Analysis of Critical values in NABL (National Accreditation Board for Testing and Calibration Laboratories) accredited Hematology and Clinical Pathology laboratory.
Keywords:
Critical call back, Turn around time, LIS (Laboratory information system)
Abstract
Background: Reporting of laboratory critical values has become an issue of national attention as illustrated by recent guidelines described in the National Patient Safety Goals of the Joint Commission on Accreditation of Healthcare Organizations. They may be considered an important laboratory outcome measurement because they reflect clinical effectiveness, patient safety and operational efficiencyAims: To improve effectiveness, patient safety and operational efficiency by improving laboratory outcome measurement.Settings and Design: Cross-sectional study done at Shree Krishna Hospital, Karamsad, from January 2012 to December 2013.Methods and Material: All data were obtained from reports generated by hematology and clinical pathology laboratory that has been recorded into critical call back log. The parameters were evaluated using descriptive statistical analysis with IBM Statistical Package for the Social Sciences v 20.0 and Microsoft Office Excel 2007 software.Results: The hematology and clinical pathology laboratory reported 19,423 critical values. The majority of critical callbacks (78.4%) resulted from testing performed in the hematology laboratory. The analytes most commonly called back were Hemoglobin and Urine Ketone. We have recorded maximum 52.7% call back from inpatient department followed by emergency department 34.2% and outpatient department 13.1%. The mean time between entering value in the critical callback register and conveying the information to the patient location or ordering clinician was 21 minutes for IPD, 30 minutes for OPD and 20 minutes for ED.Conclusions: “Every laboratory should have at its disposal a procedure to notify critical results. A consensus should be reached with clinicians to establish a specific list of critical limits. DOI: 10.21276/AABS.2017.1317References
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2. Lundberg GD. Critical (panic) value notification: an established laboratory practice policy (parameter). JAMA 1990;263:709.
3. Joint Commission on the Accreditation of Healthcare Organizations: National Patient Safety Goals. Available at: http://www.jcaho.org/accredited+organizations/patient+safety/npsg.htm. Accessed June 22, 2014.
4. Center for Medicare and Medicaid Services. Department of Health and Human Services. Clinical Laboratory Improvement Amendments of 1988: 68 Federal Register (2003) (codified at 42 CFR 493.1291(g)).1047
5. Lum G. Assessment of a critical limit protocol for point-of care glucose testing. Am J Clin Pathol 1996;106:390-395.
6. Howanitz PJ, Steindel SJ, Heard NV. Laboratory critical values policies and procedures: a College of American Pathologists Q-Probes study in 623 institutions. Arch Pathol Lab Med 2002;126:663-669.
7. Kuperman GJ, Boyle D, Jha A, Rittenberg E, Ma’Luf N, Tanasijevic MJ et al. How promptly are inpatients treated for critical laboratory results? J Am Med Inform Assoc 1998;5:112-119.
8. Bates DW, Pappius E, Kuperman GJ, Sittig D, Burstin H, Fairchild D et al. Using information systems to measure and improve quality. Int J Med Inform 1999;53:115-124.
9. Tate KE, Gardner RM, Weaver LK. A computerized laboratory alerting system. MD Comput 1990;7:296-301.
10. Dighe AS, Rao A, Coakley AB, Lewandrowski KB. Analysis of laboratory critical value reporting at a large academic medical center. AM J Clin Pathol 2006;125:758-764.
Published
2017-02-14
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Original Article
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