Survey and Proposal of Critical Value Reporting and Management in Clinical Chemistry

Abstract

Objective: It is one of the major functions of the clinical laboratory to clearly, accurately, and quickly communicate critical values directly to the patient care providers. Laboratory professionals are often confronted with many obstacles in critical value reporting, including establishing critical values, notifying the critical values to provider, and ensuring that the provider understands the severity of a critical result.Methods: A total of 30 laboratory directors voluntarily answered the questionnaire by e-mail. The questionnaire covered demographic characteristics, establishing and updating critical values lists in clinical chemistry, thresholds of critical values, appropriate timeframes for critical results, notification process, and so on.Results: Of the 30 participating institutions, 12 were general hospitals, three were commercial laboratories, and 15 were tertiary hospitals. The tests included in critical value lists are as follows in order of frequency: potassium, glucose, sodium, total calcium, chloride, ionized calcium, creatinine, magnesium, total bilirubin, phosphorus, pH, and so on. Ten of the 30 institutions notified critical value reports to the patient care providers within 1 hour.Conclusion: This study presents the status of critical value reporting policy in Korean hospitals and a literature review on critical value reporting. In addition, this article provides core components and current regulatory requirements for critical value reporting. Critical value reporting systems should be approved, reviewed, and revised periodically.