Abstract
ABSTRACT Introduction: Time for releasing test results and critical value communication by the clinical laboratory are considered important determinants of patients' length of stay in the Emergency Department (ED). As well as physician satisfaction, they are used as quality indicators of the Clinical Analysis Service (CAS). Objective: The aim of this study was to evaluate the time to return a test result, the communication of critical values and the level of satisfaction of the ED physicians of a university hospital with the CAS. Material and methods: A physician satisfaction survey was conducted using a questionnaire. The test turnaround time for emergency requests was analyzed by observation of the pre-analytical phase and monitoring the analytical and post-analytical phases through the laboratory information system. In order to evaluate the communication of critical values by the CAS, a document analysis of the process was performed. Results: Physicians' overall satisfaction with the CAS was considered average. Greater satisfaction was observed with reliability of the results and the staff courtesy and lesser with the delivery time of results. The test turnaround time exceeded clinicians' expectations and the average described in the literature. No experience with critical-value communication was perceived. Conclusion: The results show several opportunities for progress in the relationship between ED and CAS. The improvement of laboratory quality indicators also depends on the involvement of ED physicians and nurses and embraces monitoring, planning, education and investment in system computerization.
Highlights
Time for releasing test results and critical value communication by the clinical laboratory are considered important determinants of patients’ length of stay in the Emergency Department (ED)
Due to scarcity of evidence, the objective of this study is to evaluate some aspects of the relationship between the Adult Emergency Department (AED) and the Clinical Analysis Service (CAS) of a University Hospital (UH) as regards physicians’ level of satisfaction with result releasing time and communication of critical values by the laboratory
Most (90% – nine) doctors answered that “most times”, the delay in test release has slowed down patients' treatment or discharge, and that the early notification of critical values to the EAD is “very important”
Summary
Time for releasing test results and critical value communication by the clinical laboratory are considered important determinants of patients’ length of stay in the Emergency Department (ED). Emergency departments (EDs) operate 24 h a day and work as entry points to the health system, receiving patients from urgency itself, patients with conditions perceived as urgency, those lost for primary and specialized attention, besides social urgencies Such demands mix in EDs, overloading them, what compromises quality of assistance delivery[1]. Successful interaction with other areas of the health system is necessary so as to optimize service rendering[2] This optimization is important when one considers the short time for decision making, typical of an ED, what does not allow the existence of doubts and requires maximum reliability on laboratory results[3, 4]. These play a key role in the clinical decision-making process, and can influence up to 70% of diagnoses and medical treatments[5]
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