Criteria for Acceptance of Specimens

Clinical Testing:

Public Health Ontario’s laboratory only performs clinical testing on human specimens that are insured services within the meaning of Ontario’s Health Insurance Act, s. 11.

Who can Submit:

The ordering healthcare provider must be authorized to order laboratory tests in Ontario as  defined by Section 18 Ontario Regulation 45/22 of the Laboratory and Specimen Collection Centre Licensing Act.

Definitions:

• non-critical specimen:  routine specimens
• critical specimens include specimens that are difficult or impossible to recollect (i.e., CSF, tissue, autopsy material), or outbreak specimens whose conditions for collection were impossible to reproduce

Criteria for Determining Acceptance of Non-Critical Specimens

1. Specimen containers must be labelled with:
• the patient's full name (or unique code number in the case of anonymous testing)
  
  and

• one other unique identifier such as the patient's date of birth or health card number
  
  and

• the date of collection
  
  and

• the time of collection (for time-sensitive tests only)

2. All fields of the General Test Requisition must be completed including
• the patient's full name, date of birth, health card number (must match the specimen label)
• test(s) requested
• source and type of specimen
• date of onset
• date of collection
• legally authorized requester's name and address

3. Patient test requisition forms received from a clinic staffed by rotating physicians (e.g., hassle-free clinic) shall include the name of the attending physician. Patient reports may be addressed to the Coordinator of the Clinic.

4. The specimen packaging meets the minimum Federal Regulation - Transportation of Dangerous Goods packaging requirements,

5. The specimen is not leaking.

6. Specific testing criteria for analyses as outlined in the test information sheet.

Criteria for Determining Acceptance of Critical Specimens

Any critical specimen that does not meet the patient identifier acceptance criteria (e.g. missing, incomplete or conflicting identifiers on the specimen and/or requisition) will require a signed waiver by the submitting health care provider in order for the specimen to be processed and reported. Otherwise, tests will be cancelled.

Verbal Requests for Additional Tests

No additional test will be added to previously submitted specimens except under exceptional circumstances. If additional tests are required, please submit a new specimen with an appropriately completed Public Health Ontario Test Requisition form.

Environmental Samples:

Public Health Ontario’s laboratory only performs environmental tests as described in the Public Health Inspector’s Guide to Environmental Microbiology Laboratory Testing.

Who can Submit:

Official Agencies - as described in the Public Health Inspector’s Guide to Environmental Microbiology Laboratory Testing

Individuals who rely on drinking water from a privately owned water source - such as a well and other private drinking water systems (e.g., water from cisterns, treated lake water).  Refer to our Well Water Testing webpage for more details.

STAT and Critical Sample Testing

PHO's laboratory is committed to prioritizing testing to assist health-care providers in making swift patient care decisions in an urgent or emergency circumstance (“STAT”). STAT testing should only be requested when it directly affects patient care in an emergency medical circumstance.

STAT testing is available for specific test requests:

• malaria
• rapid tests for influenza outbreaks
• Suspicious Packages Bioterrorism RT PCR
• HIV and Hepatitis B surface antigen (HBsAG) needlestick (source only) or high risk patients presenting in labour who have not received prenatal care or for whom results of previous testing are not readily available

Consultation with a PHO Microbiologist will be required in circumstances where a test is not usually processed as a STAT.

Approval for after-hours testing may require some or all of the following information:  patient symptoms, travel history, date of onset of symptoms, exposure history, outbreak status and vaccination status.

STAT samples must be shipped separately from routine specimens in a clearly marked package indicating ‘STAT’ and handled in accordance with the Canadian Biosafety Standards and shipped in accordance with the Transportation of Dangerous Goods Regulations. Failure to ship separately will delay testing.

Please notify us immediately when a STAT sample is sent by contacting our Customer Service Centre.

After-Hour Testing

Approval for after-hour testing may require some or all of the following information: patient symptoms, travel history, date of onset of symptoms, exposure history, outbreak status and vaccination status.