Analysis of Laboratory Critical value Reporting Pattern at clinical biochemistry laboratory of Tertiary health care Center.

Abstract

Objectives: Objective of the study is to analyze critical value reporting data to find frequency of critical reporting, distribution of critical values across reportable range and across hospital segments and reasons for failure in critical reporting.
Material and Method: The critical value reporting data for various analysts were collected from LIS for 1 year. The data were analyzed in computer spreadsheets.
Result and Discussion: Of 548786 test results analyzed, about 10% results were critical. Total Billirubin (20.14 %), Indirect Billirubin (18 %), Glucose (18%) and Sodium (13.6 %),Potassium (11.8%) contributed most to the critical values. 29% of urea, 13.29 % of Glucose ,15.37% of Indirect Billirubin, 13.71% of Sodium, 13.29% of Glucose and 11.6 % of total analyzed potassium were critical. On a per test basis, inpatient tests were 3.6 times more likely to result in a critical callback than outpatient tests. The number of critical values per year per bed was 176.34 for ICU beds and 29.36 for non-ICU beds and 5.0 for Emergency Department.
Conclusion: The high proportion of reported critical value of urea is due to practice of reflex testing in the laboratory whenever Creatinine is in abnormal range. The high proportion of reported critical value of Indirect Billirubin is due to present of PICU, NICU in Hospital. Major reasons for failure of notification of critical alert are incomplete detail on request form, transfer of patient to Ward or ICU, phone is engaged or phone not picked up by care giver.