Open AccessEnhance the effectiveness of clinical laboratory critical values initiative notification by implementing a closed‐loop system: A five‐year retrospective observational study
Author(s) -
Li Runqing,
Wang Tengjiao,
Gong Lijun,
Dong Jingxiao,
Xiao Nan,
Yang Xiaohuan,
Zhu Dong,
Zhao Zhipeng
Publication year - 2020
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.23038
Subject(s) - medicine , beijing , notification system , medical emergency , receipt , observational study , emergency medicine , computer science , china , computer network , world wide web , political science , law
Background Accurate and timely clinical laboratory critical values notification are crucial steps in supporting effective clinical decision making, thereby improving patient safety. Methods A closed‐loop laboratory critical value notification system was developed by a multidisciplinary team of clinicians, laboratorians, administrators, and information technology experts. All the laboratory critical values that occurred at Beijing Tsinghua Changgung Hospital (BTCH, Beijing, China) from 2015 to 2019 were analyzed and studied retrospectively. Results The total number (ratio) of institutional laboratory critical values to all reported items at BTCH from 2015 to 2019 was 38 020/7 706 962 (0.49%). Percentage distribution points of critical value boundaries based on patients’ test reports are 0.007% ~ 6.04% for low boundaries and 71.70% ~ 99.99% for high boundaries. After the intervention, the timely notification ratio, notification receipt ratio, and timely notification receipt ratio of critical values of ED, IPD, and total patients had increased, with a significant difference ( P < .001). Five quality indicators, such as notification ratio, timely notification ratio, notification receipt ratio, timely notification receipt ratio, and clinician response ratio over a 5‐year period, were 100%, 94%, 97%, 92%, and 99%, respectively. Conclusions We enhanced the effectiveness of clinical laboratory critical values initiative notification by implementing a closed‐loop system and intervening. Clinical critical values and quality indicators should be analyzed and monitored to avoid adversely affecting patient care.