¶ Introduction
The Microbiology module, or Mic module for short, is designed specifically to accommodate requirements for setting up and maintaining results pertaining to Microbiology analysis which includes procedures like:
- Urine microscopy; culture and sensitivity (susceptibility)
- Blood cultures
- CSF cultures and sensitivity etc.
To enable the ordering; resulting; management and reporting of Microbiology analysis, specific LIMS setups should be completed including setting up of Organisms; Antibiotics and Microbiology procedures.
General LIMS setups to be completed prior to Microbiology setup may be completed:
- Lab departments
- Canned comments
- Methods
- Markers
- Questionnaires and group responses
- Specimen sources
- Specimen types
- Specimen containers
- Service products defined for use in Laboratory Billing
- Providers (Global address book)
- Laboratories (Warehouses)
- Units of measure (Organization administration)
¶ Navigation
¶ Step 1: Setup Antibiotics
Antibiotics are defined in LIMS to allow for resulting of susceptibility testing post isolation of cultures. Antibiotics may be combines in susceptibility procedure groups to allow for panels of antibiotics to be ordered and resulted together.
- Go to: Clinical lab information management > Setup > Microbiology > Antibiotics
- To find existing antibiotic records, enter the name; description or print number of the antibiotic in the Quick filter field and select the appropriate data source from the dropdown list
- The Navigation list is by default filtered to only display active records. Set the Show inactive slider button to Yes to view active and inactive records.
- To create a new antibiotic record:
- Click on New in the action pane
- In the General fast tab, enter a short unique name in the Antibiotic ID field. If a name is entered that is already in use, an error message will appear.
- Enter a longer Description
- The Abbreviated description will automatically default from the entry of the Description field. This may however be changed as required.
The Abbreviated description is displayed in Enter results forms and other D365 forms where space is limited.
- Enter a unique Print number following the format defined in the LIMS parameters
- Set the Reportable slider button to Yes if the antibiotic should print on laboratory reports to providers.
- The Active slider button should default to Yes to make the record available for use in LIMS.
- If a delta check should be performed for all results; irrespective of the organism isolated, set the Delta check all results slider button to Yes.
- Antibiotic records may also be created by copying an existing record and updating values as needed. To copy an existing record:
- Select a record to copy in the navigation list
- Click on Copy in the action pane.
- In the Copy antibiotic dialogue, complete the required fields:
- Enter a unique Antibiotic ID. Entering an Antibiotic ID already in use, will result in an error message and will have to be changed before being allowed to continue.
- Enter a Description
- Enter a unique Print number
- Click OK to create the record and copy all entries from the selected record to the new record.
- Expand the Organisms fast tab to define organism specific delta checks or Minimum inhibitory concentration susceptibility (MIC) values.
Organism specific definitions may only be set if organisms have already been set up in LIMS (see Step 2).
- In the Organisms fast tab, click Add
- In the grid, select an Organism in the dropdown list
Delta checks can only be set at organism level, if Delta check all results in the General fast tab is set to No.
- To set Delta checkat organism level, click on the associated check box to select it
- Expand the Minimum inhibitory concentration susceptibility fast to define MIC values, should the lab require to result the antibiotic via this method.
By default, antibiotics may be resulted by selecting either Sensitive; Resistant or Indeterminate, which are standard field in the enter results form. Setting up MIC values allows users to enter these set MIC values in Enter results instead to trigger the correct result if so required. MIC setup is however completely optional and not required, should the client prefer to use the standard resulting features.
- To add MIC values for a selected organism, click Add in the Susceptibility targets grid
- Select a Target in the dropdown list i.e. CNS (Central nervous system); NIL (none) or PULM (Pulmonary)
If only one target is selected, it will automatically be set as the Default target in enter results forms. If more than one target is entered, the default may be set using the Set default grid button.
The default target may also be defined in the Specimen type setup form to default in enter results, based on specimen type and MIC setup.
- To add the target's MIC values, click Add in the MIC values grid
- Enter a MIC value
- Select the corresponding Rx value for the MIC value entered
- Expand the Audit log fast tab to view a list of all entries and modifications made to the antibiotic record for problem solving and traceability
- Expand the Related information pane to view related and dependent Microbiology procedures or Organisms where the antibiotic may have been selected. Click on the record names in the fact boxes to access the related setup forms
- To deactivate a record, set the Active slider button in the General fast tab to No
- To delete a record, click on Delete in the action pane. A confirmation dialogue will appear to confirm the deletion before continuing.
An Antibiotic cannot be deactivated or deleted if it has any dependent records.
¶ Step 2: Setup Organisms
Organisms are defined in LIMS to allow the isolated organism to be selected in result entry, post culture.
- Go to: Clinical lab information management > Setup > Microbiology > Organisms
- To find existing organism records, enter the name; description or print number of the organism in the Quick filter field and select the appropriate data source from the dropdown list
- The Navigation list is by default filtered to only display active records. Set the Show inactive slider button to Yes to view active and inactive records.
- To create a new organism record:
- Click on New in the action pane
- In the General fast tab, enter a short unique name in the Organism ID field. If a name is entered that is already in use, an error message will appear.
- Enter a longer Description
- The Abbreviated description will automatically default from the entry of the Description field. This may however be changed as required.
The Abbreviated description is displayed in Enter results forms and other D365 forms where space is limited.
- Enter a unique Print number following the format defined in the LIMS parameters
- The Active slider button should default to Yes to make the record available for use in LIMS.
- In the Specification field group:
- Set the Abnormal slider button to Yes if the organism should be flagged as such in D365 and laboratory reports
- Set the Infection control slider button to Yes if the result should be flagged for infection control
- Select a Default susceptibility procedure from the dropdown if required. If selected, the susceptibility group will automatically be added to the result entry form and allow for entering of the susceptibility results of the antibiotics included in the group
- Select a Comment from the dropdown list if required, to automatically default to the organism result comment field in enter results
- Select a Marker from the dropdown list if required, to automatically be added to the sample during result entry
- Select a Result questionnaire from the dropdown list if required, to be added to Organism result prompts in the enter results form.
- Select a Default method from the dropdown list if required, to be automatically added to the enter results form
- Organism records may also be created by copying an existing record and updating values as needed. To copy an existing record:
- Select a record to copy in the navigation list
- Click on Copy in the action pane.
- In the Copy organism dialogue, complete the required fields:
- Enter a unique Organism ID. Entering an Antibiotic ID already in use, will result in an error message and will have to be changed before being allowed to continue.
- Enter a Description
- Enter a unique Print number
- Click OK to create the record and copy all entries from the selected record to the new record
- If any antibiotics should be excluded for susceptibility testing for the selected organism, expand the Excluded antibiotics fast tab
- Click Add
- Select the Antibiotic ID from the dropdown list
If an Antibiotic is excluded for an organism, the antibiotic will not be available for addition to the enter results form, and will not default to the susceptibility results list, even if it is included in a selected or defaulted susceptibility procedure group.
- To define defaults for an organism based on Specimen type, expand the Specimen type specifications fast tab
- Click Add
- Select a Specimen type from the dropdown list
- Select any of the following defaults for the specimen type selected:
- Default susceptibility procedure
- Comment
- Marker
- Result questionnaire
Defaults selected for specimen types, will override what was selected in the General fast tab to default for the Organism.
Where defaults are not specified for specimen types e.g. a Comment was not defined at specimen type level, but was defined in the General fast tab, then the comment in the General fast tab will default.- To define tariff codes for the organism per method, expand the Tariff codes fast tab
- Click Add
- Select a Method in the dropdown list
- Select the CPT/Tariff code from the dropdown list
- Select the Lab product code from the dropdown list
- If only one method/billing codes combination is defined, this will automatically be set as the Default. If multiple lines are entered, use the Set default button to set the correct method and associated billing codes as the default
- Expand the Audit log fast tab to view a list of all entries and modifications made to the antibiotic record for problem solving and traceability
- Expand the Related information pane to view related and dependent Antibiotics where the Organism may have been selected. Click on the record names in the fact box to access the related record.
- To deactivate a record, set the Active slider button in the General fast tab to No
- To delete a record, click on Delete in the action pane. A confirmation dialogue will appear to confirm the deletion before continuing.
An Organism cannot be deactivated or deleted if it has any dependent records.
¶ Step 3: Setup Microbiology procedures
Microbiology procedures are setup to allow ordering; resulting and reporting of Microbiology analysis.
- Go to: Clinical lab information management > Setup > Microbiology > Microbiology procedure
- The Microbiology procedure list is primarily sorted by Department print sequence, as per Laboratory department setup explained in the General setup steps.
- The secondary sort of the procedure list is the procedure Print number. The print number determines the sequencing of procedures when viewed in D365 and on laboratory reports. Each Laboratory departments has its own and separate print range, unaffected by other laboratory departments. This means the same print number may be allocated to different procedures for different laboratory departments.
Microbiology procedures by default appear in department sequence first, then in print number sequence for that department in ascending order.
- The Microbiology procedure list is generally filtered to hide inactive procedures. Click on the Show inactive slider button to view both active an inactive procedures.
- Enter data in the various Filter fields to find a specific procedure
- Click on the record name; description or print number in the list to maintain or view the record details
- Expand the Related information pane, to the right of the list, to view dependencies to other records as well as a simple event log, which lists modification events
¶ Step 3.1: Create a Microbiology procedure
Microbiology procedures may be created by either copying another existing procedure with similar parameters or from new.
- Click on New in the action pane to create a new procedure OR click on Copy in the action pane to copy data from an existing procedure to a new procedure
- The Microbiology procedure copy dialogue will appear if Copy is selected, and should be completed as follow:
- Enter a short unique Name for the new procedure
- Enter a unique Print number for the department
- Select the appropriate Department from the dropdown list
- Click on OK
- If the Name is not unique or the Print number selected has already been allocated for the selected department, an error message will appear. Correct the data then try again.
- If successfully copied, the Microbiology procedure detail form will be displayed containing values from the dialogue and from the copied procedure.
Although the copied data may also apply to the new procedure in many of the fields, it is important to check and update all fields where required.
¶ Step 3.2: Complete the General index tab
The General index tab is mandatory to be completed for all types of procedures. Some of the fast tabs in the General index tab may however be optional based on the procedure type. Warning messages appear to guide users during setup, if mandatory fields have not been completed.
¶ Step 3.2.1: Complete the General fast tab parameters
- Expand the General fast tab
- Enter the Identification details for the procedure:
Field name Purpose What to enter Additional information Name Primary key for the procedure. Used to order or locate the procedure. A short name; abbreviation or known acronym for the procedure e.g. URMIC for Urine Microscopy The name should be short; meaningful if possible and easy for staff to use likely as the procedure is already known to staff by that name The name must be unique. If a unique name is not selected an error message will appear.
Description To assist with selection of correct procedure Enter a longer description for the procedure. If a procedure may be analyzed using different specimen types, it is suggested to reference the specimen type first then the procedure. This may however be reversed in the report name if required. By entering the specimen type first, staff will be able to more easily find the procedures associated to the same specimen type.
A warning may appear if the procedure name is already in use and serves as a guide to prevent unnecessary duplication of procedures but may be ignored if the duplication is correct. Abbreviated description Used to identify the procedure in forms/reports where space is limited e.g. Enter results The Abbreviated procedure description will default from the Description field entry but may be changed if required. Active Indicate if the procedure is active or not. The Active slider button may be set to Yes when all mandatory data has been entered/selected and the procedure should be made available for use in the laboratory. Set to No when the procedure is made obsolete by the laboratory.
If not all mandatory fields have been completed, an error messages will appear to indicate the missing data when trying to activate the procedure. Start date Indicates date from which the procedure was introduced to the laboratory Select or enter a date Optional entry which does not affect ordering and selection End date Indicates date from which procedure was marked obsolete Select or enter a date Optional entry which does not affect ordering and selection - Select the Procedure type from the dropdown list in the Specification field group:
Procedure Type Purpose Target procedures Also known as the Result target. Target procedures are used to capture analysis results, which may be a single result selected from a dropdown list and/or results entered for multiple related prompts. Target procedures defined as Organism type procedures; enables additional resulting sections where Organisms isolated; results for organism prompts and the outcome of susceptibility testing may be added.
Group procedures Allows typically target procedures to be grouped together so that multiple procedures can be ordered using a single group name. Grouping procedures reduces the risk of manual entry of individual procedures as well as the risk of leaving out a procedure that should be included in a standard profile. Susceptibility group procedures Allows for Antibiotics to be grouped together so that multiple antibiotics may be added to a sample by ordering the susceptibility group for resulting, oposed to adding Antibiotics individually. Charge procedures A non-reportable and non-resultable procedure. The purpose of a charge procedure is to add a service charge to the visit e.g. Collection fees and consumables. - Select the correct Department from the dropdown list
- Enter a Print number in the format specified in the LIMS parameters. If the print number is not entered in the correct format, an error message will appear to indicate the correct format
Best practice suggestions for print number selection:
- Plan print number allocation of the lab test compliment prior to creating the tests in D365, to ensure tests appear in the expected order.
- Leave adequate space between print numbers to ensure new tests may be added if required in future
- Allocate print numbers for the Group and contents tests so that the Group is listed first followed by the target tests included in the group.
- If the procedure should be included in laboratory reports to providers, set the Reportable slider button to Yes
- Billing details:
- If the procedure has a payable charge, add the appropriate CPT/Tariff code from the dropdown list. This is the code expected by the medical aid/insurance to identify the charge in claims.
- If a CPT/Tariff code is added for a procedure, the Lab product must also be completed. The lab product is used to define the charge price of the procedure, as set by the laboratory, independent of the amount the medical fund/insurance is willing to pay.
- Select if the procedure should be Billed on order or on Completion of the sample, by selecting the appropriate option from the dropdown list.
- Order instructions
- Set the Orderable slider button to Yes if the procedure should be available for ordering during the creation of a laboratory visit. If a procedure should not be ordered on its own, but instead always be ordered as part of a group OR if the procedure should just not be available for ordering, set the slider button to No.
- Complete the other Order instructions parameters as follow:
Field name Purpose What to enter Additional information Available Indicates if procedure is currently available and restricts ordering if set to No. Typically set to No when the procedure is temporarily unavailable.
Yes to allow the procedure to be ordered for a laboratory visit. No to prevent the ordering of the procedure for a laboratory visit.
If an active and usually orderable procedure, is not available for a period due to e.g. growth medium not being available, then the slider may be set to No and a reason added why the procedure is not available currently. Whilst the procedure is not available, the staff will not be able to order the procedure but will be able to still see it in their selection list, with the reason why it is not currently available. This enhancement allows staff to advise providers when usually available procedures are suddenly not available by providing them with the necessary information. This is a cleaner and friendlier solution than completely removing the procedure from selection lists by making it non-orderable or inactive.
Procedure unavailable comments Provides a reason when the procedure is not available Enter the reason why the procedure us currently unavailable (See previous point) Only enabled when an active and orderable procedure is made unavailable. The reason entered will be visible in visit requests so those ordering tests can see the reason why the procedure is not available. Allow patient order Restricts patient ordering of procedures Set to Yes, if the patient should be allowed to order the procedure without a doctor's referral. Duplicate hours Check to dissuade reordering of a procedures for the same patient within set period of hours Enter a value if a check should be performed during visit creation Used when e.g. clinically it would not be prudent to reorder a procedure within a period of time.
When a value is entered, a check will be performed during the ordering process and if found the procedure was ordered for the patient within the set time, a warning message will appear to dissuade the staff member from ordering the procedure again. If the user decides to still continue with the ordering, a reason will have to be entered for the duplication which will be recorded in the Order audit log.Ask order count Allow increase charge count for billing Set to Yes if count may be increased during visit lab ordering. The default count and if the slider is set to No, will always be 1. Restrict to priority Restrict ordering of the procedure to a certain priority Select an option from the dropdown list if required If the ordering of a procedure may only be done when the visit is either Urgent or Routine e.g. CSF analysis should only be ordered as Urgent Order screen Add additional required data during ordering f the procedure. Select a Questionnaire from the dropdown list if required Used to capture relevant and required data during ordering of the procedure for the visit.
¶ Step 3.2.2: Add alternate procedure descriptions
Adding variations and alternate names for a procedure, allows users to find a procedure with either the standard or alternate descriptions, which is especially helpful during the ordering of procedures in a visit request.
To add alternate descriptions for a procedure:
- Expand the Alternate descriptions fast tab to record alternate names for the procedure if applicable. Multiple alternate names may be added.
- Click on Add
- Enter the Alternate description in the line added
¶ Step 3.2.3: Add Specimen types
During the ordering of Microbiology procedures for analysis, the specimen type and source must be defined. Specimen types are defined for the procedure in order to filter the dropdown list during ordering of the procedure to relevant specimen types only. Specimen sources in turn are limited to those selected for the specimen type in the Specimen type setup form.
To add Specimen types:
- Expand the Specimen types fast tab
- Click on Add
- Select the relevant Specimen type from the dropdown list.
If a single Specimen type is selected for the procedure, then that specimen type will default during the ordering of the procedure for a laboratory visit.
If a single Specimen source is defined for the Specimen type, then the specimen source will default for the selected specimen type during the ordering of the procedure for a laboratory visit.
¶ Step 3.2.4: Add Specimen containers
Specimen containers are defined to allow the system to calculate and list the types and number of containers to collect during visit creation in order to perform the ordered procedures.
Orderable target procedures must have at least one container defined, as the Sample record can only be received once containers have been indicated as collected and received, and results can only be entered if the Sample record status is Received.
When a Group procedure is ordered, the system will utilize the containers, defined for each of the procedures included in the group, to calculate the number and type of containers required. This may however lead to the system calculating a disproportionate number of containers to collect. Good practice would suggest only adding the specimen container required to one/few relevant procedures included in the group. Alternatively, adding the required containers to the Group procedure itself, will mitigate the risk of over calculating required containers, as the system will in this case ignore containers of the contents procedures and only request the container(s) defined for the group procedure.
- Expand the Specimen containers fast tab to record the specimen containers required for collection in order to perform the procedure.
- Click on Add
- Select the required Specimen container from the dropdown list. The Description will automatically be populated based on Specimen container selected.
- Enter either the Count or Volume ml required to perform the test
Either the Count or Volume ml fields will be enabled for entry based on what was selected in the Specimen container setup.
- If an Alternate container may be used to perform the procedure, select the container from the dropdown list and then add the count or volume.
Alternate containers may be selected during specimen collection for laboratory visits, if set up for the procedure. When an alternate container is defined for a procedure, either the primary or alternate container may be collected and selected for the visit, not both.
- If different types of containers are required to perform the procedure, then all required containers must be listed as primary containers rather than alternate containers. Click on Add to add a new container line to the grid, then select the additional required containers from the dropdown list also adding required volume or count.
- To Remove alternate containers only, select the relevant line then click on the fast tab button of the same name
- To remove an entire container line, select the line and click on the Remove fast tab button
¶ Step 3.2.5: Add Laboratories
Laboratories have to be defined for all Target and Charge procedures to indicate which laboratories can perform the procedure or charge for the procedure when ordered.
Adding laboratories to Group procedures is optional. When a Group procedure is ordered, the system will utilize the laboratories defined for the contents procedures to select performing laboratories if none was added at group level.
When a procedure is ordered by a laboratory, the system performs a check to see if the ordering laboratory is defined as a performing laboratory for the procedure. If the ordering laboratory is defined as a performing laboratory for the ordered procedure, the system will select the order laboratory as the performing laboratory as well. If the ordering laboratory is however not defined as a performing laboratory for a procedure; the system will direct the testing to the default laboratory entered in line 1 of the Laboratories grid.
- Expand the Laboratories fast tab
- Click Add. A new line will be added with the next line number automatically
- Select a Laboratory from the dropdown list. The Description will automatically be displayed
Except for the default laboratory in line 1, good practice suggests adding the other performing laboratories in alphabetic order in the grid to allow for easy maintenance in future.
Use the Move up and Move down buttons to move laboratories in the desired sequence and to move the default laboratory to position 1.
¶ Step 3.2.6: Add comments
- Expand the Comments fast tab
- Add any required Collection instructions in the relevant memo box for use by staff collecting specimens
- Add any relevant laboratory information and instructions to users entering results, in the User notes memo box
Collection instructions are visible in the Specimen collection section of Visit requests to assist users collecting specimens.
User notes are visible in the Enter results forms to assist laboratory users.
¶ Step 3.3: Complete the Target procedure index tab
For Target procedures, additional configuration data is required to define how results should be entered and any automated default actions defined. All mandatory fields have to be completed before the target test may be activated in the General index tab.
Select the Target procedure index tab to add the required data.
¶ Step 3.3.1: Add general Target test data
- Expand the General fast tab
- Enter the Turnaround time in hours. This is a mandatory field and will determine when tests are flagged as overdue.
- Select if Authorization is required in addition to verification of the test results. The authorization options available include:
Authorization Purpose (none) Authorization is not required if none of the options are selected and the field is left empty. All All results require authorization always irrespective of result the result. Abnormal Only abnormal results will require authorisation. Abnormal results may be defined for the result prompt answers defined in Group responses; in the procedure Results list or for selected Organisms. - Enter a Default LOINC code if required
- If a canned comment should default for the test irrespective of result and age/gender or result group, select the required Auto comment in the dropdown list
- If the procedure should allow the entry of Organism and susceptibility results, set the Organism slider button to Yes.
¶ Step 3.3.2: Add Procedure result prompts
If the procedure should prompt the entry of results for multiple related sub queries, expand the Procedure result prompts fast tab.
Example of when to use Procedure result prompts:
During Urine Microscopy analysis, various values may be observed and required to be reported e.g. Red blood cells; Leucocytes; Epithelial cells; Ova; Casts; Crystals; Bacteria; Yeast cells etc. Although the Microscopy is a single procedure step in the analysis, multiple results have to be recorded. To accommodate recording multiple results for a single procedure, a Questionnaire is created with the result prompts defined as queries in the questionnaire.
When a questionnaire is added to be used as Microbiology procedure result prompts. the queries of the questionnaire appears in the Result prompts section of the Micro enter results form, when the procedure is ordered:
Reference ranges and units may also be defined in the questionnaire for each query (Result prompt) if required.
The Answer type defined for each query in the questionnaire, will determine what type of result may be entered e.g. Numeric; Free text etc. A Group response answer type is a suggested when there is a set list of results the user should be able to select from in a dropdown list. Group response type answers have the added benefit of defining if results are abnormal; auto defaulting results; auto defaulting markers; auto defaulting methods and comments as well as defining the period in which previous results should be considered for delta checks.
To add Procedure result prompts:
- Create a Questionnaire and Group responses if appropriate. Refer to Clinical LIMS General setup, where the steps to creating questionnaires and group responses are explained
- In the Microbiology target procedure, expand the Procedure results prompts fast tab
- Click Add
- Select the appropriate Questionnaire in the dropdown list. The description will default from the selected record
- If either Prelim or Final should default upon completion of result entry for all prompts included in the questionnaire, select the appropriate option in the dropdown list. Leave the field empty if the user should manually select Prelim or Final during result entry.
- Select a Result status from the dropdown list to automatically default once all prompts have been resulted and Prelim/Final has been selected. Leave the field empty if not required.
Result status selection is only enabled if Prelim or Final has been selected in the Prelim/Final field.
- More than one questionnaire may be specified in the grid. Click Add then follow the steps above to add more questionnaires if required
Queries for multiple selected questionnaires will appear in a combined list in Result entry in the Results prompts grid.
Use the Move up or Move down buttons to move the questionnaires in the sequence it should be completed during result entry.¶ Step 3.3.2: Add Procedure results
If the target procedure should be resulted with a single pre-defined result from a dropdown list, then these results should be defined in the Results fast tab.
A target procedure is not limited to only Procedure results or Procedure result prompts. Both procedure prompts and procedure results may be utilized to enter results for the procedure. It is important to note however, if result prompts have been added to a procedure, then all prompts must first contain results before the procedure can be verified and appear on reports.
- Expand the Results fast tab of the Target procedure
- Click Add
- Enter a short identifying Code for the result
- Enter the Result text associated with the code
- If either Prelim or Final should default upon selecting the result from the dropdown list, select the appropriate option in the dropdown list. Leave the field empty if the user should manually select Prelim or Final during result entry.
- Select a Result status from the dropdown list to automatically default when a result and Prelim/Final has been selected. Leave the field empty if not required.
Result status selection is only enabled if Prelim or Final has been selected in the Prelim/Final field.
- If a comment, specific to a result should automatically default, select the comment in the Auto comment dropdown list
¶ Step 3.3.3: Add Methods
- Expand the Methods fast tab
- Click Add
- Select a Method from the dropdown list
- Select a default LOINC code if required
- If some laboratories utilize a different method that needs to be specified, then add the other methods to the grid
- A method may be defined for specific laboratories by selecting the appropriate method line and then adding the applicable laboratory in the child Laboratories grid.
- If more than one method is added to the grid, the Default method should be identified by selecting the method and then clicking on the Set default button
Any laboratories defined in the General index tab, but not selected in the Methods fast tab, will automatically utilize the Default method when ordered. It is therefore suggested to set the method and result group, that applies to most laboratories, as the default.
After completing the Methods fast tab and once all mandatory target procedure fields are completed, the procedure may be made active. See step 3.6.
¶ Step 3.4: Complete the Group procedure index tab
The Group procedure index tab is only enabled and completed if the procedure type selected in the General index tab is Group. The contents procedures to be included in the Group during ordering and entering of results, is specified in the Group test index tab and therefore mandatory once the General index tab is completed and before the Group test may be activated.
¶ Step 3.4.1: Define Group procedure contents
Once the General index tab of the Group procedure has been completed:
- Select the Group procedure index tab
- Expand the Group procedure fast tab
- Create a Group to house the contents procedures:
- In the Groups grid buttons, click Add
- Enter a descriptive name for the Group
- Add Group contents:
- Click Add in the Group contents grid buttons
- Select a Procedure from the dropdown list. The details columns will automatically be populated with the data of the selected procedure
- Add as many procedures as is required to be included in the group, following the steps above
Only active procedures will be visible and selectable in the Procedure dropdown list.
¶ Step 3.4.2: Add Selection groups
Should a different list of procedures than the default be required for specific providers; laboratories or visit priorities, then special selection groups may be created to accommodate the requirement.
The Selections feature allows a single group procedure to be created for ordering various versions of the procedure profile based on selection criteria, thereby allowing laboratories to:- Have a single procedure name for a profile irrespective of the varying contents requirements
- Reduces confusion during ordering of the procedure
- Ensure correct procedures are ordered based on special requirements
- Automates the ordering of correct procedures instead of the user having to remember special arrangements
- Prevents incorrect ordering, analysis and reporting
To create a selection group:
- Create another Group with the desired Group contents in the Group test fast tab
- The original / default group may be copied by:
- Selecting the Group to copy in the grid
- Click on Copy in the Groups grid buttons
- Enter a descriptive Group name for the new group in the Copy group test dialogue
- Click OK
- The new Group will now be added to the grid and the Group contents may be updated to match the requirements for the specific group by adding or removing some of the contents
The first group created will automatically be set as the default group and its contents tests will ordered for visits where the selection criteria is not a match. A different group may be selected as the default by selecting the group and clicking on the Set default button in the groups grid.
- Expand the Selections fast tab in the Group procedure index tab
- Click Add in the Selections fast tab buttons
- Select the appropriate Selection type in the dropdown list i.e. Provider; Priority or Laboratory
- In the Selection value column, select a record/value from the dropdown list
- In the Group column, select the Contents Group to be ordered for the Provider; Laboratory or Priority specified
After completing the Group procedure fast tab and all mandatory fields are completed, the procedure may be made active. See step 3.6.
¶ Step 3.5: Complete the Susceptibility procedure index tab
The Susceptibility procedure index tab is only enabled and completed if the procedure type selected in the General index tab is Susceptibility. The group type procedure includes a list of antibiotics that may be manually added or defaulted for isolated organisms during result entry. Creating a susceptibility group allows a set list of antibiotics to be added, rather than adding individual antibiotics one by one.
¶ Step 3.5.1: Define the Susceptibility group and contents
Once the General index tab of the Susceptibility procedure has been completed:
- Select the Susceptibility procedure index tab
- Expand the Susceptibility procedure fast tab
- Create a Group to house the antibiotics:
- In the Groups grid buttons, click Add
- Enter a descriptive name for the Group
- Add Susceptibility group contents:
- Click Add in the Group contents grid buttons
- Select an Antibiotics from the dropdown list. The details columns will automatically be populated with the data of the selected antibiotic
- Add as many Antibiotics as is required to be included in the group following the steps above
Only active antibiotics will be visible and selectable in the Antibiotic dropdown list.
¶ Step 3.5.2: Add Selection groups
Should a different list of antibiotics than the default be required for specific providers; laboratories or visit priorities, then special selection groups may be created to accommodate the requirement. The Selections feature allows a single susceptibility group procedure to be created for ordering various versions of the susceptibility profile based on selection criteria.
To create a selection group:
- Create another Susceptibility group with the desired Group contents in the Group test fast tab
- The original / default group may be copied by:
- Selecting the Group to copy in the grid
- Click on Copy in the Groups grid buttons
- Enter a descriptive Group name for the new group in the Copy group test dialogue
- Click OK
- The new Group will now be added to the grid and the Group contents may be updated to match the requirements for the specific group by adding or removing some of the contents
The first group created will automatically be set as the default group and its contents tests will ordered for visits where the selection criteria is not a match. A different group may be selected as the default by selecting the group and clicking on the Set default button in the groups grid.
- Expand the Selections fast tab in the Susceptibility procedure index tab
- Click Add in the Selections fast tab buttons
- Select the appropriate Selection type in the dropdown list i.e. Provider; Priority or Laboratory
- In the Selection value column, select a record/value from the dropdown list
- In the Group column, select the Contents Group to be ordered for the Provider; Laboratory or Priority specified
After completing the Susceptibility procedure fast tab and all mandatory fields are completed, the procedure may be made active. See step 3.6.
¶ Step 3.6: Activate the procedure
Once all mandatory fields of the procedure have been completed, access the General fast tab in the General index tab and set the Active slider button to Yes.
If any mandatory fields have not yet been completed, error messages will appear indicating what fields to complete and the test will not be allowed to be activated.
Once a procedure has dependent orders and results, it cannot and should not be completely deleted. Therefore, if a test is no longer in use, set the Active slider button to No so that it is no longer available for ordering but can still be traced when needed.
¶ Step 3.7: Troubleshoot and view dependencies
The Microbiology procedures form provides access to a full Audit log as well as Related information pane fact boxes to access dependent records and last edited information.
- Expand the related information pane on the right of the form by clicking on the Related Information icon
- Expand the various fact boxes to view related data including:
Fact box Contains Included in groups Lists Group procedures in which the selected procedure is included Last edit Displays date and time of last modification event as well as the name of the worker as a quick way to gauge if a modification was recently done that could have caused a problem or difference in output
- Click on record names listed in the fact boxes to access the records directly
- Click on the Audit log index tab for a selected procedure, to view a comprehensive list of any modification events. The modification events are sorted by modification date and time listing the latest event first. The grid may however be sorted and filtered as needed to find specific changes.