Community Laboratory Services provide collection, transportation, testing, reporting and consultant advice on tests requested by health practitioners providing services outside the auspices of a public hospital. These health practitioners include: general practitioners, specialists operating in a private capacity, midwives, dentists, and some nurses. When you see a health practitioner they will decide the number and type of tests that need to be performed. The health practitioner in addition to talking to you about the tests is required to complete a test request form to advise the laboratory what tests are required. Individuals are not able to request tests themselves.The following diagram shows the steps involved in having a test done. This is explained below.
Collection and Transportation
Collection of samples for testing can be taken at the general practice clinic, the private specialist clinic and other health provider clinics. However, most commonly individuals attend a collection centre usually operated by the community laboratory provider. The type and number of blood samples are determined by the tests requested by the health practitioner. At the collection centre a person trained in taking blood from humans (a phlebotomist) will take the blood samples. The blood samples will be collected in to special tubes that are labelled with a unique number. The unique number allows the sample to be traced ensuring your results go back to your health practitioner. The samples are then sent to the laboratory for testing. Transport of samples is usually by drivers employed by the laboratory provider or by approved couriers.
Collection can occur at an individual’s home where your health does not allow you to attend a collection centre. This service is provided by phlebotomists usually employed by the laboratory provider.
Blood tests are laboratory tests done on blood to gain an appreciation of sickness. Blood flows throughout the body, providing oxygen and other nutrients. Blood also draws waste products out for disposal. The state your blood affects, or is affected by, many medical conditions. For these reasons, blood tests are the most commonly performed medical tests. More information on the types of blood tests can be found at:
http://en.wikipedia.org/wiki/Blood_test
http://www.rcpa.edu.au/public/default.cfm
Some tests will not need a blood sample. Examples of other samples are urine and faeces samples. You may need to collect these samples yourself. Special containers will be given to you for this. Your health practitioner will advise you of how to collect theses samples. The samples then need to be dropped off at one of the collection centres.
If you live in a rural area it is more likely that there is no collection centre in your area and that the samples will be collected by one of the team at your general practitioners clinic. These samples are then sent to the laboratory.
Testing
The samples are received by the laboratory and are prepared to be tested. All testing is done according to standards determined by the contractual arrangement with the District Health Board and those directed by The New Zealand Standards Council (Standards New Zealand). These standards are monitored by International Accreditation New Zealand (IANZ). See the IANZ website for more information:
http://www.ianz.govt.nz
The District Health Board also ensures that the laboratory provider performs the service according the contracted requirements.
There are a range of tests, commonly referred to as “send away” tests that are performed by Lab Plus the Auckland District Health Board hospital laboratory. Send away tests are commonly those tests that are requested less frequently and require specialised equipment and staffing to perform. The community laboratory provider usually does not have the ability to do these tests themselves. Lab Plus is required to perform to the same standards as the community laboratory provider.
Reporting
The health practitioner who requested the test, plus any other health practitioner asked to be copied in (usually a specialist), will receive the results of the tests. These are routinely sent directly to the requesting health practitioner through the computer system. The results are not sent directly to the patient. The patient needs to discuss the results directly with the health practitioner who requested the test.
The results are also listed in the TestSafe information repository where the patient has agreed to this. A health practitioner can prevent sharing of results at the patients request or the patient can phone 0800 Lab Safe (0800 522 7232) to prevent sharing. TestSafe is a secure information repository that holds laboratory test result from both the community and hospital laboratories. The purpose of TestSafe is to provide access to heath care providers of the patient test results. This enables the number of requests for tests to be kept to a minimum. Health practitioners are only to access results for patients they are activity involved in the provision of health services. There are mechanisms in place to monitor the access of the information repository to ensure only those who need to see results do so.
Consultant Advice
For many test results the health practitioner has the ability to interpret the results and provide patients with the meaning of the results. The health professional uses the results to help decide on the best treatment for your condition. However, there are occasions when the health practitioner requires advice on understanding the results. Pathologists, specialist doctors in laboratory test result interpretation, provide any additional advice required by the requesting doctor. The pathologists also provide leadership and oversight of the operations of the laboratory.
Both community and hospital laboratories are required to have pathologists to provide advice. Some pathologists work for both laboratories.