Table 3 Participants’ Practices and Attitude Towards Critical Value Reporting

Communicate critical values immediately upon their identification

51

(83.6)

80

(92.0)

144

(93.5)

86

(86.9)

140

(95.9)

.036

501

(91.6)

Person responsible for making the call^†

 Senior staff

15

(23.1)

54

(59.3)

73

(46.8)

43

(43.0)

79

(53.4)

 < .001

264

(47.1)

 Laboratory technician

16

(24.6)

70

(76.9)

97

(62.2)

67

(67.0)

102

(68.9)

 < .001

352

(62.9)

 Others

41

(63.1)

19

(20.9)

22

(14.1)

24

(24.0)

32

(21.6)

 < .001

138

(24.6)

 No answers

5

(7.7)

3

(3.3)

3

(1.9)

4

(4.0)

1

(0.7)

.053

16

(2.9)

Person who receives the call^†

 Physicians ordering the test

42

(64.6)

57

(62.6)

92

(59.0)

52

(52.0)

114

(77.0)

.001

357

(63.7)

 Nurses

25

(38.5)

72

(79.1)

73

(46.8)

59

(59.0)

110

(74.3)

 < .001

339

(60.5)

 Any physician on call

28

(43.1)

42

(46.2)

40

(25.6)

39

(39.0)

82

(55.4)

 < .001

231

(41.3)

 Any people working on the ward

7

(10.8)

11

(12.1)

14

(9.0)

15

(15.0)

9

(6.1)

.201

56

(10.0)

 Others

4

(6.2)

6

(6.6)

7

(4.5)

2

(2.0)

3

(2.0)

.252

22

(3.9)

 No answers

5

(7.7)

1

(1.1)

3

(1.9)

5

(5.0)

1

(0.7)

.021

15

(2.7)

Critical values are reported to the caregiver mainly by^†

 Sending test report to ward

28

(43.1)

36

(39.6)

36

(23.1)

33

(33.0)

22

(14.9)

 < .001

155

(27.7)

 Telephone

40

(61.5)

57

(62.6)

95

(60.9)

55

(55.0)

121

(81.8)

 < .001

368

(65.7)

 Computer

11

(16.9)

34

(37.4)

49

(31.4)

54

(54.0)

57

(38.5)

 < .001

205

(36.6)

 Direct contact with requesting physician

34

(52.3)

20

(22.0)

74

(47.4)

33

(33.0)

34

(23.0)

 < .001

195

(34.8)

 Fax

0

(0.0)

0

(0.0)

1

(0.6)

1

(1.0)

0

(0.0)

.855

2

(0.4)

 All tools

10

(15.4)

28

(30.8)

15

(9.6)

24

(24.0)

14

(9.5)

 < .001

91

(16.3)

 No answers

8

(12.3)

1

(1.1)

2

(1.3)

1

(1.0)

1

(0.7)

 < .001

13

(2.3)

Wireless technologies used to report critical values

18

(29.5)

31

(35.2)

52

(34.2)

42

(43.8)

36

(25.0)

.032

179

(33.1)

Re-testing for critical values verification

49

(80.3)

81

(92.0)

152

(97.4)

79

(79.8)

141

(96.6)

 < .001

502

(91.3)

In sample re-testing, the person responsible for drawing the sample contacted to verify the validity of drawing the sample

25

(43.1)

51

(61.4)

102

(66.7)

55

(59.1)

77

(53.5)

 < .001

310

(58.4)

In case of handling repeat critical values from the same patient, the usual practice is to:

 < .001

 Report initial critical value and all subsequent critical values, regardless of previous results

25

(49.0)

36

(42.4)

59

(41.0)

36

(40.0)

68

(51.5)

224

(44.6)

 Report worsening values, values that were "grossly different" from previous values, and values that moved in and out

5

(9.8)

29

(34.1)

23

(16.0)

27

(30.0)

37

(28.0)

121

(24.1)

 Report repeated critical values once per interval of time

21

(41.2)

20

(23.5)

62

(43.1)

27

(30.0)

27

(20.5)

157

(31.3)

Reported critical laboratory values are documented:^†

 In the computer system

15

(23.1)

31

(34.1)

56

(35.9)

38

(38.0)

45

(30.4)

.276

185

(33.0)

 Written on the result form

8

(12.3)

19

(20.9)

24

(15.4)

12

(12.0)

21

(14.2)

.457

84

(15.0)

 Documented in the laboratory register

14

(21.5)

23

(25.3)

45

(28.8)

19

(19.0)

30

(20.3)

.311

131

(23.4)

 All of the above

39

(60.0)

43

(47.3)

73

(46.8)

48

(48.0)

84

(56.8)

.197

287

(51.2)

 It is not documented

0

(0.0)

2

(2.2)

0

(0.0)

2

(2.0)

1

(0.7)

.205

5

(0.9)

 No answers

6

(9.2)

1

(1.1)

4

(2.5)

0

(0.0)

3

(2.0)

.010

14

(2.5)

In case of documenting verbal communication on a log, the following is included:^†

 Identification of patient

13

(20.0)

28

(30.8)

65

(41.7)

37

(37.0)

33

(22.3)

.001

176

(31.4)

 Identification of sender

3

(4.6)

7

(7.7)

14

(9.0)

11

(11.0)

9

(6.1)

.521

44

(7.9)

 Identification of recipient (person receiving the report)

6

(9.2)

19

(20.9)

31

(19.9)

23

(23.0)

22

(14.9)

.139

101

(18.0)

 Critical test result reported

10

(15.4)

20

(22.0)

53

(34.0)

19

(19.0)

21

(14.2)

 < .001

123

(22.0)

 Date and time of reporting

11

(16.9)

22

(24.2)

51

(32.7)

25

(25.0)

31

(20.9)

.074

140

(25.0)

 All information

31

(47.7)

47

(51.6)

55

(35.3)

47

(47.0)

99

(66.9)

 < .001

279

(49.8)

 No answers

16

(24.6)

6

(6.6)

25

(16.0)

7

(7.0)

5

(3.4)

 < .001

59

(7.9)

The time from result availability to the responsible caregiver notification is measured

39

(63.9)

60

(69.0)

112

(75.7)

65

(69.1)

111

(76.0)

.025

387

(72.2)

Reasons for delay in reporting critical values:^†

 Getting someone to accept the results

20

(30.8)

49

(53.8)

48

(30.8)

21

(21.0)

30

(20.3)

 < .001

168

(30.0)

 Reporting critical values to the physician responsible for the patient

15

(23.1)

46

(50.5)

52

(33.3)

16

(16.0)

23

(15.5)

 < .001

152

(27.1)

 Knowing the name of the assigned physician

7

(10.8)

29

(31.9)

19

(12.2)

12

(12.0)

30

(20.3)

.001

97

(17.3)

 Provider contact information is not available

24

(36.9)

54

(59.3)

48

(30.8)

39

(39.0)

73

(49.3)

 < .001

238

(42.5)

 The person receiving the result is unwilling to read it back to ensure that it is correct

5

(7.7)

14

(15.4)

15

(9.6)

10

(10.0)

24

(16.2)

.294

68

(12.1)

 List of critical values is too long

0

(0.0)

5

(5.5)

6

(3.8)

2

(2.0)

4

(2.7)

.450

17

(3.0)

 Reporting critical results disrupts the workflow

0

(0.0)

19

(20.9)

8

(5.1)

6

(6.0)

12

(8.1)

 < .001

45

(8.0)

 Discharged patients at the time of reporting the result

11

(16.9)

41

(45.1)

49

(31.4)

35

(35.0)

51

(34.5)

.046

187

(33.4)

 There are no difficulties

15

(23.1)

4

(4.4)

36

(23.1)

33

(33.0)

28

(18.9)

 < .001

116

(20.7)

 No answers

17

(26.2)

7

(7.7)

14

(9.0)

8

(8.0)

12

(8.1)

.001

58

(10.4)

There is a delay in reporting critical laboratory values

4

(7.0)

22

(25.9)

31

(20.8)

12

(12.6)

29

(21.0)

.112

98

(18.7)

Satisfied with the way a staff would report critical laboratory values

42

(73.7)

75

(86.2)

132

(86.8)

81

(84.4)

129

(93.5)

.002

459

(86.6)

The average time from result availability to the responsible caregiver notification in each of the following shifts

 Morning shift

  Range

0 – 600

10 – 4320

0 – 120

5 – 2880

0 – 1440

0 – 4320

  Mean ± SD

150.21 ± 760.53

153.13 ± 760.53

26.89 ± 28.66

303.54 ± 795.09

78.08 ± 250.62

.048

104.55 ± 408.16

  Median

120

10

30

60

30

30

 Evening shift

  Range

0 – 2880

10 – 60

0 – 120

5 – 120

0 – 1440

0 – 2880

  Mean ± SD

447.5 ± 765.82

19 ± 15.94

19.58 ± 27.08

61.25 ± 46.11

77.28 ± 250.43

 < .001

94.44 ± 317.18

  Median

120

10

10

30

30

30

 Night shift

  Range

0 – 120

10 – 60

0 – 120

5 – 120

0 – 1440

0 – 1440

  Mean ± SD

83.21 ± 51.8

18.33 ± 14.99

21.94 ± 29.8

61.25 ± 46.11

77.28 ± 250.43

.389

60.36 ± 191.45

  Median

120

10

5

30

30

30