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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

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1437-4331
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Volume 49, Issue 2

Issues

Global trends in critical values practices and their harmonization

Gerald J. Kost
  • Point-of-Care Technologies Center and Pathology and Laboratory Medicine, Pathology and Laboratory Medicine, School of Medicine, University of California, Davis, USA
  • UC Davis-LLNL Point-of-Care Technologies Center and the Point-of-Care Testing Center for Teaching and Research (POCT-CTR), Pathology and Laboratory Medicine, School of Medicine, University of California, Davis, USA
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/ Kristin N. Hale
  • UC Davis-LLNL Point-of-Care Technologies Center and the Point-of-Care Testing Center for Teaching and Research (POCT-CTR), Pathology and Laboratory Medicine, School of Medicine, University of California, Davis, USA
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Published Online: 2010-11-23 | DOI: https://doi.org/10.1515/CCLM.2011.033

Abstract

Background: The objectives of this article were 1) to identify current trends in critical values practices in North America, Europe, and other regions; 2) to describe progress toward harmonization of critical limits; and 3) to synthesize strategies that will encourage global consensus. Critical limits are described in national surveys. Critical value practices are guided by federal statutes, The Joint Commission regulations, and accreditation requirements in the US; by provincial healthcare agencies in Canada; by thought leaders and ISO EN 15189:2007 in Europe; and in SE Asia, mostly by ad hoc policies lacking statutory grip.

Methods: Review of databases, literature, websites, federal statutes, litigation, official policies, current affairs, and accreditation agency requirements.

Results and conclusions: Practical strategies will accelerate harmonization of critical values practices, as follows: a) continue national and international survey comparisons; b) clarify age, ethnic, and subject dependencies; c) standardize qualitative and quantitative decision levels for urgent clinician notification; d) monitor compliance and timeliness for safety; and e) alert high frequencies of critical values related to adverse events. New expectations and communication technologies present opportunities for enhanced performance using wireless closed-loop reporting with recipient acknowledgment to reduce phone calls and improve efficiency. Hospitals worldwide can benefit from developing consensus for critical values practices.

Keywords: closed-loop electronic reporting and acknowledgment; critical limits; ISO; point-of-care; standard of care; visual logistics

About the article

Corresponding author: Gerald J. Kost, MD, PhD, MS, FACB, POCT-CTR, Pathology and Laboratory Medicine, 3455 Tupper Hall, School of Medicine, University of California, Davis, CA 95616, USA Phone: +1-530-752-2710, Fax: +1-530-752-4548


Received: 2010-07-23

Accepted: 2010-09-03

Published Online: 2010-11-23

Published in Print: 2011-02-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 49, Issue 2, Pages 167–176, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2011.033.

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©2011 by Walter de Gruyter Berlin New York. Copyright Clearance Center

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