Prevalence and Clinical Utility of "Incidental" Critical Values Resulting From Critical Care Laboratory Testing.

Abstract:

OBJECTIVE:Panels of clinical laboratory testing may generate "incidental" critical values from unordered parameters. Existing regulations do not clearly delineate guidelines for handling incidental critical values. The objective of this study was to examine the patterns and clinical utility of incidental critical values at 2 critical care laboratories within an academic medical center. METHODS:In this retrospective study, the electronic health record and laboratory information system were reviewed for incidental critical results obtained from blood gas analyzer analysis of whole blood specimens between November 2010 and August 2014. RESULTS:Within the retrospective time period, 9,092 incidental critical results were documented, of which only 11.8% were added to the "parent" order following clinical notification. Incidental critical results frequently occurred in patients who had recent critical values for the same parameter. CONCLUSION:In this study, at an academic medical center, incidental critical values associated with blood gas analyzers were added on at a low rate and often provided redundant information. Relative to the manual effort involved in care providers' notification and documentation of results, incidental critical values appear to have low clinical utility.

journal_name

Lab Med

journal_title

Laboratory medicine

authors

Grieme CV,Voss DR,Olson KE,Davis SR,Kulhavy J,Krasowski MD

doi

10.1093/labmed/lmw044

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

338-349

issue

4

eissn

0007-5027

issn

1943-7730

pii

lmw044

journal_volume

47

pub_type

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