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[Utilization of panic values in our institution: hematological testing].
Chisato Shimazu1, Yukihisa Miyazawa
1Central Clinical Laboratory, Teikyo University Hospital, Itabashi-ku, Tokyo 173-8606, Japan. chisato@med.teikyo-u.ac.jp
Rinsho Byori. the Japanese Journal of Clinical Pathology
|August 28, 2009
Summary
This study outlines a system for reporting critical laboratory values, known as panic values, to physicians. The approach enhances clinical technologists' awareness and improves patient care by ensuring timely communication of life-threatening results.
Area of Science:
- Clinical Pathology
- Laboratory Medicine
- Hematology
Context:
- Abnormal hematological examination results, termed panic values, can indicate life-threatening situations and significantly impact patient diagnosis and treatment.
- Effective communication of these critical values is essential for timely clinical intervention and patient safety.
- Existing methods for reporting panic values require careful evaluation for accuracy and clinical relevance.
Purpose:
- To describe an institutional approach for the utilization and reporting of panic values in a clinical laboratory setting.
- To analyze the frequency and types of panic value reports and associated clinical conditions.
- To identify challenges and propose improvements for panic value reporting systems.
Summary:
- The study details a system where clinical technologists report panic values directly to physicians via telephone or pager, after gathering clinical information and seeking confirmation for additional tests.
- Analysis of six months of data (March-August 2008) revealed that specific hemostasis-related tests (SFMC + TAT + D-d + FDP) constituted the highest proportion of reported panic values (28%).
- Common clinical conditions associated with panic values included blood collection issues (11.9%), warfarin mismanagement (9.3%), leukemia/lymphoma (7.7%), and chemotherapy (7.4%).
Impact:
- The implemented system facilitated quick and accurate reporting of panic values, enhancing clinical technologists' engagement in medical practice and their awareness of test values.
- Identified challenges include potential interference with physician practice, variations in technologist performance, and inconsistencies in panic value management.
- Future improvements involve integrating panic value reporting with electronic medical records and mobile physician terminals for more efficient information dissemination and record management.
