Armonizzazione della notifica dei valori critici come contributo al miglioramento della sicurezza e della cura del paziente
Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera-Università, Padova
Harmonization of the notification of critical values as contribution to the improvement of patient safety and care
A project for harmonizing the notification of critical values was performed in our department, which covers 3 different hospitals. We achieved the harmonization of definitions by distinguishing critical values, critical tests and abnormal results, according to the Joint Commission proposal. For critical tests, the requesting physicians should verify the availability of results as soon as possible, while the laboratory professionals must ensure appropriate and timely results. As an example, all requests from the Emergency Room are relevant and considered as critical tests, avoiding overload of alarms or calls, which distract the busy medical team. Identification of critical values was based on consensus, guidelines and clinicians’ opinion. The practice was harmonized by automated notification systems and by establishing who should report critical values on an established time frame to the responsible licensed caregiver, so that the patient can be promptly treated. Timeliness was linked with clinical effectiveness with the aim
to provide the best outcome at the lowest cost. Finally, harmonization was directed to develop quality indicators regarding the policies of critical value communication, the monitoring of the timeliness in reporting and the need to evaluate how the effectiveness of improved communication assures better clinical outcomes. The realization of harmonized critical value notification may support the clinical decision making, leading to an improvement in patient safety and care.