An urgent result needs an active handover
Some laboratory results may require immediate clinical attention. WHO’s Laboratory Quality Stepwise Implementation tool recommends an established system for notifying the requester promptly when results fall within agreed critical intervals. It also addresses continuing attempts when the initial contact fails and keeping a verifiable notification record. [1]
The system should be designed before a critical result occurs. Uploading a report to a portal alone may not establish that the responsible clinician has received the alert.
Agree on the clinical pathway
Critical limits should be appropriate to the test, patient group and service, with clinical consultation. [1] Copying an internet threshold table without considering the laboratory’s setting may create confusion.
Identify who is authorised to notify, whom to contact and what happens outside routine hours. Keep contact details current and establish escalation routes for unanswered calls.
Communicate the right information to the right person
My recommended handover identifies the patient, sample time, test, result, units and relevant limitations. Confirm that the recipient is the appropriate person for the patient and ask them to repeat the key details back where required by the communication procedure.
WHO reporting guidance emphasises verifying that the correct clinician receives and records the correct patient’s results. [2]
Make notification traceable
Document the communication time, the people involved, the information conveyed and unsuccessful contact attempts. If a corrected result is issued, make the revision and related communication clear.
The record should show what actually happened. An attempted call and a completed handover are different events and should be distinguishable.
Test the process in practice
Review a small sample of alerts to see whether the intended recipient was reached and where delays occurred. Use the findings to improve contact lists, escalation and staff training.
Critical result communication connects laboratory measurement with clinical action. A defined, rehearsed process helps prevent an urgent finding from becoming an unread report.
References
[1] World Health Organization. LQSI, immediate notification of urgent and critical results. Read source
[2] World Health Organization. LQSI, recording reporting and archiving results. Read source