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Llopis Diaz M.A.,Comision de la Calidad Extraanalitica | Gomez Rioja R.,Comision de la Calidad Extraanalitica | Alvarez Funes V.,Comision de la Calidad Extraanalitica | Martinez Bru C.,Comision de la Calidad Extraanalitica | And 4 more authors.
Revista del Laboratorio Clinico | Year: 2010

Introduction: Detection and reporting of critical values have great implications on patient safety. The SEQC Committee for the extra-analytical quality assessment has carried out a survey in order to evaluate these in Spanish laboratories. Material and methods: Two surveys were distributed among 728 participants registered in the External Quality Assessment Scheme (clinical chemistry, serum). Participants were asked to provide information regarding reporting of critical values and their decision limits. Outpatient and in-patient reporting were considered separately. Results: Most laboratories (81.5 %) had their critical values already defined; physicians assumed the responsibility of notifying critical results in 87.3 % of cases; critical results were mainly informed by telephone (91.1 %); 58 % of laboratories further verified that such notifications were received; delivery time was not taken into account in 54.8 % of laboratories; 87.9 % did not employ any indicator to track this process. Median values obtained for most constituents did not differ and were similar for outpatient and hospital settings. Nevertheless, differences were found for the lower calcium critical value and for high critical values for creatinine, glucose and urea. Conclusions: Handling of critical values lacks standardization and a consensus among Spanish laboratories. Suitable strategies should be developed between laboratories and clinicians in order to correctly define and set up critical values, as their detection requires urgent medical action. © 2010 AEBM, AEFA y SEQC. Source

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