Implementation of criteria for automatic release of clinical chemistry test results in a laboratory at an academic public hospital

Abstract

Introduction: Autoverification is the release of laboratory test results from clinical instruments to hospital interface, or to patients' records, with no human intervention. Verification rules are inserted in the middleware and/or in the laboratory information system (LIS), based on criteria established by the laboratory. As a result, it ensures that every result is consistently reviewed in the same way, improving the entire verification process and patient safety. Objective: Describe the implementation of autoverification of clinical chemistry tests results at the core laboratory of Hospital das Clínicas da Universidade Federal de Minas Gerais (HC/UFMG), Brazil. Material and methods: Twenty-six automated chemistry assays were chosen. They were fully automated including internal quality control, interfaced with LIS, available 24 hours a day, seven days a week. Rules were set up in the middleware and in the LIS. Instrument flags, evaluation of sample integrity, test linearity, delta check and critical values were used to construct the verification algorithms. Results: An autoverification algorithm was constructed; delta check values were calculated and defined, as well as automatic verification ranges. The results retained for manual verification followed a flowchart prepared for this purpose. Conclusion: Autoverification implementation led to a more consistent reviewing process of test results, efficiency and improved patient safety.