REPORTING CLINICAL LABORATORY CRITICAL VALUES: A FOCUS ON THE RECOMMENDATIONS OF THE AMERICAN COLLEGE OF PATHOLOGISTS
AbstractBackground: Reporting critical values continues to receive a widespread attention from health care givers as it symbolizes a crucial clinic-laboratory link. This is because healthcare providers did realize the importance of prompt and timely communication of the critical results, which have positive implications on patient safety and treatment outcomes. In addition to physician and nurses, patients are also recipients of critical values, where they can make informed decisions prior to clinical intervention. The College of American Pathologists (CAP) requires stringent policies for reporting critical values in all laboratories, including adoption of a robust quality assurance system. Research studies have indicated that there still no universally accepted critical values list. This is because of various factors; such as differences in institutional organization, patient population, clinical demand, staffing, and instrumentation. However, through collaboration with other stakeholders involved in the delivery of healthcare, lab professionals may be able to come up with a realistic critical values list that reflects on the local needs and dynamics of patients’ service. Conclusion: This review offers an insight into the process of reporting critical values, some challenges encountered, as well as the policies and procedures of effective reporting with a particular focus on the guidelines of the College of American Pathologists. There should be a common global guideline introduced by the health care governing agencies to be adapted with some flexibility in clinical laboratories in different clinical settings.Keywords: Critical values; reporting; guidelines; CAP
Lippi G, Mattiuzzi C. Critical laboratory values communication: summary recommendations from available guidelines. Ann Transl Med 2016;4(20):400.
Hanna D, Griswold P, Leape LL, Bates DW. Communicating critical test results: safe practice recommendations. Jt Comm J Qual Patient Saf 2005;31(2):68–80.
Malone B. The Dilemma Surrounding Critical Value Reporting. Clin Lab News 2012;38(12):1
Howanitz PJ, Steindel SJ, Heard NV. Laboratory critical values policies and procedures: a college of American Pathologists Q-Probes Study in 623 institutions. Arch Pathol Lab Med 2002;126(6):663–9.
Campbell CA, Horvath AR. Harmonization of critical result management in laboratory medicine. Clin Chim Acta 2014;432:135–47.
Dufour DR, Kost GJ. Critical values launch interpretive lab medicine and clinical pathology. Interview by Carren Bersch and Kristin N. Hale. MLO Med Lab Obs 2009;41(3):18–9.
Pereira TC, Silverman JF, LiVolsi V, Fletcher CD, Frable WJ, Goldblum JR, et al. A multi-institutional survey of critical diagnoses (critical values) in surgical pathology and cytology. Am J Clin Pathol 2008;130(5):731–5
Dighe AS, Rao A, Coakley AB, Lewandrowski KB. Analysis of laboratory critical value reporting at a large academic medical center. Am J Clin Pathol. 2006;125(5):758–64.
Wagar EA, Friedberg RC, Souers R, Stankovic AK. Critical values comparison: a College of American Pathologists Q-Probes survey of 163 clinical laboratories. Arch Pathol Lab Med 2007;131(12):1769–75.
Campbell C, Horvath A. Towards harmonisation of critical laboratory result management - review of the literature and survey of australasian practices. Clin Biochem Rev 2012;33(4):149–60.
Genzen JR, Tormey CA. Pathology consultation on reporting of critical values. Am J Clin Pathol 2011;135(4):505–13.
Singh H, Vij MS. Eight recommendations for policies for communicating abnormal test results. Jt Comm J Qual Patient Saf 2010;36(5):226–32.
McFarlane A, Aslan B, Raby A, Bourner G, Padmore R. Critical values in hematology. Int J Lab Hematol 2015;37(1):36–43.
Piva E, Sciacovelli L, Zaninotto M, Laposata M, Plebani M. Evaluation of effectiveness of a computerized notification system for reporting critical values. Am J Clin Pathol 2009;131(3):432–41.
Özcan O, Çakırca G, Motor S, Yönden Z. Delays in reporting critical values from clinical laboratories to responsible healthcare staff. Turkish J Bioch 2017;42(1):45–50.
Murari M. Reporting critical laboratory values in hematology. Indian J Hematol Blood Transfus 2008;24(2):81–2.
Mosallam R, Ibrahim SZ. Critical Value Reporting at Egyptian Laboratories. J Patient Saf 2019;15(3):205–11.