Survey of Critical Value Reporting and Reduction of False-Positive Critical Value Results

Abstract

Abstract Context.—Reporting of laboratory critical values has become an issue of national attention because of important regulatory, medicolegal, and clinical concerns. Objective.—To survey aspects of the laboratory critical-value reporting process at a broad range of institutions. Design.—A survey was developed regarding the operational and information-technology aspects of critical value reporting. Results.—More than 730 responses were obtained from a broad distribution of hospitals. In addition, we analyzed more than 700 written responses from survey participants. Conclusions.—The survey results provide insight into the standard of practice and level of compliance with current Joint Commission and College of American Pathologists requirements for critical values, demonstrate considerable heterogeneity, and suggest areas for improvement. A common issue raised during the survey and follow-up teleconference was the incidence of outpatient false-positive critical values. In this report, we also demonstrate that attention to preanalytic transport and processing issues can assist in minimizing this issue.