Test Your Knowledge with Our Clinical Case Studies!
Clinical Chemistry 56: 417-423, 2010. First published December 29, 2009; 10.1373/clinchem.2009.135376
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
clinchem.2009.135376v1
56/3/417    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Parl, F. F.
Right arrow Articles by Shultz, E. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Parl, F. F.
Right arrow Articles by Shultz, E. K.
Related Collections
Right arrow Informatics and Statistics
(Clinical Chemistry. 2010;56:417-423.)
© 2010 American Association for Clinical Chemistry, Inc.

Informatics and Statistics

Implementation of a Closed-Loop Reporting System for Critical Values and Clinical Communication in Compliance with Goals of The Joint Commission

Fritz F. Parl1,a, Mandy F. O'Leary1, Allen B. Kaiser2, John M. Paulett3, Kristina Statnikova3 and Edward K. Shultz1,3

Departments of1 Pathology and 2 Internal Medicine and 3 Informatics Center, Vanderbilt University Medical Center, Nashville, TN.

aAddress correspondence to this author at: Clinical Chemistry Laboratory, Professor of Pathology, Department of Pathology, TVC 4918, Vanderbilt University Medical Center, Nashville, TN 37232. Fax 615-343-9563; e-mail fritz.parl{at}vanderbilt.edu.

Background: Current practices of reporting critical laboratory values make it challenging to measure and assess the timeliness of receipt by the treating physician as required by The Joint Commission’s 2008 National Patient Safety Goals.

Methods: A multidisciplinary team of laboratorians, clinicians, and information technology experts developed an electronic ALERTS system that reports critical values via the laboratory and hospital information systems to alphanumeric pagers of clinicians and ensures failsafe notification, instant documentation, automatic tracking, escalation, and reporting of critical value alerts. A method for automated acknowledgment of message receipt was incorporated into the system design.

Results: The ALERTS system has been applied to inpatients and eliminated approximately 9000 phone calls a year made by medical technologists. Although a small number of phone calls were still made as a result of pages not acknowledged by clinicians within 10 min, they were made by telephone operators, who either contacted the same physician who was initially paged by the automated system or identified and contacted alternate physicians or the patient’s nurse. Overall, documentation of physician acknowledgment of receipt in the electronic medical record increased to 95% of critical values over 9 months, while the median time decreased to <3 min.

Conclusions: We improved laboratory efficiency and physician communication by developing an electronic system for reporting of critical values that is in compliance with The Joint Commission’s goals.




The following articles in journals at HighWire Press have cited this article:


Home page
 Clin. Chem.Home page
P. Valenstein
Critical Communication
Clin. Chem., March 1, 2010; 56(3): 334 - 335.
[Full Text] [PDF]