Notification of Critical Results: A College of American Pathologists Q-Probes Study of 121 Institutions

Abstract

Abstract Context.—Hospital accreditors are placing increased emphasis on the timeliness with which critical laboratory results are reported to caregivers. Objective.—To measure the speed of critical result notification at a group of laboratories, identify factors associated with faster reporting, and place findings in the context of the time required to transport and test specimens and to correct critical abnormalities. Design.—Contemporaneous review of 3545 inpatient and emergency department critical result notifications in 121 laboratories enrolled in the College of American Pathologists Q-Probes program. Results.—The median laboratory required a median of 5 minutes for staff to notify someone about a critical result once testing was complete. Laboratories affiliated with smaller institutions (P = .01), rural laboratories (P = .001), and sites that called results before releasing them from the laboratory computer (P = .02) were able to notify caregivers more quickly. There was variation among institutions in the time it took to notify caregivers (interquartile range, 1.5–8 minutes). At the median facility, notification took place 56.5 minutes after the specimen had been collected. Conclusions.—The time required to notify caregivers of a critical laboratory result is a small proportion of the time taken to collect and test specimens or the time that has been reported for caregivers to correct abnormalities. Although failure to notify caregivers of critical results may represent an important patient safety vulnerability, the timeliness of laboratory notification is a minor contributor to total test turnaround time at most institutions.