Improving Critical Reports Notification and Turnaround Time Experience from a Tertiary Level Government Clinical Laboratory in North India

Background & Objective: A significant percentage of clinical decisions rely on laboratory test results. An accurate and timely reporting of critical values of laboratory tests is crucial in supporting effective clinical decision-making, thereby improving patient safety. The main objective of the study was to improve the existing system of critical value reporting for which an intervention was planned after understanding the problem of delayed turnaround time (TAT). Methods:The study was performed over three months, to monitor the existing system of critical values reporting. Thereafter interventions were made; modifying settings in the computer program and introducing a critical value software flagging alert system to identify them at an early stage. Additionally, an observational checklist was made for proper recording and communication. This was followed by monitoring the change and looking for improvisation. Later this data was statistically analyzed and comparedResults:In June, 141 critical reports were recorded and 108 were notified (76.6%). It was observed that the reported critical values had a very high TAT in June, the average TAT being 6 hours. However, in August 165 critical alert values were recorded and 100% were reported on the phone as critical values as soon as identified. TAT significantly reduced after the intervention. Post-intervention median TAT reduced to 1.5 hours in August. Conclusion:Implementation of critical value software flagging alert system improved critical reports notification and turnaround time.All laboratories must identify, monitor, record, and report the critical reports immediately to the clinician, facilitating timely action to manage the patient.