PAOD) and stroke. The typical heart patient often suffers from several atherosclerosis-related diseases.  Next, take a look at how atherosclerosis develops and how arterial hypertension can occur.   Congratulations. You have completed the syngo Lab Data Manager Investigate Held Results Online Training. Listed below are the key points that have been presented.  Take time to review the material before you proceed to the final quiz. Locate Held Samples Launch Result Manager, which defaults to Held 24 Hour filter Held 24 Hour filter contains samples with at least 1 result in Held status Navigate to the Sample Review Screen From the Held 24 Hour screen, select the checkbox next to the samples to be reviewed Select Sample Review function button Review the sections of the Sample Review Screen: Samples - Displays a list of the sample IDs previously chosen for review from the Samples screen, the sample that is highlighted is the currently displayed sample Sample Details - Displays the detailed sample information Sample Comments - Displays any comments entered manually in the Sample Details screen and/or interpretative comments included in custom rules Patient Details - Displays the detailed patient information Patient Visit - Displays visit specific details Results - Displays function buttons and a list of assays and results Result Comments - Displays comments generated if any errors occurred during assay processing on the instrument or manually entered in the Result Details screen. Recognize Why Results are Held Review Sample Comments and Result Comments for reason result was held, such as Instrument errors, QC failure, Critical ranges, Specimen Quality, or Delta checks. Review the status of Results: Code Description  N New – Order has been created but not yet processed through the rules  O Open – Order has been processed through the rules and is available for pushdowns and queries  D Deferred – Order has been processed through the rules, but is not yet available  F Available/Forwarded – Order has been forwarded to the subsystem  P Pending-Order has been downloaded to an instrument and is awaiting a result  C Cancelled-Order has been processed through the rules and permanently no longer available  R  Resulted- A result has been received, but rules have not yet processed the result  V Validated – Result has been processed through the rules and is available for LIS validation  H Held – Result is being held for review and should not yet be transmitted  I Ignored – Result has been marked to be permanently ignored and should  not be transmitted, used in rules, or reported S Scheduled – Transmission to the LIS has started T Transmitted – Transmission to the LIS is complete  A Archived – Result has been validated but cannot be transmitted to the LIS because no corresponding test(s) exists  W Waiting – results waiting for closing QC when using bracket QC; results waiting for the sample to complete when using release on sample complete; auto-release is not configured  J  Rejected from LIS – Result has failed transmission to the LIS.  Connectivity will automatically re-send.  B Scheduled to Automation.  Transmission to instrument/LAS has started.  K Rejected from Automation – Order/Result has failed transmission to the LAS. Connectivity will automatically re-send.  E Error – An internal error occurred while processing the result.     Investigate QC and Previous Results To view Controls select the QC link next to a result when it is held due to a QC rule failure Select the H (History) link next to a result when it is held due to a critical range or delta check failure Demonstrate Actions that can be Performed on a "Held" Result Select the Checkbox next to result(s) that require action, then select the desired function button. Functions available on the Sample Review Screen: Release Sample - Releases the sample results to the LIS History - Toggles between displaying and not displaying sample history Delete - deletes selected test orders and/or results Release - releases selected results to the LIS Reorder - Retains the selected current test orders and results and requests that they be run again Reset - Removes the current test orders and results, and requests that they be run again. Ignore - sets the result status to "I" and prevents the result from transmitting to the LIS Apply Rules-evaluate new results based on enable rules Select Next to continue. syngo Lab Data Manager Result Manager: Manages the workflow between the analyzer and the Laboratory Information System (LIS) Applies definable rules and can hold result transmission for review Displays the Held 24 Hour filter by default, showing samples with results in Held status Select Next to continue. Sample Review Screen: View Held Results Take Action on Held Results Sample Review Screen Identify the areas of the Sample Review screen. Base ImageHotspotsText BlocksImage File Sample Details: Displays information about the sample such as identification number, sample time, and sample type.  Samples: Displays a list of the sample IDs previously chosen for review from the Samples screen.  The sample that is highlighted is the currently displayed sample.       Sample Comments: Displays any comments entered manually in the Sample Details screen and/or interpretative comments included in custom rules.  Patient Details: Displays the detailed patient information, such as identification number, name, etc.  Patient Visit: Displays specific information about the patient at the time of the visit, such as age, weight, etc.  Results: Displays function buttons and a list of assays and results    Result Comments: Displays comments generated if any errors occurred during assay processing on the instrument or manually entered in the Result Details screen.     Navigate to the Sample Review Screen Learn how to navigate to the Sample Review screen. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Navigate to the Sample Review Screen From the syngo Lab Data Manager home menu (or main screen), select Result Manager.   Select Result Manager to continue.  Note: If audio does not automatically start, select the play arrow in the top left to begin.You have just finished a run of samples on your instrument and now it is time to see whether there are any results that have been held. To do this in the syngo Lab Data Manager, begin by launching Result Manager. 2 Held 24 Hour The system displays any sample with at least one result held in the past 24 hours.  Select Next to continue. In Result Manager, the default filter is set to Held 24 Hour, which means the system will display any sample with at least one result held in the past 24 hours. 3 Review Held Samples Select the Checkbox next to Sample ID to view all samples Select Review Samples Select Review Samples to continue. To review held samples, you can either select the top checkbox which selects all samples in the list or select a row to view a single sample from the list. To optimize your time typically you will review all Held Samples. To continue, select the top checkbox in the gray bar and the Review Samples button. 4Sample Review Screen Left pane displays a list of the samples selected Highlighted sample is displayed on the right When complete, select the X in the upper-right corner to close the window and continue.  The sample review screen is the area where you can review, investigate, and take action on the held results. On the left, you will see a list of the samples that you selected. Notice how the first sample highlighted in the left pane is the one displayed on the right. Electromagnetic waves - we can imagine them as particles (photons) wiggling their way through space and matter - carry a certain amount of energy, which is inversely related to the wave length of the wiggle. When electromagnetic waves travel through matter (that consists of atoms), part of their energy is absorbed. Depending on the energy and thus the wavelength of the electromagnetic radiation, the atoms may lose electrons, thereby changing their structure and becoming electrically charged. This phenomenon is called ionization.   Not all electromagnetic radiation is ionizing. Only radiation with shorter wavelengths, such as UV light and X-rays, is ionizing.   Results are held due to: Error Codes QC Failure Critical Value Delta Check Specimen Quality Note: To learn why a result was held, review the Result Comments and Sample Comments sections of the Sample Review screen.  Reasons for Held Results Learn about common reasons results are held. Tab TitleTextError Code (Instrument Flag) Result held due to an error code. Each lab can determine what action to take when a specific error code is received with a result.   QC out of range Result held due to QC being out of range.   A rule has been configured to prevent patient results from transmitting to the LIS until the QC is in range.   Critical value Result held because it was outside user-defined critical ranges. The operator can perform certain actions (repeat, check sample, call to doctor) before transmitting to the LIS.  Specimen Quality Result held to alert the operator to specimen integrity concerns (such as hemolysis, icterus, and lipemia).      Delta Check Result held due to delta check failure. Delta check rule is designed to hold results if the current result and the previous result for the same assay differ by a specific percentage or value within a specified time period.  When complete, select the X in the upper-right corner to close the window and continue.       Review Result Status Learn about Result Status. Code Description  N New – Order has been created but not yet processed through the rules   O Open – Order has been processed through the rules and is available for pushdowns and queries  D Deferred – Order has been processed through the rules, but is not yet available  F Available/Forwarded – Order has been forwarded to the subsystem  P Pending-Order has been downloaded to an instrument and is awaiting a result  C Cancelled-Order has been processed through the rules and permanently no longer available   R  Resulted- A result has been received, but rules have not yet processed the result  V Validated – Result has been processed through the rules and is available for LIS validation  H Held – Result is being held for review and should not yet be transmitted  I Ignored – Result has been marked to be permanently ignored and should  not be transmitted, used in rules, or reported S Scheduled – Transmission to the LIS has started T Transmitted – Transmission to the LIS is complete  A Archived – Result has been validated but cannot be transmitted to the LIS because no corresponding test(s) exists  W Waiting –results waiting for closing QC when using bracket QC; results waiting for the sample to complete when using release on sample complete; auto-release is not configured  J  Rejected from LIS – Result has failed transmission to the LIS.  Connectivity will automatically re-send.  B Scheduled to Automation.  Transmission to instrument/LAS has started.   K Rejected from Automation – Order/Result has failed transmission to the LAS. Connectivity will automatically re-send.  E Error – An internal error occurred while processing the result.   When complete, select the X in the upper-right corner to close the window and continue. You have learned how to determine why results are held. Let's investigate further before deciding which action to perform on the held results.   Investigate QC Learn how to investigate QC. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Investigate QC In the Sample Review screen the QC link next to each result provides an opportunity to review the corresponding QC results before taking action on the held results. Select the QC link next to the vancomycin result.     Note: If audio does not automatically start, select the play arrow in the top left to begin.You are reviewing held results and would like more information before deciding what action to perform. Take a moment and consider the answer to this question. In what situation would you want to review the corresponding QC results? Exactly, when the results are held because the QC results for that assay have violated a QC rule. So let's begin, in the Sample Review screen select the QC link to the far right of the vancomycin result.2Investigate QC In the Controls screen select the row for the Control that has a status of Error. The Controls screen opens and you can see a list of Controls that are current for this assay. Notice that one has a status of Error. Let's take a closer look at that Control by selecting the row. 3The Controls Details screen displays the Levey Jennings graph which shows both the data point that is out of range and the data point representing the QC rerun. This additional information will assist you in making the decision to take the appropriate action on the held result.When complete, select the X in the upper-right corner to close the window and continue.  In the Controls Details screen you can see the outlier (red data point) on the Levey Jennings graph. Notice the data point next to it is in range so it is apparent that the QC was rerun and is acceptable. By viewing this additional information you can easily make a decision and take the appropriate action on the held result. Investigate History Learn how to investigate previous results. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Investigate History In the Sample Review screen the H (History) link next to each result provides an opportunity to review this patient's results for the same assay from previous samples before taking action on the held results. Select the H link next to the potassium result to continue.   Note: If audio does not automatically start, select the play arrow in the top left to begin.In a similar scenario you are reviewing held results and would like more information before deciding what action to perform. Take a moment and consider the answer to this question. In what situation would you want to review the results for the same assay from previous samples for this patient? Exactly, when the results are being held due to a critical range rule or delta check rule. So let's begin, in the Sample Review screen select the H (History) link to the far right of the potassium result.2Investigate History In the Patient History screen you can review the historical results. This additional information will assist you in making the decision to take the appropriate action on the held result.  You can close the Patient History screen with the X to return to the Sample Review screen.   Select Next to continue.  The Patient History screen opens and you can view this patient's results for the same assay on previous samples. By viewing this additional information you can easily make a decision and take the appropriate action on the held result.3Investigate History In the Sample Review screen you can proceed with performing the appropriate action on the held result.    When complete, select the X in the upper-right corner to close the window and continue.  Now that you have made your decision you can proceed with performing the appropriate action on the held result in the Sample Review screen. Atherosclerosis is a disease affecting the entire arterial system, but the manifestation of the disease varies among individuals. It may manifest itself within the heart as coronary artery disease (CAD) or in the periphery as peripheral arterial occlusive disease (PAOD), or both. While atherosclerosis of the coronary arteries is potentially life-threatening, narrowing of the arteries in the leg, although certainly painful (possibly even involving amputation) is less likely to be fatal. As you have already seen, plaque can build up in any arteries. The risk associated with plaque, and the resulting symptoms depend on which part of the body is affected. While atherosclerosis of the coronary arteries is potentially life-threatening, narrowing of the arteries in the leg, although certainly painful, is less likely to be fatal, although serious cases may involve loss of the affected extremity. Some vessels are more prone to stenosis than others simply because they have a smaller diameter. Such is the case with the coronary arteries: the proximal segments of the three large coronary arteries only have a diameter of about 3 to 5 mm. The risk of stenosis is therefore much higher here than for instance in the aorta, which normally measures about 2.5 to 3.5 cm in diameter.   Actions that can be performed on a "Held" Result: Delete - deletes selected test orders and/or results Release - releases selected results to the LIS Reorder - Retains the selected current test orders and results and requests that they be run again Reset - Removes the current test orders and results, and requests that they be run again Ignore - sets the result status to "I" and prevents the result from transmitting to the LIS Apply Rules - evaluate new results based on enabled rules   Take Action on Held Result Learn how to take action on held results. Instructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90004674/sim_sLDM_InvestigateHeld_9/sim_sLDM_InvestigateHeld_9.swfHTML5 File:/content/generator/Course_90004674/sim_sLDM_InvestigateHeld_9/index.htmlPDF File: The Quality Control feature has been removed from Version VA12C. If your system is operating with Version VA12C, then the following is in effect:   All access to QC features have been removed QC will continue to upload to the LIS even when QC screens are disabled QC rules for holding patient results will no longer function For further information, refer to the “syngo Lab Data Manager and syngo Lab Process Manager Version VA12C Release Notes” or contact your local Siemens support. Select Next to continue.