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Greeley Reflections

Accreditation Connection, July 27, 2009

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Critical test? Result? Critical test result—yes!

Part 2 of 4

The one issue that was misunderstood by so many of our clients was the distinction the goal required in a critical test and a critical result. This idiosyncrasy was often times missed completely and therefore found non-compliant.

The proposed changes to this NPSG bring the focus back to where it belonged to begin with: the patient. The goal’s previous seven requirements have been reduced to two. The proposed changes now reflect the reporting of critical results.

Review the list:

• Assemble a team of each of the areas needing representation. Ensure the medical staff is kept aware of the changes being proposed. Keep it simple!
• Define which of those results are considered critical. According to Merriam-Webster’s online dictionary, the definition of critical is “being or relating to an illness or condition involving danger of death.”
• Using this definition should assist you in refining your list. All results of a patient test or diagnostic procedure should be reviewed and placed into context with the current health and disease process of the process. However, not all of these results can be considered a marker indicating a danger of death however. Laboratory “panic values” are appropriately titled; however, providers of care will agree that a panic value, while needing attention in a timely way, does not always indicate danger of death.
• Consider making critical results a subset of the panic values that require a higher level of reporting priority. Remember to address those certain situations in which results that would be “critical” for most patients are not critical for a particular patient or for patients with a particular diagnosis. Also, improving results can be handled differently as well. This makes sense!
• Apply the same to diagnostic test results.

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