USC-MFA:  LAC+USC request for input re lab tests

Dear USC School of Medicine Clinical Faculty Member:

As you know, Los Angeles County is seeking to improve its health care system and make it more efficient.  An aspect of that process is the consolidation of laboratory testing.  Currently, three consolidation opportunities are under study:
   1.  Histopathology processing is being progressively
       consolidated at Olive View Medical Center.
   2.  Microbiology is being studied by a task force including
       USC infectious disease faculty.
   3.  Other USC faculty are studying consolidation opportunities
       for chemistry/coagulation/hematology/serology tests.

A survey has been created to obtain faculty input regarding appropriate turnaround times (TAT) for various laboratory tests.  I am would like to be sure that _all_ clinical faculty have an opportunity to provide input into that survey.  Below is a form you can modify and either email or fax back to me.  Details as to how to respond are below.

This email message has been distributed via the department-specific listservers recently created by the Office of Faculty Affairs and the Medical Faculty Assembly (MFA).  The MFA is in the process of setting up a _voluntary_ list-server dedicated to issues affecting USC and the Los Angeles County healthcare system (to be termed USC-MFA-LACHS-L).  A subsequent message will describe this listserver in more detail.

Because I must submit a report on laboratory consolidation issues on January 10, 1999, this email message comes to you prior to the launch of USC-MFA-LACHS-L.  I would greatly appreciate receiving all feedback on the survey by January 9, 1999.

If any questions arise, please contact me directly at the email address or fax number below.  DO NOT USE THE REPLY FUNCTION OF YOUR EMAIL PROGRAM.  Doing so will send the message to the MFA, not to me, and will delay my receipt of your input.  This form is also available as a Word file, which may be easier to distribute and fax.  If you wish to have a copy of this Word file, please email your request to me.  The form has also been posted by the MFA at:

http://www/hsc/medicine/mfa/RLK-001.htm

I recognize that there is limited time for you to fill out the form, and thank you for your consideration of the deadlines and for your cooperation.

Ronald L. Kaufman, MD, MBA
Chief of Staff, LAC+USC Medical Center
rkaufman@hsc.usc.edu   FAX = 323-226-5760.

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PLEASE FILL OUT THE FORM BELOW AND EITHER:
EMAIL TO rkaufman@hsc.usc.edu
    DO NOT USE REPLY FUNCTION OF EMAIL PROGRAM, OR
FAX TO 323-226-5760

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Your NAME (optional):

Your LAC+USC DIVISION/DEPARTMENT:

Your USC DIVISION/DEPARTMENT:
 

In the right-hand column termed "YOUR INPUT" please enter:
    OK:  if you consider that TAT (Turn-Around Time) to be OK
    #d or #hr:  for your input for another adequate TAT
    LAC-USC (etc):  if you consider that the test needs to be performed at location other than the one shown.

PLEASE NOTE: Tests with asterisks "**" indicate TATs for weekdays only. Samples received on weekends will have longer TATs.

TESTS CONSIDERED BY THE
CHEMISTRY/HEMATOLOGY CONSOLIDATION TEAM

TEST              LOCATION   CURRENT OR
                             PROPOSED TAT     YOUR INPUT:

****TUMOR MARKERS****

Acid phosphatase    Hbr+UCLA  1-2 d**

AFP (a-fetoprotein) LAC+USC     4 d

CA-125              LAC+USC     4 d

CEA                 LAC+USC     3 d

PSA                 LAC+USC     3 d

Squamous cell
   carcinoma        LAC+USC     3 d

****ENDOCRINE, DIABETES, & HYPERTENSION****

ACTH                Hbr+UCLA  1-3 d**

Aldosterone         Hbr+UCLA  1-2 d**

Bile acid           Rancho    3 d

C-peptide           Hbr+UCLA  1-3 d**

Cortisol            LAC+USC   3 d

DHEA-sulfate        LAC+USC   4 d

Estradiol           Hbr+UCLA  1-8 hr

Estrogen            Hbr+UCLA  1-2 d**

Free T3             Rancho    3 d

Free T4             LAC+USC   3 d

FSH                 LAC+USC   5 d

Hemoglobin A1c      LAC+USC   3 d

LH                  LAC+USC   5 d

Progesterone        LAC+USC   4 d

Progesterone-17OH   Hbr+UCLA  1-3 d**

Prolactin           LAC+USC   4 d

PTH                 LAC+USC   7 d

Reverse T3          Hbr+UCLA  1-2 d**

T-uptake            LAC+USC   3 d

T3, total           LAC+USC   3 d

T4, total           LAC+USC   3 d

Testosterone        LAC+USC   4 d

TSH                 LAC+USC   3 d

VMA                 MLK       7 d

****COAGULATION/HEMATOLOGIC DISORDERS****

Activated protein C
   resistance (APCR)LAC+USC   7 d

Alpha-2-plasmin
      inhibitor     LAC+USC   3 d

Anti-thrombin III   LAC+USC   7 d

Erythropoietin      Hbr+UCLA  1-3 d**

Factor II, VII, X,
 XI, XII, XIII      LAC+USC   1 d

Factor V            LAC+USC   3 d

Factor VIII         LAC+USC   5 d

Ferritin            LAC+USC   3 d

Folic acid          LAC+USC   3 d

Ham test            LAC+USC   1 d

Hemoglobin
  electrophoresis   LAC+USC   5 d

Lupus anticoagulant LAC+USC   5 d

Osmotic fragility   LAC+USC   2 d

Plasminogen         LAC+USC   3 d

Porcine F.
   VIII inhibitor   LAC+USC   5 d

Protein C           LAC+USC   7 d

Protein S           LAC+USC   7 d

Reptilase           LAC+USC   1 d

Unstable hemoglobin LAC+USC   3 d

Vitamin B12         LAC+USC   3 d

TOXICOLOGY

Caffeine            Hbr+UCLA 1-8 hr

Cyclosporine        LAC+USC   1 d

Heavy metals
 Hg, Arsenic        Hbr+UCLA  >8 hr
Lead (blood)        Hbr+UCLA  1-2 d**

Thiocyanate         Hbr+UCLA  1-3 d**
 

TESTS CONSIDERED BY THE
SEROLOGY/IMMUNOLOGY CONSOLIDATION TEAM

****SERUM/URINE/CSF PROTEIN ELECTROPHORESIS & OTHER PROCEDURES****

Protein electrophoresis: CSF
  oligoclonal bands,
  +IgG synthesis rate LAC+USC  4 d

Protein electrophoresis: serum
  + immunofixation & immoglobulin quantitation, if needed
                     LAC+USC     3-5 d

Protein electrophoresis: urine
  + immunofixation & immoglobulin quantitation, if needed
                     LAC+USC    3-5 d

Cold Agglutinin,
  Quant              LAC+USC    4 d

****INFECTIOUS DISEASE SEROLOGY****

Antistreptolysin(ASO)LAC+USC  1-2 d

CMV, total           LAC+USC  4 d

HIV-1 antibody       LAC+USC  4 d

HIV-1/2 antibody     Hbr+UCLA
                     or MLK   4  d

Infectious mononuclosis
 screening for heterophile agglutinin, Monospot test
                     LAC+USC   3 d

Rubella:  screening & quantitative
                     LAC+USC   3 d

Toxoplasma IgG/IgM   LAC+USC   1-2 d

Treponemal testing: RPR (serum & quantitation)
                     LAC+USC   1 d

Treponemal testing: MHA-TP
                     LAC+USC   3 d

VDRL Screen CSF, Qualitative & quantitative
                     LAC+USC   4 d

HTLV-1 antibody      Hbr+UCLA  2 d

****AUTOIMMUNE DISEASE****

ANA Screen, qualitative & titer
                      LAC+USC  3 d

Anti-Centromere, Screen & titer
                      LAC+USC  7 d

Anti-DNA, Screen & titer
                      LAC+USC  7 d

Anti-Jo-1             LAC+USC  7 d

Anti-RNP              LAC+USC  7 d

Anti-Sc1-70           LAC+USC  7 d

Anti-SmAntigen        LAC+USC  7 d

Anti-SSA/Ro, and Anti-SSB/La
                      LAC+USC  7 d

Complements (C3,C4 or C5)
                      LAC+USC  2 d

Cryoglobulin          LAC+USC  8 d

Rheumatoid Factor, screen & titer
                      LAC+USC  1 d

Thyroid anti-Microsomal antibody
                      LAC+USC  4 d

Anti-cardiolipin:
  IgG, IgA, IgM       Hbr+UCLA 2-5 d

Anti-Mitochondrial    Rancho   5 d

Anti-Smooth Muscle    Rancho   5 d

Thyroid anti-thyroglobulin antibody
                      Hbr+UCLA 1-3 d

****MISCELLANEOUS****

Alpha-1 antitrypsin   LAC+USC  3 d

Alpha 2-Macroglobulin LAC+USC  3 d

Haptoglobin           LAC+USC  2 d

Transferrin          LAC+USC  3 d

****LIVER DISEASE****

Anti-HAV-IgM (screening & confirmation)
                      LAC+USC  3 d

Anti-HBc, IgM         LAC+USC  3 d

Anti-HBc, Total       LAC+USC  3 d

Anti-HBs              LAC+USC  3 d

Anti-HCV screening    LAC+USC  3 d
 + confirmation       LAC+USC  3 d

HBs Ag (screening & neutralization)
                      LAC+USC  3 d

Amebiasis Titer       Hbr+UCLA 2-3 d

Ceruloplasmin         Hbr+UCLA 3 d

HBe Ab                LAC+USC  4 d

HDV Ag; HDV IgG/IgM   Rancho   up to 7 d
 

****ADDITIONAL COMMENTS ON TAT REQUIREMENTS****
 
 
 
 
 
 
 
 
 

****ADDITIONAL COMMENTS ON IMPACT ON TRAINING IF TESTING
         IS NOT PERFORMED ON-SITE****

none or minimal   OR  definite impact (elaborate):
 
 
 
 
 
 
 
 
 
 
 
 

****ADDITIONAL COMMENTS ON OTHER REQUIREMENTS OR ISSUES****