Critical results in medical laboratory. management and communication

Abstract

The medical community is gaining increased attention to streamlining a clear mechanism for reporting critical test results in the clinic. DSTU ISO 15189: 2015 requires laboratories to report critical test results to clinitians within a specified period of time. Moreover, they should have a clearly established procedure in place. In order to standardize processes and avoid misunderstandings between stakeholders, international organizations (RCPA, AACB, CLSI) have developed terminology, communication algorithm and requirements for data documentation. In order to harmonize this part, a lot of surveys have been conducted as to which analytes should be included in the notification sheet and, in particular, the limits of their values for hematological, hemostasiological and biochemical studies. According to ICSH recommendations, critical risk results include hemoglobin, leukocytes, neutrophils, platelets, activated partial thromboplastin time (aPTT), prothrombin time (PT) / international normalization ratio (INR) and fibrinogen. The laboratories include different biochemical tests in the alert list. The most common analytes are glucose, potassium, sodium and calcium. It should be noted that this alert list is only recommended for clinical laboratories, such as the number of indicators and alert threshold of analytes should be agreed with the clinicians of a particular medical institution, taking into account their experience and local patient population. The developed recommendations will allow to react as quickly as possible to situations that may threaten patient’s life, provide qualified medical care in a timely manner and adjust work processes in accordance with the requirements of international standards.