CRITICAL VALUE NOTIFICATION PROCESS IN THE HEMATOLOGY LABORATORY OF A TRAUMA CARE SET UP

Abstract

Introduction: In order to improve the critical value notification (CVN) in our hematology laboratory of a busy trauma care set up, the study was planned with an aim of evaluating and improving the critical value notification process using the principles of Quality Improvement. Settings and Design: The pre-test/post-test intervention study was conducted in the hematology laboratory of a trauma care set up over three months by undertaking three Plan-Do-Check-Act (PDCA) cycles. Materials and Methods: In the pre-intervention phase, process mapping and fish bone analysis were done to identify barriers for CVN. Barrier specific solutions were proposed, discussed and implemented. CVN rate was calculated in all phases and process improvement was measured. For the perspective of the medical technologists, a feedback form was circulated. SQUIRE guidelines were followed to write the manuscript. Statistical analysis: Descriptive data in frequency and percentages. Results: QI team achieved the goal within the time frame successfully. Rate of critical value notification improved from 2.8% in the pre-intervention phase to 68.1% in the post-intervention phase. CVN rates were highest for ICU and emergency area. Abnormal platelet count was the most commonly (42%) notified parameter. Busy telephone line was the most prominent barrier for CVN in our set up. All the medical technologists unanimously believed that CVN is a good laboratory practice, and they and their colleagues give due importance to it. Conclusions: The principles of quality improvement proved effective to improve critical value notification in a highly demanding trauma care set up. It can be further boosted with administrative and clinician support.