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Establishing, harmonizing and analyzing critical values in a large academic health center

Ibrahim A Hashim, Jennifer A Cuthbert

    Clinical Chemistry and Laboratory Medicine
    |March 14, 2014
    PubMed

    Insights

    Harmonizing critical values (CVs) lists across hospitals standardized testing criteria, reducing unnecessary calls by 33%. Periodic review ensures ongoing appropriateness of these essential laboratory safety measures.

    Area of Science:

    • Clinical Pathology
    • Laboratory Medicine
    • Healthcare Quality Improvement

    Background:

    • Lack of standardized processes for critical values (CVs) lists in large academic health centers.
    • Absence of long-term validation for harmonized CVs lists.

    Purpose of the Study:

    • To establish a process for harmonizing critical values lists across multiple hospital laboratories.
    • To validate the effectiveness and appropriateness of CVs lists over a 5-year period.

    Main Methods:

    • Adopted a standardized definition for critical values.
    • Analyzed existing CVs lists and reporting times for chemistry, hematology, and coagulation (CH&C) tests.
    • Reviewed and revised CVs lists for compliance and uniformity across campus hospitals.

    Main Results:

    • Harmonized 37 CH&C tests, eliminating 26 and modifying 61 values.
    • Achieved a 33% reduction in critical value calls at a primary teaching hospital.
    • Demonstrated stability of the revised list over 5 years, with minor adjustments and one re-instatement.

    Conclusions:

    • Successful harmonization of critical values lists achieved uniformity and reduced unnecessary alerts.
    • Established a framework for periodic review and evaluation of critical values lists.
    • Emphasized the importance of ongoing assessment for the appropriateness of critical value thresholds.
    Abstract

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