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Standardization of haematology critical results management in adults: an International Council for Standardization in Haematology (ICSH) Survey and Recommendations

Authors & Contributors

T. B. Keng - B. De La Salle - G. Bourner - A. Merino - J-Y. Han - Y. Kawai - M. T. Peng - R. McCafferty

First Published

18 July 2016





These recommendations are intended to develop a consensus in the previously published papers as to which parameters and what values should be considered critical. A practical guide on the standardization of critical results management in haematology laboratories would be beneficial as part of good laboratory and clinical practice and for use by laboratory-accrediting agencies.


A working group with members from Europe, America, Australasia and Asia was formed by International Council for Standardization in Haematology. A pattern of practice survey of 21 questions was distributed in 2014, and the data were collected electronically by Survey Monkey. The mode, or most commonly occurring value, was selected as the threshold for the upper and lower alert limits for critical results reporting.


A total of 666 laboratories submitted data to this study and, of these, 499 submitted complete responses. Full blood count critical results alert thresholds, morphology findings that trigger critical result notification, critical results alert list, notification process and maintenance of critical results management protocol are described.


This international survey provided a snapshot of the current practice worldwide and has identified the existence of considerable heterogeneity of critical results management.

The recommendations in this study represent a consensus of good laboratory practice. They are intended to encourage the implementation of a standardized critical results management protocol in the laboratory.

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