Survey of Critical Value Reporting and Reduction of False-Positive Critical Value Results

2008 ◽  
Vol 132 (10) ◽  
pp. 1666-1671
Author(s):  
Anand S. Dighe ◽  
Jay B. Jones ◽  
Sue Parham ◽  
Kent B. Lewandrowski
Keyword(s):  
False Positive ◽  
Critical Value ◽  
Critical Values ◽  
Broad Distribution ◽  
Written Responses ◽  
Standard Of Practice ◽  
Survey Results ◽  
Value Reporting ◽  
Insight Into

Abstract Context.—Reporting of laboratory critical values has become an issue of national attention because of important regulatory, medicolegal, and clinical concerns. Objective.—To survey aspects of the laboratory critical-value reporting process at a broad range of institutions. Design.—A survey was developed regarding the operational and information-technology aspects of critical value reporting. Results.—More than 730 responses were obtained from a broad distribution of hospitals. In addition, we analyzed more than 700 written responses from survey participants. Conclusions.—The survey results provide insight into the standard of practice and level of compliance with current Joint Commission and College of American Pathologists requirements for critical values, demonstrate considerable heterogeneity, and suggest areas for improvement. A common issue raised during the survey and follow-up teleconference was the incidence of outpatient false-positive critical values. In this report, we also demonstrate that attention to preanalytic transport and processing issues can assist in minimizing this issue.

Application of PDCA-Cycle on the Management of Critical Values Reporting

2013 ◽  
Vol 712-715 ◽  
pp. 3203-3206
Author(s):  
Hong Wang ◽  
Ying Chang ◽  
Wen Sheng Che
Keyword(s):  
Statistical Analysis ◽  
Quality Management ◽  
Critical Value ◽  
Reporting Rate ◽  
Critical Values ◽  
Medical Field ◽  
Field Methods ◽  
Pdca Cycle ◽  
Value Reporting ◽  
Staff Number

Objective: Through the PDCA (Plan-Do-Check-Act, also called quality loop) cycle in the management of Critical Value Reporting, and then the discussion on the values of their application in the medical field. Methods: Data were divided into two groups (January to March in 2012 as before the implementation of PDCA-cycle and August to October as after the implementation of PDCA-cycle). Statistical analysis was applied for these two groups. Results: After the application of PDCA-cycle, the executing rate of critical values reporting increased from 38.2% to 96.4 % (P=0.000). The percentage of reporting time, repeat critical values reporting, reporters name and staff number, receivers name and staff number rised from 96.4%, 83.6%, 83.6%, 69.1% to 100.0%, 98.8%, 98.8%, 99.8%, respectively (P=0.000). Meanwhile, critical values reporting rate of Laboratory and Radiology also increased from 47.9%, 30.6% to 96.5%, 96.3% (P=0.000). Conclusion: This study suggested that the PDCA-cycle is an important tool for quality management, and it can effectively improve the executions of critical values reporting.

Assessment Monitoring of Laboratory Critical Values: A College of American Pathologists Q-Tracks Study of 180 Institutions

2007 ◽  
Vol 131 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Elizabeth A. Wagar ◽  
Ana K. Stankovic ◽  
David S. Wilkinson ◽  
Molly Walsh ◽  
Rhona J. Souers
Keyword(s):  
Health Care Providers ◽  
Monitoring Program ◽  
Mixed Linear Model ◽  
Critical Value ◽  
Critical Values ◽  
Care Providers ◽  
Critical Range ◽  
Clinical Laboratories ◽  
Definition Of ◽  
Value Reporting

Abstract Context.—Critical laboratory value reporting is a highly visible and essential key activity for clinical laboratories. Objective.—To measure critical laboratory value reporting in multiple institutions over time and to examine the practice patterns and demographic factors associated with sustained improvement in critical value reporting. Design.—A longitudinal cohort study of 180 clinical laboratories that provided quarterly critical values reporting data for 2 to 16 quarters was conducted using a uniform definition of successful caregiver notification. Mixed linear model analysis of the 2001 through 2004 dataset was performed. Results.—A decrease in total and inpatient rates of undocumented critical values per 1000 results was associated with (1) the American Association of Blood Banks inspection within the past 2 years (P = .01, for both total and inpatient rates); (2) unit secretary/clerical staff not authorized to accept inpatient critical value notification (P = .004 [total] and .001 [inpatient]); and (3) the mandatory practice of requiring notification of health care providers when handling inpatients known to have results repeatedly in the critical range (P = .01, for both total and inpatient rates). Continued participation in the Q-Tracks monitoring program was associated with significant and progressive improvement in total, inpatient, and outpatient critical value reporting (P = .02, .01, and .003, respectively). Conclusions.—Critical value reporting improved as the duration of participation in the Q-Tracks monitoring program increased. Improved total and inpatient critical value reporting was associated with factors that may be markers for institutions with priorities of quality management and enhanced communication with responsible caregivers.

scholarly journals Multi-band optical light-curve behavior of core-collapse supernovae

2013 ◽  
Vol 9 (S296) ◽  
pp. 352-353
Author(s):  
Brijesh Kumar
Keyword(s):  
Spectroscopic Properties ◽  
Core Collapse ◽  
Study Behavior ◽  
Optical Light Curve ◽  
Survey Results ◽  
Light Color ◽  
Optical Telescopes ◽  
Observational Science ◽  
Insight Into

AbstractWe present survey results obtained from the UBVRI optical photometric follow-up of 19 bright core-collapse SNe during 2002-2012 using 1-m class optical telescopes operated by the Aryabhatta Research Institute of Observational Science (acronym ARIES), Nainital India. This homogeneous set of data have been used to study behavior of optical light/color curve, and to gain insight into objet-to-object peculiarity. We derive integrated luminosities for types IIP, Ibc and luminous SNe. Two peculiar type IIP events having photometric properties similar to normal IIP and spectroscopic properties similar to sub-lumnious IIP have been identified.

Delays in reporting critical values from clinical laboratories to responsible healthcare staff

2017 ◽  
Vol 42 (1) ◽  
Author(s):  
Oğuzhan Özcan ◽  
Gökhan Çakırca ◽  
Sedat Motor ◽  
Zafer Yönden
Keyword(s):  
Clinical Laboratory ◽  
Critical Value ◽  
Critical Values ◽  
University Hospital ◽  
Care Staff ◽  
Professional Status ◽  
Health Care Staff ◽  
Healthcare Staff ◽  
Working Day ◽  
Value Reporting

AbstractObjective:We aimed to investigate the frequency of delayed notifications and probable causes of delays for critical value notification in clinical laboratory of university hospital.Materials and methods:All data was obtained from critical value reporting forms and laboratory information system. The frequency and location of critical and delayed results, latencies throughout a working day and the professional status who received the critical callbacks were shown as percentages.Results:A total of 2018 (1.02%) critical values were reported and 13.1% of them were delayed notifications. Most of them were observed in laboratory tests ordered from patients of service and polyclinics compared to ICU and emergency department (26.7%, 26%, 6.2% and 4.9%, respectively, p<0.01). Delayed notifications were significantly higher for biochemical parameters (19.7%, p<0.001) and observed particularly in morning hours (06:00 a.m.–10:00 a.m.), lunch break time (12:00–14:00) and end of the working day (16:00–18:00). Latencies of mild-delayed reporting were 18.5±4.4 min for 62.8% and advanced-delayed reporting were 47.1±11.3 min for 37.2% of total delayed notifications. Most of the critical results were reported to the health care staff other than physician (55.6%).Conclusion:Laboratory professionals should work in collaboration with responsible clinician and healthcare staff in critical value reporting process.

scholarly journals Critical laboratory values - an experience in Apollo Hospitals Dhaka

Pulse ◽  
1970 ◽  
Vol 3 (1) ◽  
pp. 7-11
Author(s):  
M Ibrahim ◽  
I Islam ◽  
TA Nasir ◽  
D Saha
Keyword(s):  
Patient Safety ◽  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Medical Center ◽  
Clinical Care ◽  
Time Factors ◽  
Critical Value ◽  
Critical Values ◽  
Healthcare Organizations ◽  
Value Reporting

Reporting of laboratory critical values has become important for patient safety as described by recent guidelines in National Patient Safety Goals of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The use of critical values reporting was adopted as a requirement in the Clinical Laboratory Improvement Amendments (CLIA'88). Herein, we reported the results of an analysis of 4260 consecutive laboratory critical values from July 2007 to June 2008 at our institution, a large tertiary medical center. We evaluated critical value reporting by parameters, laboratory speciality (Clinical Chemistry & Hematology), clinical care area (IPD, OPD, Emergency), and Turn around time. Factors leading to delays in critical value reporting are identified, and we describe approaches to improving this important operational and patient safety.DOI: 10.3329/pulse.v3i1.6544Pulse Vol.3(1) July 2009 p7-11

scholarly journals A study to assess the critical result reporting at B &C Medical College and teaching hospital

2018 ◽  
Vol 8 (2) ◽  
pp. 1350-1352
Author(s):  
Sujan Sharma ◽  
Barsha Koirala ◽  
Niraj Keyal
Keyword(s):  
Teaching Hospital ◽  
Critical Value ◽  
Critical Values ◽  
Care Providers ◽  
Medical College ◽  
Repeat Test ◽  
Adequate Care ◽  
Almost All ◽  
Heath Care

Background: The critical value can occur while performing panels of tests at laboratory by different chemistry or blood analysers with varieties of principles. The main objective of the study was to study the process of critical result reporting and to know the way of communication and documentation done for critical value in the laboratory, ICUs and the wards.Materials and Methods: This study was prospective and non-experimental was conducted at B&C Medical College and Teaching Hospital from 14.04.2018 to 14.05.2018. Total 60 critical values samples were included. The data was collected by means of observing the critical values of inpatient and the process of reporting from the laboratory to the respective wards and ICUs.Results: Out of 60 samples included in our study, there was 100% communication to concerned treating units. For the confirmation of critical value repeat test was done in 68% of cases. In 75% of cases clinicians did follow up. Recording of a critical report in lab was done in 96% of cases and almost all of the critical values 98% were immediately reported to the respective wards by technical staffs. There was no communication in 1.6% of cases to treating units by technical staff. Majority 78% of critical values were communicated by respective wards and ICUs nurses to concerned doctors.Conclusion: Critical value can occur while performing panels of tests at laboratory and reporting such values to treating clinicians or respective wards or ICUs could help heath care providers for effective treatment of the patients and their adequate care.

scholarly journals Analysis of laboratory critical values at a referral Spanish tertiary university hospital

2018 ◽  
Vol 29 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Ariadna Arbiol-Roca ◽  
Sofía Corral-Comesaña ◽  
Ruth Cano-Corres ◽  
María José Castro-Castro ◽  
Macarena Dastis-Arias ◽  
...  
Keyword(s):  
Oxygen Partial Pressure ◽  
Partial Pressure ◽  
Critical Value ◽  
Potassium Ion ◽  
Critical Values ◽  
Sodium Ion ◽  
University Hospital ◽  
Ion Concentrations ◽  
Glucose Phosphate ◽  
Value Reporting

Introduction: The aim of this study was to analyse critical value data from our laboratory and compare our critical value reporting policy with others in the literature. Materials and methods: Analysis of critical values was performed on data obtained over a 6-month period in a tertiary university hospital. Results: We identified 5723 critical values, of which approximately 80% came from STAT testing (4577), 15% from routine inpatients testing (884) and 5% from routine outpatients testing (262). The highest proportion of critical values corresponded to oxygen partial pressure (17.7%), followed by potassium ion (17.6%) concentrations. The parameters associated with the highest critical value notification percentage in emergency patients were pH, haematocrit, glucose, potassium ion and haemoglobin concentrations. In inpatients, these parameters were glucose, phosphate, haemoglobin, sodium ion and potassium ion concentrations. In outpatients, they were calcium and potassium concentrations. Conclusions: The analysis of critical values in our hospital is in accordance with that reported in the literature. Our findings demonstrate the importance of incorporating improvement actions not only in critical value notification, but especially in the registration of this activity.

Improving diagnosis of acute appendicitis with atypical findings by Tc-99m HMPAO leukocyte scan

2002 ◽  
Vol 41 (01) ◽  
pp. 37-41 ◽  
Author(s):  
S. Shung-Shung ◽  
S. Yu-Chien ◽  
Y. Mei-Due ◽  
W. Hwei-Chung ◽  
A. Kao
Keyword(s):  
Acute Appendicitis ◽  
False Positive ◽  
False Positive Rate ◽  
Accurate Method ◽  
Clinical Findings ◽  
Pathological Findings ◽  
Lower Quadrant ◽  
Predictive Values ◽  
Positive Rate

Summary Aim: Even with careful observation, the overall false-positive rate of laparotomy remains 10-15% when acute appendicitis was suspected. Therefore, the clinical efficacy of Tc-99m HMPAO labeled leukocyte (TC-WBC) scan for the diagnosis of acute appendicitis in patients presenting with atypical clinical findings is assessed. Patients and Methods: Eighty patients presenting with acute abdominal pain and possible acute appendicitis but atypical findings were included in this study. After intravenous injection of TC-WBC, serial anterior abdominal/pelvic images at 30, 60, 120 and 240 min with 800k counts were obtained with a gamma camera. Any abnormal localization of radioactivity in the right lower quadrant of the abdomen, equal to or greater than bone marrow activity, was considered as a positive scan. Results: 36 out of 49 patients showing positive TC-WBC scans received appendectomy. They all proved to have positive pathological findings. Five positive TC-WBC were not related to acute appendicitis, because of other pathological lesions. Eight patients were not operated and clinical follow-up after one month revealed no acute abdominal condition. Three of 31 patients with negative TC-WBC scans received appendectomy. They also presented positive pathological findings. The remaining 28 patients did not receive operations and revealed no evidence of appendicitis after at least one month of follow-up. The overall sensitivity, specificity, accuracy, positive and negative predictive values for TC-WBC scan to diagnose acute appendicitis were 92, 78, 86, 82, and 90%, respectively. Conclusion: TC-WBC scan provides a rapid and highly accurate method for the diagnosis of acute appendicitis in patients with equivocal clinical examination. It proved useful in reducing the false-positive rate of laparotomy and shortens the time necessary for clinical observation.

Attitudes of Elderly People in the South Moravian Region to Further Education

2014 ◽  
Vol 4 (2) ◽  
pp. 54-78
Author(s):  
Petr Adamec ◽  
Marián Svoboda
Keyword(s):  
Quality Of Life ◽  
Elderly People ◽  
Further Education ◽  
The South ◽  
The Third ◽  
Interesting Insight ◽  
Survey Results ◽  
Insight Into ◽  
Demographic Features

This paper deals with the results of sociological survey focused on identification of the attitudes of elderly people to further education. The research was carried out in September 2010. Experience of elderly people with further education, their readiness (determination) for further education as well as their motivation and barriers in further education were also subjects of this research. Detecting elderly population’s awareness of universities of the third age and finding out their further education preferences were an integral part of the research. Research sample consisted of citizens over 55 years living in the South Moravian region. The survey results are structured by socio-demographic features e.g.: age, sex, educational attainment etc. and provide an interesting insight into the attitudes of the target group to one of the activities that contributes to improvement of their quality of life.

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