Affiliation:
1. Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Centre, Hospital Clínic , Barcelona , Spain
2. CORE Laboratory, Biochemistry and Molecular Genetics Department , Biomedical Diagnostic Centre, Hospital Clínic , Barcelona , Spain
Abstract
Abstract
Objectives
The communication of critical results (CR) is considered an essential role in clinical laboratories to ensure patient safety. This is especially relevant to outpatients, who are non-hospitalized and more difficult to locate. In our laboratory, there is a specific protocol for CR management that sets up the communication pathway to adequately provide these results to clinicians. The aim of this study is to evaluate the impact of CR reporting on outpatient care.
Methods
This is a retrospective study focused on CR for biochemistry parameters in a clinical laboratory of a Spanish tertiary hospital during 2019. A total of 156 CR were determined and properly provided to clinicians. We collected CR, age, gender, and the requesting department. We also collected the medical action data resulting from the communication of the CR.
Results
Seventy-six outpatients (49%) were properly treated because of effective CR communication. Hypoglycemia was the most frequent event (33%), however, the greatest clinical impact was observed for patients with hyponatremia (100%), hyperkalemia (62%), hypokalemia (60%), and hypercalcemia (57%). Based on these findings, we evaluated new glucose alert thresholds depending on whether or not the outpatient was diabetic (1.7 and 2.2 mmol/L, respectively). Based on these new thresholds, we established a CR reporting protocol with 69% effectiveness in outpatients.
Conclusions
We demonstrate that CR communication in outpatients has a significant clinical impact. To increase the effectiveness of the CR reporting protocol, we propose to adjust alert thresholds according to pathology, department, and patient population.
Subject
Biochemistry, medical,Clinical Biochemistry,General Medicine
Reference38 articles.
1. Lippi, G, Giavarina, D, Montagnana, M, Salvagno, GL, Cappelletti, P, Plebani, M, et al.. National survey on critical values reporting in a cohort of Italian laboratories. Clin Chem Lab Med 2007;45:1411–3. https://doi.org/10.1515/CCLM.2007.288.
2. Lundberg, G. When to panic over abnormal values. Med Lab Obs 1972;4:47–54. https://doi.org/10.1093/labmed/3.5.47.
3. Piva, E, Sciacovelli, L, Pelloso, M, Plebani, M. Performance specifications of critical results management. Clin Biochem 2017;50:617–21. https://doi.org/10.1016/j.clinbiochem.2017.05.010.
4. Clinical and Laboratory Standards Institute (CLSI). Management of critical- and significant-risk results, 1st ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2015.
5. Agarwal, R, Chhillar, N, Tripathi, CB. Study of variables affecting critical value notification in a laboratory catering to tertiary care hospital. Indian J Clin Biochem 2015;30:89–93. https://doi.org/10.1007/s12291-013-0409-x.
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