Haematology critical values: Cross-sectional analysis and insights

Objectives: The laboratory critical value (CV) reporting has gained significance in recent times due to national and international focus on patient safety. International Organization for Standardization (ISO) 15189: 2012 has accepted CV notification (CVN) as an essential part of accreditation in medical laboratories. Hence, the present study was conducted to document the CVs and analyse clinician satisfaction of CVN. Material and Methods: This study was a cross-sectional, descriptive, observational and analytical study design for the period of one year (Jan 2024 to Dec 2024). The parameters considered critical are haemoglobin, platelet count and white blood cell count (WBC) as per the standard operating procedure (SOPs) followed in Sri Devaraj Urs medical college. A test result that was significantly outside the normal range and that required immediate communication was considered as a “CV”. CVs were communicated to the clinicians within 30 mins of reporting. All the CVs were documented. A survey was conducted to analyse the satisfaction of clinicians over haematology CVN. Results: Among 90,717 haematology samples analysed, 4,408 were classified as critical values, representing 4.8%. The highest CVs were received from the medicine department, 2362 (53.5%), followed by the paediatric department, 750 (15.16%). The analytes most notified CV was haemoglobin, 2476 (2.73%) followed by platelets, 1727 (2.27%) and WBCs, 166 (0.22%). Conclusion: Most CVs were reported from the Department of Medicine, with adults forming the largest affected age group. Implementation of the CVN system facilitated timely communication of life-threatening laboratory results, enabling early clinical intervention and improving patient outcomes in critical care settings.