Abstract :
Background: The issue of laboratory critical value (CV) reporting has gained importance in the recent times due to the national focus on patient safety. Critical value notification (CVN) has become an essential part of accreditation procedures for medical laboratories, including the universally accepted International Organization for Standardization (ISO) 15189: 2012.
Aims and Objectives: Our study aimedto analyze the critical value data in hematology and biochemistry sections of the laboratory, to compare the frequencies of critical values for different parameters and to suggest measures for improving the effectiveness and operational efficiency of the critical value notification process.
Materials and Methods: Our study was a retrospective, cross-sectional, descriptive study done over a period of one year six months (January 2020 to June 2021). The parameters chosen for CVN included platelets, hemoglobin and International Normalized Ratio (INR) from hematology section and creatinine, glucose, sodium, potassium and calcium from the biochemistry section. A test result that was significantly outside the normal range and that required immediate communication was considered as a “critical value (CV)”. Both verbal (through telephone) and non-verbal [through short message service (SMS)] communication processes for CVN were implemented in our lab. We also followed the practice of CV “read-back” by the person who was informed over the phone.
Results: A total of 2199 critical values were reported. A maximum of 1224 (55.7%) critical values were recorded from the emergency department. CVs were highest from biochemistry (1898, 86.3%) section. Analyte most commonly notified was creatinine (1151, 52.3%). CVNs were maximum in the morning shifts (1378, 62.7%).
Conclusions: Implementation of the critical alert short message service (SMS) send outs has greatly helped us in reducing the CV turn around time (TAT). Our study has successfully demonstrated the importance of both verbal and non-verbal communication processes for notification of CVs.
Keyword :
Critical value notification, Critical call out, Critical alert, Short message service (SMS), Turn around time (TAT)