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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.


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Assessment of critical values policies in Italian institutions: comparison with the US situation

Elisa Piva1 / Laura Sciacovelli1, 2 / Michael Laposata3 / Mario Plebani1, 2

1Department of Laboratory Medicine, University-Hospital of Padua, Padua, Italy

2Center of Biomedical Research, Castelfranco Veneto, Treviso, Italy

3Department of Pathology, Vanderbilt University School of Medicine, Nashville, TN, USA

Corresponding author: Prof. Mario Plebani, Dipartimento Medicina di Laboratorio, Azienda Ospedaliera-Università di Padova, Via Nicolò Giustiniani 2, 35128 Padova, Italy Fax: +39-049-663240,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 4, Pages 461–468, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.096, February 2010

Publication History

Received:
2009-11-17
Accepted:
2009-11-24
Published Online:
2010-02-04

Abstract

Background: Critical value reporting is considered an essential tool to ensure the quality of medical laboratory services. Important issues include defining cut-off values, assessing responsibility for communication and adopting information technology solutions to improve notification. Here, we report the state of critical value reporting in a large cohort of Italian laboratories and comparison with Q-Probes surveys from the College of American Pathologists as representatives of the US situation.

Methods: To compare critical value policies and procedures, formulation of critical values list with critical values limits and monitoring tools, a web-based questionnaire was formulated for 389 institutions participating in the External Quality Assessment Schemes of Veneto Region, in Italy.

Results: A total of 90 clinical laboratories submitted data. Accredited laboratories represented 82.2% of participants, but written procedures for reporting were indicated by 70.5% of participants. Relevant differences between US and Italian policies have been observed, particularly regarding who provides the notification and on the formulation of the cut-off threshold for critical values.

Conclusions: Accreditation according to international standards can decrease differences regarding the management of critical values across laboratories of different countries. However, the issues concerning critical limits should be debated and a consensus critical values list should be considered. Automated systems could offer improvements regarding some issues, such as who makes the notification, reducing the time spent in notification of critical values. Surveys for comparing and improving existing policies regarding critical values should be promoted at an international level.

Clin Chem Lab Med 2010;48:461–8.

Keywords: automated notification; critical values; patient safety; policies and procedures; result communication

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[1]
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Clinical Chemistry and Laboratory Medicine (CCLM), 2015, Volume 0, Number 0
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[3]
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Clinical Biochemistry, 2014, Volume 47, Number 13-14, Page 1163
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C.A. Campbell and A.R. Horvath
Clinica Chimica Acta, 2014, Volume 432, Page 135
[5]
Kristin M. Aakre, Gunhild Garmo Hov, Øyvind Skadberg, Armin Piehler, Sonia Distante, and Helle B. Hager
Tidsskrift for Den norske legeforening, 2013, Volume 133, Number 21
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Jillian R Tate, Roger Johnson, Julian Barth, and Mauro Panteghini
Clinica Chimica Acta, 2014, Volume 432, Page 4
[7]
Maria Salinas, Maite López-Garrigós, Alberto Asencio, Javier Lugo, Mercedes Gutiérrez, Lucia Flors, and Carlos Leiva-Salinas
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Clinical Chemistry and Laboratory Medicine, 2011, Volume 49, Number 5
[10]
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