Control Number
What lab???
QUALITY POLICIES AND
PROCEDURES
Document Code: Document Name: Effectivity Date:
QPPRO-RM-254-01-00 SELECTION OF SEND-OUT March 16, 2022
LABORATORIES WHERE TESTS NOT
PROVIDED IN THE LABORATORY ARE
REFERRED
Statement of Policy: The Pre-Lab Diagnostics Clinic has a policy for selection of Send-out
Laboratories where tests not provided in the laboratory are referred to provide sufficient
laboratory services rendered to the patients which aid in the diagnosis of their disease
thereby promoting immediate recovery.
QUALITY PROCEDURE
1.0 Title: PROCEDURE ON SELECTION OF SEND-OUT LABORATORIES WHERE TESTS NOT
PROVIDED IN THE LABORATORY ARE REFERRED
2.0 Purpose:
2.1 To provide the patients with sufficient laboratory tests which aid in the
diagnosis of the disease and prompt recovery.
2.2 To compensate the deficient laboratory services
2.3 To set criteria in selecting referral laboratory
2.4 To be able to determine and collaborate with a referral laboratory that could
augment diagnostic services
3.0 Scope: This covers from the determination of the unavailable laboratory test up to
the execution of Memorandum of Agreement with the selected Referral Laboratory
4.0 Materials:
Computer set and Printer stapler and staple wires
Bond papers paper clips
Folders Pens
5.0 Definition of Terms:
5.1 Referral Laboratory/ Reference Laboratory/ Send-out Laboratory – the
laboratory of choice where the unavailable tests in the facility are referred.
5.2 Send-out Examinations – tests that are not available in the laboratory which
will be sent out to other laboratory or referral lab for the performance
5.3 MOA – Memorandum of Agreement executed between the Referral
Laboratory and the Referring Laboratory
1
Control Number
What lab???
QUALITY POLICIES AND
PROCEDURES
Document Code: Document Name: Effectivity Date:
QPPRO-RM-254-01-00 SELECTION OF SEND-OUT March 16, 2022
LABORATORIES WHERE TESTS NOT
PROVIDED IN THE LABORATORY ARE
REFERRED
6.0 Responsibilities
6.1 Laboratory Owner/Operations Manager– peruses the price quotations of
laboratory examinations from different prospective diagnostic laboratories
- selects and approves referral laboratory of choice based on
criteria set by the management
6.2 Medical Technologist/ Any Laboratory Staff – receives the laboratory
request and determines availability of the requested examination.
- if test is unavailable, he/she facilitates the send-out procedure
6.3 Chief Medical Technologist (CMT) – receives and notes the report on the
exhaustion of laboratory reagents thus determining the need for outside
laboratory referral
6.4 Pathologist – suggests certain method or principle of certain reagent for the
necessitated laboratory procedure
- gives recommendations on preferred brands and methods which
might be of use by other laboratories
6.5 Management – secures list of prospective send-out laboratories who caters
tests that are unavailable in our laboratory
- Facilitates the execution of Memorandum of Agreement with the
referral laboratory of choice
7.0 Flow of Procedures:
7.1. Reading the manual of the equipment.
7.2. Following every steps on how to use the machine.
7.3. Choosing the number one leading machine that can be helpful in provinding
accurate results.
8.0 Monitoring
8.1. Calibrating the machine before using it to ensure that it will provide reliable
results.
8.2. Monitoring transportation of samples and data.
8.3. Validatitation of laboratory equipment.
9.0 Dissemination Plan
9.1 Spur the adoption and integrition of the design guide analysis equipment and
standard practice within the laboratory.
10.0 Statement of Statement of Policy with Existing Policy
2
Control Number
What lab???
QUALITY POLICIES AND
PROCEDURES
Document Code: Document Name: Effectivity Date:
QPPRO-RM-254-01-00 SELECTION OF SEND-OUT March 16, 2022
LABORATORIES WHERE TESTS NOT
PROVIDED IN THE LABORATORY ARE
REFERRED
This is a new and separate policy and procedure exclusively applicable for Lab assess
Diagnostics Clinic.
10.0 References:
11.1. Manual of Standards of Quality Management System in the Clinical
Laboratory, 2008
11.2. Merriam-Webster, 2012
11.0 Attachments:
11.1 MOA with the referral laboratory
11.2 LTO of the referral laboratory
Reviewed
Written and
By: Approved
By:
XXXXXXXXXXXXXX, RMT zzzzzzzZZZZZZZZZZZZZZZ, MD,FPSP
Head of Laboratory
