Retrospective Study of Critical Values: Agreement and Improvement

Abstract

Background: Accreditation agencies now require clinical laboratories to list critical limits, formulate notification procedures, document critical results, and notify clinicians. The objective of this study has been to perform a retrospective review of our critical value notification procedure and improve it by reaching a consensus with our clinicians. Methods: The main outcome measures were the number of critical values (CVs) reported in our laboratory and the number and rate of CVs if we had applied the universal critical limit list used by the majority and the supercritical limit list. Results: Fifty-four CVs were reported with 660 theoretical CVs and 120 supercritical CVs. The list CV and notification procedure was improved according to expert opinion. Conclusion: Every laboratory should have at its disposal a procedure to notify critical results. A consensus should be reached with clinicians to establish a specific list of critical limits according to the type of patient and the timeliness of laboratory tests.