Harmonization of critical values across the GTA hospitals


The project team

Felix Leung (Chair), Mount Sinai Hospital

Saranya Arnoldo, William Osler Health System

Daniel Beriault, St. Michael’s Hospital, Unity Health Toronto

Davor Brinc, Toronto General Hospital, University Health Network (UHN)

Sarah Delaney, St. Michael’s Hospital, Unity Health Toronto

Elaine Goh, Trillium Health Partners

Matthew A. Lafrenière, Sunnybrook Health Sciences Centre


Critical values aid in the interpretation of patient test results.

Harmonization of critical values used by hospitals and their associated clinical laboratories across the GTA is essential to ensure consistency in the definition and identification of 'critical state' patients.

To assess the feasibility for harmonization of critical values across GTA, we are surveying Laboratory Medicine departments of hospitals in areas of:

  • Genetics
  • Chemistry
  • Hematology
  • Pathology

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Latest guidelines from the Harmonization of critical values working group

View an update from the project team

We held a workshop on May 5, 2021, covering an update and discussion on the project, presented by Dr. Elaine Goh and Dr. Felix Leung.

Other available guidelines

GP47 Management of Critical- and Significant-Risk Results, 1st Edition

This guideline provides current best practice recommendations for developing and implementing a policy and procedures for the identification, reporting, and management of critical- and significant-risk laboratory results.

It emphasises management responsibilities such as development of the policy, the process, procedures, job descriptions, and monitoring systems that ensure effective reporting and compliance with regulatory requirements.

Relevant publications for further information

Establishing, harmonizing and analyzing critical values in a large academic health center. Hashim IA, et al. Clin Chem Lab Med 2014;52(8):1129-35. doi: 10.1515/cclm-2014-0029. PMID: 24622791.

Critical risk results – an update on international initiatives. Lam Q, et al. eJIFCC. 2016;27(1):66-76. PMID: 27683507.

Laboratory critical values policies and procedures: a College of American Pathologists Q-Probes Study in 623 institutions. Howanitz PJ, et al. Arch Pathol Lab Med. 2002;126(6):663-9. doi: 10.1043/0003-9985(2002)126<0663:LCVPAP>2.0.CO;2. PMID: 12033953.

Harmonization of critical result management in Laboratory Medicine. Campbell CA, et al. Clin Chim Acta. 2014;432:135-47. doi: 10.1016/j.cca.2013.11.004. PMID: 24246790.

No upcoming events were found.

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