Is it Necessary to Repeat Critical Values in the Laboratory?

Abstract

Repeating a test for accuracy is a well-established practice in laboratories. In the early days of laboratory instrumentation, this was appropriate, since instruments had poor precision relative to today’s machines. Currently, however, laboratory information systems (LISs) and ultrasensitive level sensors and clot detectors on testing instruments have improved the accuracy of results. In this study, we address whether values that fall outside the reference range must be repeated or whether critical time and resources are wasted through this practice. We monitored early notification (EN) and critical value (CV) repeats that were performed on automated instruments in chemistry, coagulation, and hematology. We recorded the differences in results between the original and the repeated test results. Our goals were to maintain quality, improve efficiency, provide our clinicians with accurate results, and eliminate unnecessary repeat testing in the automated areas mentioned above. Analysis of the data helped us change our practices and improve efficiency and turnaround time (TAT) for critical values.