Comunicación de valores críticos: resultados de una encuesta realizada por la comision de la calidad extraanalítica de la SEQC

Enhancing clinical laboratory reporting: The impact of implementing a critical laboratory value protocol

“…Llopis Díaz et al (2010) in Israel, reported in their study conducted in a medical center in Israel that at the end of four years of implementation there were gradual improvements in the report of a critical value, where it was concluded that the report increased from 55% in 2010 to 95% in 2014. These improvements are summarized in the importance of: a) selecting suitable tests and values for the list of critical values, b) using technology and computerized measures to support the process, and c) developing rapid procedures to monitor and control the process.…”

“…There is controversy about who is responsible for receiving the information about the critical value since it will not always be received by the doctor. Llopis Díaz et al (2010) in the results of a survey on the communication of critical values carried out by the extra analytical quality commission of the SEQC (Quality Assurance and Accreditation Committee, Spanish Society of Clinical Biochemistry and Molecular Pathology) concluded that the information of the notification of a critical value can be received by a doctor or can be performed by another health professional.…”

“…In the protocol, the ideal is that the notification is given by the specialist in clinical pathology or resident doctor of clinical pathology (laboratory physician) because there will be a more rational opportunity to analyze, discuss the case and help in making a clinical decision [35,36], however, the person responsible for notifying is defined by each hospital (López- Pelayo et al, 2012), and in the protocol of the hospital given to the great demand that attends it was established that in the absence of the specialist doctor in the shift the person responsible for notifying is the medical technologist followed by the technical staff because it is the one who performs and detects the altered result, but the verification steps of the same must be followed to avoid giving an incorrect result (Llopis Díaz et al, 2010). Likewise, although it is ideal that the information be received by the attending physician and given that in the emergency area, this is not always possible, the protocol established that in order to expedite the notification this information could be received by the resident physician, the medical intern, technician or nursing staff since studies support that health professionals (residents, nurses, etc.)…”

“…Only after confirming the correct request, the value is considered to have been communicated. In all cases of oral communication, it is necessary to confirm the correct reception of the information, through what is called in the literature the read-back, that is, to ask the person who receives the call to write down the dictated value and to repeat it to the person who informs him, in order to avoid adverse effects capable of causing harm to patients Llopis Díaz et al, 2010;Kost and Hale, 2011;López Pelayo et al, 2011;Piva et al, 2014;Schifman et al, 2016). Table 1 shows the list of critical values that are taken into account in the clinical laboratory.…”