07 December 2007

Bad, bad week.

Ever since we consolidated our pathology information management system with the Mother Ship, we've been lurching from one disaster to another. We formerly both had different configurations of this system - ours was a lean, mean, results-releasin' machine, with many small scripts that didn't take too long to load and meant that the person validating results could see everything they needed to in one screen - except in Microbiology, where they sometimes ran to two screens' worth of data.

The Mother Ship has far fewer scripts, but they are exceedingly poorly designed from a user point of view. Most of the Micro scripts run to six screens, which is a big, big pain and slows us down as we bounce from the last screen (which can't be viewed by clinicians, and is where we record all the stuff we do to test organisms of interest) back up to the first screen (where it tells you what this specimen actually is, and where the Gram stain results are) and bounce back to the middle, and then have to exit out of the whole thing and go back in again to see how the final (clinician-viewable) report will look. It's insane.

And then we have the problem of worklists and electronic daybooks (which capture result entry fields from the various scripts, as defined and selected by whomever writes the worklists and daybooks) sometimes capturing the data they're supposed to, and sometimes not, and no-one can tell why.

Essentially, what this has meant to us is that we have had to change our workplace practises to match theirs, which are monolithically inefficient and not properly documented in any accepted sense of the word "documented".

Next Monday, we have assessment by NATA coming up. NATA is the National Association of Testing Authorities. From their webpage blurb,

The National Association of Testing Authorities ( NATA ) is Australia's national laboratory accreditation authority. NATA accreditation recognises and promotes facilities competent in specific types of testing, measurement, inspection and calibration.

It's not legally required for a lab to be accredited, but it's strongly recommended, and there are moves to allow Medicare benefits and funding only to accredited labs. Last time we did pretty well. At the end, a lab is issued with a set of recommendations and/or issues that must be addressed within a stated timeframe, and the date set for the next assessment. We've always addressed all of ours (not always in as timely a manner as they'd like, but still), whereas TMS seem to file all of their recommendation lists in a basement in another suburb and just plod along exactly as before.

So on Monday these people will come and go over us with a fine-toothed comb. They will be checking our manuals, for the Mother Ship-style processes we have had to implement since consolidation, and which we have had to write as TMS doesn't seem to have anything recognisable as a manual for anything they do. They've been hauled over the coals by NATA for this before, and now have shanghaied us into pretty much doing it for them. Bastards. There are over twenty of these manuals, detailing every single test, procedure, policy and protocol we use, and because we had less than a month to produce them all, they are full of errors. But we got them done.

And now there's the Great Hepatitis Debacle.

In his boundless wisdom, the section head of Biochemistry at the Other Place decided that, since we and they were no longer using the same analyser to do hep serology and most of the signal/noise ratios and interpretations had changed with the machine they're now using, that someone's hep test codes (which generate the scripts for various serological tests for hep A, B and C) had to change too. (Why is the biochem section head monkeying around with tests that are under the general umbrella of microbiology? Good question. Perhaps it's because the analysers in question are nominally biochem machines.)

He picked us.

And didn't tell us he'd done it.

And then he went interstate for a week.

The change took effect at 00:00:01 on Saturday morning. I've been in Serology this week. On Monday I was too busy to look at coding the heps (we have a general default hep serology code, which functions only to alert the Serology person that this particular specimen needs hep serology, so then that person enters the correct codes after checking the request slip and clinical details. It's a bit involved.). Tuesday I start having a crack at them, and I keep getting all these weird flags and the lab info mgmt system starts changing all my hep codes on me. Worse, the ones from last week that weren't coded right then and needed more tests added are losing all the results that they did have.
So I tell our Micro section head, and she rings IT at TMS, and they tell her that their Biochem section head has done it but "he meant to tell you last Thursday". While she's on the phone to them, I go tell our lab manager, and our biochem section head, and everyone who has a legitimate involvement in hep serology, and a few other people just so I can vent. And then our lab manager tells his boss, and also has to tell TMS's medical microbiologist (the pathologist responsible for serology). The man responsible for this disaster has been under a malign star for some time now anyway, and is going to get his sorry arse imperially kicked for this. And there have been constant IT/hep problems all week as IT try to fix up this gigantic ballsup. This "small change" wasn't even mentioned to anyone apart from IT Over There, let alone discussed or - god forbid - properly thought out and tested.

And when NATA come on Monday, if they should happen to ask me why there's been such a delay in getting heps done, and why the manual does not reflect what we actually do, I will tell them.

Not good enough, Neil. I wouldn't like to be you right now, you idiot.

1 comment:

Moorecat said...

Sounds like a first-rate numpty.

Is he blood-related to the Big Chief Legal Eagle at our office, who had me move workstations twice in one day, because I was too close to his precious office and was "too loud"?

Can't think what he means exactly by loud - can you?

Luckily for him, I'm too mature to be tempted by his closed office door - with the key in the lock on the outside.....