Critical values in hematology

Area of Science:

• Clinical Pathology
• Laboratory Medicine
• Hematology

Background:

• Critical values are life-threatening laboratory results necessitating prompt healthcare provider notification.
• Accreditation bodies mandate that laboratories establish critical value policies.
• A survey assessed current practices for critical values in Ontario hematology laboratories.

Purpose of the Study:

• To determine current practices for establishing and reporting critical values in hematology laboratories.
• To identify variability in critical value policies and reporting procedures.

Main Methods:

• A survey was distributed to 182 hematology laboratory professionals in Ontario.
• The survey queried sources for critical value establishment, policy review frequency, delta checks, and reporting protocols.
• Participants included laboratory managers, supervisors, and technologists.

Main Results:

• Most laboratories have established critical limits for hemoglobin, leukocyte, and platelet counts, as well as for malaria parasites and blast cells.
• Practices varied regarding policy sources, review frequency, and application to repeat samples.
• Delta checks were rarely used to identify critical values, and most labs required confirmation of critical results with patient care providers.

Conclusions:

• There is a significant lack of consensus in critical value reporting practices within hematology laboratories.
• Standardization of critical value reporting is recommended to enhance patient safety and ensure consistent laboratory performance.