The importance of hospital re-accreditation: improving the timeliness of laboratory critical value reporting

  • Wahyu Febrianto
  • Menis Rahmawati
  • I Gede Sastrawan
  • Tita Hariyanti
Keywords: re-accreditation, critical value, laboratory, patient safety, hospital

Abstract

Background: Patient safety is the main issue in healthcare services nowadays. Delaying to inform the critical value of laboratory results is a significant source of harm for the patient. The aim of this study is to compare the timeliness of laboratory critical value reporting before and after re-accreditation as one of the service quality indicators in Hospital X.

Methods: This study was done by using observational cross-sectional in Hospital X on January - February 2020 with total sampling method of critical value reporting to the responsible clinician that originated from Intensive Care Unit (ICU), Verlos Kamer (VK), and inpatient ward (IW) 1-6 from January-December 2019. The timeliness of reporting was counted since the laboratory result was obtained until received by the responsible clinician within £ 30 minutes and categorized as "On time" or "Late".

Results: During 2019, there were 816 reporting which has been done before re-accreditation (511) and after re-accreditation (305) with 17 kinds of tests. The most reported test was platelet with 349 (before re-accreditation) and 101 (after re-accreditation), whilst SGOT/SGPT and albumin were the fewest one. The lowest timeliness of reporting percentage was 76,00% (February), whilst the highest was 98,48% (November). The timeliness of reporting's percentage was 84,34% (before re-accreditation) and 94,43% (after re-accreditation). The statistical analysis result revealed Pearson Chi-Square correlation was 18,535 with significance 0,000 and 3,145 odds ratio which shows that re-accreditation could significantly increase the timeliness of critical value reporting three times.

Conclusion: This result showed that re-accreditation could affect the timeliness of laboratory critical value reporting to the responsible clinicians.

Keywords: re-accreditation, critical value, laboratory, patient safety, hospital

 

Abstrak

Latar belakang: Keselamatan pasien merupakan isu utama dalam pelayanan kesehatan. Tertundanya komunikasi hasil nilai kritis laboratorium merupakan sumber bahaya yang signifikan terhadap pasien. Penelitian ini bertujuan untuk membandingkan ketepatan waktu pelaporan nilai kritis laboratorium sebelum dan setelah reakreditasi sebagai salah satu indikator mutu di RS X.

Metode: Penelitian dilakukan dengan cara observasional dengan metode cross sectional di RS X pada Januari - Februari 2020 dengan total sampling laporan nilai kritis kepada Dokter Penanggung Jawab Pasien (DPJP) yang berasal dari ruang Intensive Care Unit (ICU), Verlos Kamer (VK), dan ruang rawat inap 1 – 6 sejak Januari – Desember 2019. Ketepatan waktu pelaporan dihitung sejak hasil pemeriksaan didapatkan hingga diterima oleh DPJP dalam waktu £ 30 menit dan dinyatakan sebagai "Tepat Waktu" atau "Terlambat".

Hasil: Selama tahun 2019, terdapat 816 pelaporan yang dilakukan sebelum akreditasi (511) dan setelahnya (305) dengan 17 jenis pemeriksaan. Pemeriksaan trombosit menjadi yang paling banyak dilaporkan yaitu 349 (sebelum akreditasi) dan 101 (setelah akreditasi), sedangkan SGOT/SGPT dan albumin menjadi yang paling sedikit. Persentase ketepatan waktu pelaporan paling rendah adalah 76,00% (Februari) sedangkan yang paling tinggi adalah 98,48% (November). Persentase ketepatan waktu pelaporan didapatkan 84,34% (sebelum akreditasi) dan 94,43% (setelah akreditasi). Hasil analisis statistik didapatkan korelasi Pearson Chi-Square 18,535 dengan signifikansi 0,000 dan Odds ratio 3,145 menunjukkan re-akreditasi mampu meningkatkan kemungkinan ketepatan waktu pelaporan nilai kritis sebesar tiga kali lipat.

Kesimpulan: Hal ini menunjukkan bahwa re-akreditasi mampu mempengaruhi ketepatan waktu pelaporan nilai laboratorium kritis kepada DPJP.

Kata kunci: re-akreditasi, nilai kritis, laboratorium, keselamatan pasien, rumah sakit.

References

WHO. Patient Safety [Internet]. Factsheet. 2019 [cited 2020 Jan 23]. p. 1. Available from: https://www.who.int/news-room/fact-sheets/detail/patient-safety

Kementerian Kesehatan. Keputusan Menteri Kesehatan Republik Indonesia tentang Pedoman Audit Medis di Rumah Sakit. Indonesia; 2005.

Lippi G, Mattiuzzi C. Critical laboratory values communication: Summary recommendations from available guidelines. Ann Transl Med. 2016;4(20):2–5.

KARS. Standar Nasional Akreditasi Rumah Sakit. 1st ed. KARS, editor. Standar Akreditasi Rumah Sakit. Jakarta: KARS; 2017. 421 p.

Kemenkes RI. Keputusan Direktur Jenderal Pelayanan Kesehatan Kementerian Kesehatan RI No.HK.02.03/I/2642/2016 Tentang Perubahan Keputusan Direktur Jenderal Pelayanan Kesehatan Kementerian Kesehatan RI No.HK.02.03/I/0147/2016 Tentang Indikator Kinerja Terpilih (IKT) Ta. Indonesia; 2016.

Desai KN, Chaudhari S. Analysis of Critical values in NABL (National Accreditation Board for Testing and Calibration Laboratories) accredited Hematology and Clinical Pathology laboratory. Ann Appl Bio-Sciences. 2017;4(1):A14–8.

Yang Z, Tan EH, Li Y, Lim B, Metz MP, Loh TP. Relative Criticalness of Common Laboratory Tests for Critical Value Reporting. J Clin Pathol. 2019;72(4):325–8.

Gyawali B, Ramakrishna K, Dhamoon AS. Sepsis: The evolution in definition, pathophysiology, and management. SAGE Open Med. 2019;7:205031211983504.

Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA - J Am Med Assoc. 2014;311(13):1308–16.

Li R, Wang T, Gong L, Dong J, Xiao N, Yang X, et al. Enhance the effectiveness of clinical laboratory critical values initiative notification by implementing a closed-loop system: A five-year retrospective observational study. J Clin Lab Anal. 2020;34(2):1–10.

Yang D, Zhou Y, Yang C. Analysis of Laboratory Repeat Critical Values at a Large Tertiary Teaching Hospital in China. PLoS One. 2013;8(3):11–4.

Arbiol-Roca A, Corral-Comesaña S, Cano-Corres R, Castro-Castro MJ, Dastis-Arias M, Dot-Bach D. Analysis of laboratory critical values at a referral Spanish tertiary university hospital. Biochem Med. 2019;29(1):1–11.

Özcan O, Çakırca G, Motor S, Yönden Z. Klinik laboratuvarlardan kritik değerlerin sorumlu sağlık personeline bildiriminde gözlenen gecikmeler. Turkish J Biochem. 2017;42(1):45–50.

Tursinawati Y, Ramaningrum G, Aprilia I. Laboratory Finding and Clinical Manifestation Affecting the Length of Stay of Hospitalization. Pros Semin Nas Int Muhammadiyah Univ Semarang. 2017;130–5.

Layfield LJ. Critical values: Has their time arrived for cytopathology? Cancer Cytopathol. 2014;122(3):163–6.

Liu VX, Fielding-Singh V, Greene JD, Baker JM, Iwashyna TJ, Bhattacharya J, et al. The timing of early antibiotics and hospital mortality in sepsis. Am J Respir Crit Care Med. 2017;196(7):856–63.

Sergi C. Promptly reporting of critical laboratory values in pediatrics: A work in progress. World J Clin Pediatr. 2018;7(5):105–10.

Özcan O, Çakırca G, Motor S, Yönden Z. Delays in Reporting Critical Values from Clinical Laboratories to Responsible Healthcare Staff. Turkish J Biochem. 2017;42(1):45–50.

Bhatia K, Bhatia P, Udari SN, Patil N. Study on laboratory critical value analysis in a multi-speciality hospital. MedPulse Int J Biochem. 2019;12(1):06–9.

Shawan D Al. The effectiveness of the joint commission international accreditation in improving quality at king fahd university hospital, saudi arabia: A mixed methods approach. J Healthc Leadersh. 2021;13:47–61.

Published
2021-12-16
How to Cite
Febrianto, W., Rahmawati, M., Sastrawan, I., & Hariyanti, T. (2021). The importance of hospital re-accreditation: improving the timeliness of laboratory critical value reporting. Health Science Journal of Indonesia, 12(2), 81-87. https://doi.org/10.22435/hsji.v12i2.3315
Section
Articles