Modern clinical laboratories have dramatically improved instrument performance and testing procedures, ensuring accuracy and precision through vigorous quality management, yet “many labs continue to repeat critical results prior to reporting them out,” which adds to lab costs and delays results, increasing chances of patient harm, writes Sihe Wang, PhD, DABCC, FAACC, director of clinical laboratories at Akron Children’s Hospital in Akron, Ohio, in the Bench Matters column of April’s Clinical Laboratory News.
At the Cleveland Clinic, where Wang served as head of the section of clinical biochemistry, the policy had been to repeat testing prior to reporting out critical results, provided that no quality issues were found with a specimen. However, some thought this repeat step might slow the process of notifying caregivers about critical results. To decide which route to take, a team of researchers led by Melissa Zimmer, BS, conducted a retrospective study, focusing on glucose and potassium measurements in the Cleveland Clinic’s automated clinical chemistry laboratory, two areas that produced the lion’s share of critical results.
“In our study, we randomly selected critical values and the corresponding repeat results for glucose and potassium tests, all performed on a Roche Diagnostics cobas c 702 analyzer,” writes Wang. Based on its observations, the team concluded that the lab’s high performance instruments and quality assurance programs negated the need for repeat testing for critical values prior to releasing the results.
“Eliminating this unnecessary step allowed our laboratorians to reach out more rapidly to our clinicians, thereby enabling them to respond more promptly to the critical values,” concludes Wang.
Pick up April’s CLN to get more details on this important study that analyzed the value of repeating critical test results.