Unnecessary testing. Why am I the only one who cares?

The BBQ Pit
1

I think it might be bad for me to go into too much detail, due to confidentiality issues and such, though I will answer questions if I can, if there are any. Advance apologies if any of my rant is difficult to understand.

Basically, there is a mongolian clusterfuck of a system glitch happening in our lab ordering systems where duplicate orders are being entered and never taken care of. That duplicate order ends up coming out on phlebotomy’s collection lists, hours and hours later. Instead of asking questions about the weird stuff printing out on their lists, they just go and draw the patient’s blood. No questions asked.

So, at 0100 I’m in the lab, getting samples with draw times of 1534 or 1825 or whatever else, from the PREVIOUS DAY.

I am the only person who decided it was out of the norm, and worth reporting. The only person. No one else in the entire lab thought to report it. This has been going on for at least two weeks.

I’ve documented and documented and complained and complained and I feel like all my complaints are falling on deaf ears. Finally, on Friday, I emailed the lab supervisor and phlebotomy supervisor. If they do not respond to me on Monday or Tuesday, I’ll be going to the compliance office and reporting it.

It’s a billing issue. It’s a patient care issue. It’s a serious compliance issue. It’s a multi-department issue and no one is taking responsibility or even recognizing there’s a problem. I even talked directly to phlebotomy and told them to stop doing these draws, and they still go on their merry way doing it.

Sometimes people tell me it’s not my job, or not to worry about it because it’s not their problem or not my problem, and I don’t buy that. I’m tired of that attitude. I like my job and believe it or not, I care about the patients.

I’m sick of the lack of communication, the bullshit stalling tactics, the ‘We’ll look into it’ answers when it’s clear that they don’t, and everything else that people do to shrug the responsibility off their own damn shoulders.

Please tell me I’m not crazy for being upset about this, and actually taking care to do my job properly. Maybe it will help my headache.

To make this pit-appropriate: Fuck fuckity-fuck fuck fucking fuckwits.

P.S. Yak cock.

2

Well done for being proactive and doing something about this - the world needs more people like you! It’s really hard to get multi-department issues sorted because it’s so easy for those in charge to pass the buck. I hope you’ve told the supervisors that you plan to report this to compliance as that should give them a kick up the bum if nothing else will.

3

Same shit happens in my job. My co-workers and I find a problem and report it, and no one else wants to bother to find the root cause or a solution. The lead person in our group is being driven crazy by it. Meanwhile, parts don’t ship because we can’t find the documentation that our customers want. We’re having major problems with this new software they’ve installed since January. Nobody listened to our concerns during training (and before), and no one listens now even when it must be affecting the bottom line.

My husband used to be an engineer at my company, and he was really good at unraveling messy problems. Too bad they gave the promotion he wanted to someone else, so he found a job at a different company. A lot of good employees who have been with the company a long time are leaving in droves, which just means the “not-my-problem-itis” is just going to get even worse in the near future. I wonder why I even care anymore. It’s nice to hear that I’m not the only one who cares, even if it’s in a totally different company and industry.

4

Leah M, you my kind. When I take over the world, I want you in charge.

Sorry your bosses suck. :frowning:

5

Sad to say but if your company is making money from this situation, your bosses probably don’t and won’t care, nor will they do anything about it. If the entity being billed is an insurance company or Medicare/Medicaid, your recourse will be to report your company for billing fraud and then, of course, your task will be to prove it. None of this means you shouldn’t go forward with your plan but you should be aware of possible consequences.

6

It’s the same at our company too; it’s frustrating. I’ve decided to embrace it. I go in for my shift, find out what the Clusterfuck-du-Jour is, and watch them scurry around panicking about whatever problem has been going on for weeks or years and must be resolved NOW. They’re obsessed with saving pennies but the pennies lay on the ground while the dollars blow out the window. At least I only have to work with automated machinery, it would be much more frustrating to know there were people on the other end of all this nonsense.

7

I realize, ultimately, it could come to that, which is why I have at least been diligent about documenting it and documenting my reporting of it, so at least hopefully it can’t come back and bite me in the ass due to lack of proper documentation.

I don’t think it’s so much that we’re ‘making money’ off of it, since these tests are actually getting run and supplies are actually being used up, it’s that it’s a complicated thing to fix and nobody can be bothered.

If we were charging patients and say, not even running the tests, we’d be making money off it, but that’s not the case. I’m sure there is a small margin of profit, after all, we need to pay the bills, but it’s not the primary issue. It’s laziness. :frowning:

8

What’s going to happen is the insurance companies will start calling in asking why duplicate tests are being done. They’re going to refuse to pay for the extra tests, and company will then be looking at the money loss. They may decide to press the patients for the money the insurance company refused to pay, passing their screw up onto the patient who will have to fight this. In the mean time they won’t admit there is a problem.

9

Exactly.

And the problem with duplicate testing for us is that if there is a duplicate, the insurance refuses to pay for EITHER the necessary order OR the duplicate order. Patients get saddled with the bill for BOTH.

This is supposed to be a punishment to us for ordering duplicates, but it’s the patient who suffers.

I also live in an area with a high population of foreigners / refugees / etc. Many are low-income. Many have no medical insurance. Thus, it becomes an even bigger problem. Hell, we may end up losing money over it, if people can’t/don’t pay the bill for the stuff we’re running duplicate times.

10

Before leaving work today, I stayed for 10 minutes of extra, unpaid overtime. I did this so I could explain to one of the supervisors directly and in person, to tell her what was going on. She said she would alert the supervisor above her, who is the one that I e-mailed.

Hopefully this will actually happen, and at least I can list one person that I talked to directly about it, so no one can say, ‘Oh, we didn’t get the e-mail’. (Which happens, often).

Normally I don’t get to talk to anyone in person because of the shift I work. I work nights, and I’m gone before any of the supervisors with any sort of clout actually get in.

11

If I understand you correctly, Leah M, this means that instead of taking blood samples from a patient one time, you have to draw blood from them two times for the second, duplicate test. I can tell you from my perspective as someone who doesn’t care much about needles, and my husband’s perspective from someone who is needlephobic that this is absolute crap (which you already know). Do the patients not complain that you just took their blood already today? As a former lab tech, I’m always aware of what tests are being ordered on me; do the general public not get a little suspicious?

12

You’re doing the right thing & there should be more people in this world like you.

13

Welcome to the Lone Voice in the Wilderness club.

Been there, done that. Just save the paper trail that shows you brought this issue up with the bosses, and document document document. This way, when this little mess escalates into a flying shitstorm in a few months (or possibly even years), you’ve got an iron-clad ass cover for yourself as well as a giant neon sign reading “GUILTY” in 5’ letters pointing straight at your boss(es).

Yes, it sucks, but sometimes there’s nothing you can do to force your gaping arsehole incompetent boss into realising that a little work now will save them a whole lot of grief in the near future. All they hear is “a little work now” and stop listening.

14

I’ve been in the hospital for coming up on six weeks now, and I throw an absolute fit when they try to give me extra blood draws. I have to have a type and screen done every three days (I’m at a high risk for hemorrhage, and because I am pregnant they are concerned about weird immune things popping up suddenly), and they try to schedule any other blood tests for the same day so I don’t have to have any more needles than that. Occasionally the type and screen people will arrive a day early. Once someone did my draw for the type and screen, and another phlebotomist came in five hours later. I told her to go look at my chart, that I had had it five hours before and she was not taking it again unless she came back and told me there was something wrong with the last sample. I can’t believe other people just quietly let their blood be drawn multiple times for the same test without asking questions. (Well, I can believe it, but it infuriates me.)

On the other hand, maybe no one is logging the patients who protest and refuse the second draw, so it looks like everything is hunky-dory with them, when the problem is actually even more widespread than Leah has noticed.

15

You’re doing exactly the right thing; keep your chin up and keep doing it. Keep on documenting, too. I wish you well and hope it all comes out okay.

16

I know it might be hard to believe, but most of the time? Patients don’t even bat an eyelash. They trust that we know what we’re doing. Luckily, some of them do raise an eyebrow and say, “Hey, I was just drawn!” When someone comes in ten minutes later with a duplicate order.

Part of the problem is that these orders are coming in so many hours later. Patients might not realize that they didn’t need another blood draw when it’s five hours, seven hours, ten hours after their last blood draw.

17

I know, it makes me angry, too. And so I speak up when I notice things.

Some of it seems too big and too beyond my scope to even handle. Sometimes nurses will page multiple phlebotomists, thinking it will get them serviced faster. Sometimes duplicate orders get put in the computer, and never credited out. Sometimes multiple departments will receive orders (nursing, phlebotomy) and both of them try to go do the blood draw. There’s just so much margin for error in so many of the systems that things happen. I always try to make notes of and fix things when I see them, but a lot of people are lazy or just don’t care.

All of these things are good reasons for patients to take a proactive interest in their health care. Don’t be afraid to ask questions. Don’t be afraid to say, ‘Hey, someone just did that, does it REALLY need to be done again?’ If someone treats you like you’re an inconvenience, well, too bad for them. Their job is to assist the patient and answer questions. And if anyone ever tells you to stop asking questions, that’s absolutely wrong and they should be spoken to and/or reported for it. Every patient has a right to know what’s going on. If the person who you asked the question of isn’t authorized to answer that, they should be able to direct you to someone you can ask, like your nurse or doctor.

You did absolutely the right thing by speaking up about the duplicate, it’s so important for people to stop feeling intimidated by their doctors and nurses, because they have the right to know what’s going on with their treatment!

18

I want to join the chorus applauding your sense of duty, and attention to detail, Leah M. Thanks for continuing to try to stop this idiocy.

19

Last week, I spent 5 days in the hospital. (On vacation, a big blister on my foot developed into a big, swollen infection halfway up my calf.) On my first night there, a flea-bottom tech drew a blood sample, “for a CBC and platelets.” After another hour, another flea-bottom gal came to draw samples “for cultures.” She waved odd-looking bottles at me, as if to illustrate that point. After another long time, a third flea-bottom guy woke me up to draw more blood. “For cultures,” he said, waving the same bottles at me. I told him the second one already drew for cultures. “You’re welcome to my blood, if it’s necessary.” He left to ask his boss. He came back later, explaining, “we have to take two cultures, at least an hour apart.” Why didn’t he know that the first time?

Okay, fine. The next person who woke me up rigged an IV into my arm, but didn’t hook anything up to it. Then a nice lady whose tag seemed to mean “manufacturer’s suggested retail price” plugged me into what I came to call my little Martian friend.

On the day I left, I asked what results had come from my blood tests. The nurses didn’t know. I guess they played Scarlatti for my blood, and read poetry to it, to find out if I had picked up that Mensa infection in San Francisco.

This post contains some joking. I was resolutely cheerful through my entire stay. Nurses have plenty of grumps, without me joining in.

20

I received an update from my boss.

Ever feel like while you were sleeping, someone must have abducted you and dropped you off on a strange planet where all the words SOUND like English but mean completely different things?

I feel like that right now.

Nothing got addressed, and mostly excuses were made.

My boss forwarded the email I sent HER to the director of OUTPATIENT PHLEBOTOMY. Who has nothing to do with any of this. It only concerns inpatients. This boss also stated that, “I hope phlebotomy wouldn’t be doing these draws without investigating first!” … They ARE! That’s why it’s a problem!

I received an ‘I’m out of the office until 4/25!’ auto-reply from the other person I e-mailed. Today is 4/29.

insert random keysmashing and head-banging sounds here

I tried explaining again, and if everyone still seems to be on another planet, it’s off to the compliance office. Sigh. Meanwhile, logging every single one of these as a ‘SAFE / Patient Impact’ report is a lot of paperwork, and will ultimately piss someone up in the paperwork department off, and they might actually investigate it, in that case.

Meanwhile, this same boss has her head up my ass constantly sending emails that I haven’t finished my ‘continuing education’ for the quarter. We’re required to log a certain number of hours of ‘outside education’ related to our job, IE watch videotapes or attend lectures or whatnot. People on the day and evening shifts get to do this during their paid work time. Night shifters have to find time during their off time to do it, or come in for unpaid time to atted the hospital-sponsored events.

I don’t think I mentioned that I have seen this boss in person for about 4 minutes of my entire nearly 5 years working here, yet she is the one that does my annual employee evaluations. Aforementioned evals are coming up, soon. I’ll be getting a ‘Needs Improvement’ in at least one field and ‘Meets Expectations’ in the rest, since they apparently have a ‘quota’ of ‘needs improvement’ fields to fill, and can’t make their employees look too good.

:mad: :mad: :mad: :mad: :mad:

(Don’t get me wrong, I love my job. I think I have a masochistic streak. At least I know the patients appreciate it, even if they don’t know they know.)