The first responsibility of the head of a clinical laboratory is to ensure the provision of a high quality service across a wide range of parameters culminating in laboratory accreditation against an international standard, such as ISO 15189. Optimal use of laboratory medicine relies on dynamic and authoritative leadership outside as well as inside the laboratory. When used optimally laboratory medicine generates knowledge that can facilitate patient safety, improve patient outcomes, shorten patient journeys and lead to more cost-effective healthcare. Laboratory medicine is a medical specialty at the centre of healthcare. Selection of critical assays for notification and setting the limits of notification exhibited wide variation as well.Īdding value to laboratory medicine: a professional responsibility. Critical value policies and practices showed interinstitutional variation with deficiencies in some reporting practices. The cutoff limits for reporting different assays showed considerable interlaboratory variation. Wireless technologies are used in reporting in only 10.0% of hospitals. The call is received mainly by nurses and physicians ordering the test (67.5% and 55.0%, respectively) and the channel of reporting is mainly the telephone or through sending test report to the ward (67.5% and 50.0%, respectively). The hospital laboratory physician was responsible for critical value reporting followed by the laboratory technician (75.0% and 50.0%, respectively). Three-fifths of laboratories had a policy for assessing the timeliness of reporting and 3 quarters stated that the laboratory policy requires feedback (60.0% and 75.0%, respectively). For laboratories having a critical value list, the number of tests in the list ranged from 7 to 40. Written procedure for reporting of critical values was present in 77.5% of laboratories and a comprehensive list of critical values in 72.55%. The fourth section explored critical value ranges for selected common laboratory assays. The third section explored the reporting process. The second section assessed policies and procedures of critical value reporting. The first section explored hospital and laboratory characteristics. Data were collected using a questionnaire composed of 4 sections. Subjects were from inpatient division of all laboratories of Alexandria hospitals (40 laboratories). A cross-sectional descriptive study design was used. To examine critical value reporting policies and practices and to identify critical value ranges for selected common laboratory assays at inpatient division of laboratories of Alexandria hospitals. We provide here an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis.Ĭritical Value Reporting at Egyptian Laboratories. A broad heterogeneity exists about critical values in hemostasis worldwide. KEY MESSAGES Critical values are laboratory test results significantly lying outside the normal (reference) range and necessitating immediate reporting to safeguard patient health. Due to the heterogeneity of available data, this paper is hence aimed to analyze the state of the art and provide an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis, thus providing a basic document for future consultation that assists laboratory professionals and clinicians alike. This is especially true in hemostasis, where a timely and efficient communication of critical values strongly impacts patient management. The identification and effective communication of "highly pathological" values has engaged the minds of many clinicians, health care and laboratory professionals for decades, since these activities are vital to good laboratory practice. The term "critical values" can be defined to entail laboratory test results that significantly lie outside the normal (reference) range and necessitate immediate reporting to safeguard patient health, as well as those displaying a highly and clinically significant variation compared to previous data. Lippi, Giuseppe Adcock, Dorothy Simundic, Ana-Maria Tripodi, Armando Favaloro, Emmanuel J Critical laboratory values in hemostasis: toward consensus.
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