Critical Value Matters: A Study of Critical Value Identification and Notification to Clinicians in the Hematology Section of the Pathology Laboratory at a Tertiary Care Hospital

Abstract

Objective: To analyze the critical value (CV) data in the hematology section of the laboratory

Methodology: A retrospective analysis of 5 months (June-October 2024). All consecutive samples (169,667) received for investigations were included. We aim to analyze the critical value data in the hematology section and compare the frequencies of critical values for various parameters, including Hemoglobin, White cell count, Platelet count, Malaria parasite infestation, Prothrombin time (PT), International normalized ratio (INR), and Activated partial thromboplastin time (APTT). The test requests were received from outpatient departments (OPDs), inpatient departments (IPD), and the emergency department (ER).

Results: Out 402 of the total critical values, 250 (62.1%) coagulation abnormalities, including prolonged prothrombin time (PT) & Activated partial thromboplastin (APTT) followed by 61(15.1%) were decreased platelet count, 52 (12.9%) were the malarial parasites on peripheral smears, 33(8.2%) reduced hemoglobin levels, 05(1.2%) deranged leucocyte count, 01(0.2%) leukemia. Critical values constituted 0.2% of the total test results reported. The mean total turnaround time (TAT) for all tests ranged from 1.3 to 2.1 hours. The success rate of critical result reporting within 1 hour was 25.3%

Conclusion: This study suggests that the mean TAT in this teaching hospital is slightly longer than the benchmark. Further research is needed to determine the causes of delays and develop interventions to solve this problem