Laboratory Operations, quick reference 10 of 10
10 / 10 · Laboratory Operations
Calling a critical result
Who to call, what to say, read-back, documentation, and escalation
Follow your laboratory's critical-result procedure: its alert limits, authorized recipients, timing, and escalation chain. Each laboratory sets its own critical-value list.1
1. Before the call
Match the result, patient identifiers, and specimen label. Check for hemolysis, lipemia, icterus, an unexpected clot, intravenous-fluid contamination, or the wrong tube. Follow the test's specimen requirements.2,3 See guide 08: Hemolysis, lipemia, and icterus. Follow local policy on repeating the test first. If the procedure allows an urgent preliminary call, identify the result as preliminary and explain what confirmation is pending.1
2. Who receives it, and when
Call immediately when a result meets a critical value on your laboratory's list. Reach the authorized person responsible for acting on it, as named by local policy, within its notification time. Identify the receiver before giving patient information.4
3. What to say
Give your name and laboratory, and confirm the receiver's name. State two patient identifiers, the test, the result with its unit, the specimen type, and its collection date and time.1,5
4. Read-back
Ask the receiver to record and read back both patient identifiers, the test, the result, and its unit. Listen to the whole read-back. Confirm it, or correct the mismatch and obtain another read-back before ending the call.5
5. What to record
Record the date and time, patient and specimen, test and result with its unit, receiver's name, your name, and confirmation that the read-back matched. Document the call as it happens.1,3,5
6. When no one answers
Use the laboratory's escalation chain when the responsible person cannot be reached within the required time. Record every attempt, its time, the contact sought, and the outcome. Continue until the receiver confirms receipt.1
7. When the result is questioned
Explain which checks are complete, which remain pending, and what the findings support. Describe relevant specimen or method limitations.4 Arrange the next step under local policy, such as a repeat or redraw.3 Involve the supervisor or pathologist when needed.1