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Objectives-This is the first systematic review of the effectiveness of barcoding practices for reducing patient specimen and laboratory testing identification errors. Design and Methods-The CDC-funded Laboratory Medicine Best Practices Initiative systematic review methods for quality improvement practices were used. Results-A total of 17 observational studies reporting on barcoding systems are included in the body of evidence; 10 for patient specimens and 7 for point-of-care testing. All 17 studies favored barcoding, with meta-analysis mean odds ratios for barcoding systems of 4.39 (95% CI: 3.05-6.32) and for point-of-care testing of 5.93 (95% CI: 5.28-6.67). Conclusions-Barcoding is effective for reducing patient specimen and laboratory testing identification errors in diverse hospital settings and is recommended as an evidence-based "best practice." The overall strength of evidence rating is high and the effect size rating is substantial. Unpublished studies made an important contribution comprising almost half of the body of evidence.

Objective-To conduct a systematic review of automatic notification methods and consider evidence-based recommendations for best practices in improving the timeliness and accuracy of critical value reporting.Results-196 bibliographic records were identified, with nine meeting review inclusion criteria. Four studies examined automated notification systems and five assessed call center performance. Average improvement from implementing automated notification systems is d = 0.42 (95% CI = 0.2 -0.62) while the average odds ratio for call centers is OR = 22.1 (95% CI = 17.1 -28.6).Conclusions-The evidence, though suggestive, is not sufficient to make a recommendation for or against using automated notification systems as a best practice to improve the timeliness and accuracy of critical value reporting in an in-patient care setting. Call centers, however, are effective in improving the timeliness and accuracy of critical value reporting in an in-patient care setting, and are recommended as an "evidence-based best practice." KeywordsClinical laboratory information systems; critical care methods; hospital laboratory organization and administration; medical laboratory personnel organization and administration Corresponding Author: Edward Liebow, Battelle Centers for Public Health Research and Evaluation, 1100 Dexter Ave N, Suite 400, .6683, liebowe@battelle.org. Human Subjects ProtectionNo human subjects research was conducted for the purposes of the findings reported here. The attention directed towards improvements for critical value notification is driven by the assumption that timely reporting will lead to timely clinical interventions and corresponding secondary prevention of co-morbidities and more effective treatment outcomes. Despite the number of entities interested in improving critical value reporting, evidence has been lacking concerning which practices are effective at achieving these improvements. HHS Public AccessImplementing an effective critical value reporting system is concomitantly complex ( Figure 1 Quality Gap: Manual Notification of Critical ValuesThe standard notification mode in most healthcare facilities includes a manual process of contacting clinicians, connecting them to the laboratory, and conveying critical results verbally. When contact is not successfully completed, escalation procedures are followed, based on routing rules and procedures relevant to the indications for testing, the clinician who ordered the test, attending clinicians, and finally, supervising clinicians. This is often a time-consuming practice that diverts the laboratorian's attention from other laboratory work, frequently results in the handoff of information to an intermediary, and creates opportunities for transfer errors and reporting delays. Alternative mechanisms that have been instituted to replace the standard laboratory phone contact efforts include the use of automated notification systems and call centers (also known as "customer service centers"). Practice Descriptions MethodsThis evidence review ...