Alert value reporting: a new strategy for patient safety.

OBJECTIVES: The objectives of this study are to introduce the "alert value reporting" concept in primary care setting, to propose a list of chemistry and hematology alert limit tests that can be chosen for that strategy, to show how this notification procedure can be designed and established, and finally to evaluate the effectiveness and physicians' satisfaction regarding the proposed approach. In contrast to critical value reporting, alert value reporting would not allude to a result that may imply a life-threatening situation, but would indicate that an early diagnostic/therapeutic action would improve the patient's management and quality of life. DESIGN AND METHODS: A list of chemistry and hematology alert limit tests to be used for the strategy was agreed upon between laboratory professionals and general practitioners. Next, a retrospective 12-month study involving more than 1 million laboratory tests was made to check how many of these alert values would have been communicated if these theoretical alert values had been applied. A prospective analysis of every reported alert value during 6 months was carried out to assess the intervention effectiveness and the requesting physician's satisfaction with the new strategy.
RESULTS: The alert value reporting was successfully executed. 20% of the reported alert values motivated the decision to reschedule the next patient's appointment. 90% of physicians considered alert value reporting as an interesting strategy to be continued.
CONCLUSIONS: Alert value reporting strategy motivated changes in patient's management. Further studies are needed to test if this approach can contribute to enhance patient safety and decision-making.