Critical Value Report: Survey and Literature Review

BACKGROUND: Communication with clinicians in the pre- and post-analytical period to report correct and adequate laboratory test results is crucial. Specifically, the notification of critical values that identify a treatable life-threatening condition should be effectively implemented. Although critical value reporting consists of a series of inter-dependent decisions and processes, standard critical value practices in clinical laboratories have not been agreed upon yet. METHODS: We analyzed the critical value reporting protocols currently used in Korea and performed a systematic review of published literature to provide best practices to improve the quality of critical value reports. RESULTS: Commonly included critical value reports (number of healthcare facilities) are such as followings: hemoglobin (59/59), platelet (52/59), white blood cell (51/59), activated partial thromboplastin time (45/59), glucose (56/59), potassium (55/59), sodium (50/59) total calcium (42/59), creatinine (42/59), and gram stain result when blood culture is positive (24/59). CONCLUSIONS: Substantial variations in the critical value report protocols exist among the participating clinical laboratories. Further effort should be invested to standardize the protocol.

Laboratory critical value reporting system at pediatric clinics / 中国小儿急救医学

Objective To evaluate the influence of laboratory critical value reporting on the efficacy of pediatric critical care.Methods A comparative analysis was conducted to evaluate the changes after the establishment of laboratory critical value reporting system.The parameters chosen for assessment included laboratory test turnaround time,medical intervention start time,survival rate,etc.Results Before the establishment of laboratory critical value reporting system,laboratory test turnaround time was (44.5±14.6)min,medical intervention start time was (40.7±5.3)min,and the success rate of the emergency treatment in ICU was (80.36±6.32)%[the rate in normal ward was(82.64±9.21)%].But after the establishment of laboratory critical value reporting system,laboratory test turnaround time,medical intervention start time,the success rate of the emergency treatment in ICU (normal ward) were (18.7±8.8)min,(23.9±6.7)min and (89.49±4.58)% [(90.04±6.45)%].Laboratory critical value reporting system shortened laboratory test turnaround time and medical intervention start time (P<0.05),and the successful rate of the emergency treatment improved evidently.Conclusion Laboratory critical value reporting system can improve successful rate of the emergency treatment significantly.