Maria Isabel Llovet1, Carmen Biosca2, Alicia Martínez-Iribarren2, Aurora Blanco3, Glòria Busquets4, María José Castro3, Maria Antonia Llopis2, Mercè Montesinos4, Joana Minchinela2, Carme Perich5, Judith Prieto6, Rosa Ruiz7, Núria Serrat8, Margarita Simón9, Alex Trejo10, Josep Maria Monguet11, Carlos López-Pablo12, Mercè Ibarz6. 1. Medical Laboratory ICS Terres de l'Ebre, Hospital Verge de la Cinta, C/Esplanetes, 14, 43500 Tortosa, Spain. 2. Medical Laboratory ICS Barcelonés Nord i Vallès Oriental, Badalona, Spain. 3. Medical Laboratory Universitary Hospital Bellvitge, Barcelona, Spain. 4. Medical Laboratory ICS Girona, Girona, Spain. 5. Medical Laboratory Universitary Hospital Vall d'Hebron, Barcelona, Catalunya, Spain. 6. Medical Laboratory ICS Lleida, Lleida, Catalunya, Spain. 7. Medical Laboratory ICS L'Hospitalet, Barcelona, Spain. 8. Medical Laboratory ICS Camp de Tarragona, Tarragona, Spain. 9. Medical Laboratory Consorci Intercomarcal Anoia, Penedès i Garraf (CLI), Vilafranca del Penedes, Spain. 10. Onsanity Solutions S.L., Barcelona, Spain. 11. UPC Barcelona Tech., Barcelona, Catalunya, Spain. 12. Molecular Biology and Research Section Hospital Verge de la Cinta, Tortosa, Catalunya, Spain.
Abstract
BACKGROUND: There is no consensus in the literature about what analytes or values should be informed as critical results and how they should be communicated. The main aim of this project is to establish consensual standards of critical results for the laboratories participating in the study. Among the project's secondary objectives, establishing consensual procedures for communication can be highlighted. METHODS: Consensus was reached among all participating laboratories establishing the basis for the construction of the initial model put forward for consensus in conjunction with the clinicians. A real-time Delphi, methodology "health consensus" (HC), with motivating and participative questions was applied. The physician was expected to choose a numeric value within a scale designed for each analyte. RESULTS: The medians of critical results obtained represent the consensus on critical results for outpatient and inpatient care. Both in primary care and in hospital care a high degree of consensus was observed for critical values proposed in the analysis of creatinine, digoxin, phosphorus, glucose, international normalized ratio (INR), leukocytes, magnesium, neutrophils, chloride, sodium, calcium and lithium. For the rest of critical results the degree of consensus obtained was "medium high". The results obtained showed that in 72% of cases the consensual critical value coincided with the medians initially proposed by the laboratories. CONCLUSIONS: The real-time Delphi has allowed obtaining consensual standards for communication of critical results among the laboratories participating in the study, which can serve as a basis for other organizations.
BACKGROUND: There is no consensus in the literature about what analytes or values should be informed as critical results and how they should be communicated. The main aim of this project is to establish consensual standards of critical results for the laboratories participating in the study. Among the project's secondary objectives, establishing consensual procedures for communication can be highlighted. METHODS: Consensus was reached among all participating laboratories establishing the basis for the construction of the initial model put forward for consensus in conjunction with the clinicians. A real-time Delphi, methodology "health consensus" (HC), with motivating and participative questions was applied. The physician was expected to choose a numeric value within a scale designed for each analyte. RESULTS: The medians of critical results obtained represent the consensus on critical results for outpatient and inpatient care. Both in primary care and in hospital care a high degree of consensus was observed for critical values proposed in the analysis of creatinine, digoxin, phosphorus, glucose, international normalized ratio (INR), leukocytes, magnesium, neutrophils, chloride, sodium, calcium and lithium. For the rest of critical results the degree of consensus obtained was "medium high". The results obtained showed that in 72% of cases the consensual critical value coincided with the medians initially proposed by the laboratories. CONCLUSIONS: The real-time Delphi has allowed obtaining consensual standards for communication of critical results among the laboratories participating in the study, which can serve as a basis for other organizations.
Entities:
Keywords:
Delphi; benchmarking; clinical laboratory; consensus on critical values; critical results; health consensus