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Review of Diagnostic Test Results and Notification to Patients in the UW Health Carbone Cancer Clinics (12.14)

Review of Diagnostic Test Results and Notification to Patients in the UW Health Carbone Cancer Clinics (12.14) - Policies, Clinical, UWHC Clinical, Department Specific, Ambulatory, Clinic Specific

12.14

12.14 Review of Diagnostic Test Results and Notification to Patients in the UW Health Carbone Cancer 
Clinics  
Category:  UWHC Departmental Policy   
Policy Number:  12.14    
Effective Date:  January 28, 2015 
Version:  Revision    
Manual:  Ambulatory    
Section:  Clinic Specific (Ambulatory)   
 
 I. PURPOSE

To establish a process for the UW Health Carbone Cancer Clinics health care providers or their designees to review
results and notify patients of diagnostic test results.

II. POLICY
A. Diagnostic results are directed to either the ordering provider or the Clinical Results Pool for review.
B. A designee of the Clinical Results Pool will consult with the ordering provider or their designate for all
abnormal results, as defined by laboratory ranges or by clinical relevance.
C. A designee of the Clinical Results Pool may initiate a patient notification letter, call a patient, or send
MyChart message with any normal results. They may do this for abnormal results once direction is
received from the ordering provider or their designee.
III. PROCEDURE
A. Each physician/provider is responsible for reviewing test results and notifying the patient of the results
and any needed changes in therapy in a timely way. The physician/provider may delegate the review of
results to a qualified health care team member who may also assume the responsibility of notifying the
patient based on the physician/provider direction.
B. Abnormal laboratory values designated as "critical" will be communicated to the ordering health care
provider or their designee immediately by the laboratory staff. (See UWHC Administrative Policy 8.07 -
Critical Results and Critical Tests/Procedures, Communication of).
C. Abnormal results and any changes in the plan of care should be communicated to the patient as soon as
possible.
D. Documentation of notification will be made in the patient's electronic medical record (EMR) by the person
notifying the patient.
E. Patients may be notified in person, by direct phone call, or using one of the following forms: letter,
dictated note, or other approved system.
F. When it is necessary to communicate with the patient outside of the clinic setting, please follow UWHC
Administrative Policy 6.24 – Communication with Patients Outside of the Clinical Setting.
G. Cancer Clinics Specific Processes
1. The Registered Nurse (RN) and/or Medical Assistant (MA) in the Cancer Clinics (Bone Marrow
Transplant, Hematology, GYN Oncology and Medical Oncology) will review all laboratory results
for:
a. Patients with scheduled appointments.
b. Patients having laboratory tests at local communities that are either phoned or faxed to
UWHC.
c. Clinic patients having laboratory tests at UWHC with no physician/provider appointment.
d. Clinic patients receiving chemotherapy at UWHC with no physician/provider
appointment.
2. Patient receives resulted lab results during their clinic visits.

3. The RN will notify the physician/provider for the following abnormal laboratory values:
Lab Value
Absolute Neutrophil Count (ANC) less than 500 uL
Calcium 11 mg/dL or higher
Creatinine greater than 2 mg/dL
Hematocrit (HCT) less than 24%
Hemoglobin (Hgb) less than 8 g/dL
Magnesium less than 1.2 mg/dL or greater than 2.3 mg/dL
Platelets less than 20,000 K/uL
Potassium less than 3.2 mmol/L or greater than 5 mmol/l
Sodium less than 132 mmol/L or greater than 144 mmol/L
Note when reviewing lab values from organizations outside of UW Health, reference ranges may
differ from UWHC norms.
4. The RN or physician/provider will notify the patient of the abnormal test results and provide
necessary instructions for care or follow-up during the clinic visit or by telephone.
5. For GYN Oncology patients:
a. For abnormal PAP results, the RN, under the direction of the physician/provider, or the
GYN Oncologist will contact the patient by phone or letter to provide the necessary
instructions for care or follow-up in a timely manner unless prior arrangements have
been made.
b. For all diagnostic test orders, including PAP smears, the patient receives written
notification of the results.
IV. REFERENCES

Holmes Gobel, B. (2005). Metabolic emergencies. In J.K. Itano & K.N. Taoka (Eds.), Core curriculum for oncology
nursing (4th ed., pp. 400-406). St. Louis: MO: Elsevier Saunders.
UWHC Administrative Policy 6.24 - Communication with Patients Outside of the Clinical Setting
UWHC Administrative Policy 8.07 - Critical Results and Critical Tests/Procedures, Communication of

V. WRITTEN BY

Cancer Clinics Manager

VI. REVIEWED BY

Director, Cancer Service Line
Clinic Manager, GYN Medical Oncology
Clinic Manager, Oncology
Ambulatory Policy and Procedure Committee
Clinics Administration

SIGNED BY

Karen Leimkuehler, RN, MS, Clinic Operations Director