Background: Critical value is an urgent notifiable result suggestive of immediate medical attention requirement within a defined timescale. Follow-up action reflects clinical effectiveness, patient safety and coordinated operational efficiency. To have an effective critical value reporting process, the organization must understand and address all the variables involved in the process. Aims and Objectives: To evaluate the perception of critical alerts and audit its implementation by lab staff and critical care team. Materials and Methods: Mixed method study design was conducted in a tertiary care hospital in two phases for a period of one year. First, perception about awareness of critical alerts by lab staff and critical care team were recorded. Second Implementation was audited at two different timeframes of all the notified critical alerts. All those participants unwilling to complete the questionnaire and/or not a part of immediate point of contact for critical alerts were excluded. Responses to questionnaire were exported to Microsoft Excel version 2105 to analyse for percentage frequency to describe the outcome of the study. Results: Although lab staff and critical care team were aware of critical alerts, there were major deficits in documentation. Auditing revealed 9.6% of critical results were not notified by lab staff. Subsequent retraining and re-auditing after six months revealed a decline in &lsquo;missed-out&rsquo; critical alert notifications. Conclusion: Majority of lab staff and critical care team were aware of critical value reporting process. Although, there was a gap in the critical alert notification, it improved with monitoring. Frequent retraining and monitoring would be needed for continuous implementation of critical care protocol.
Authors: Alam Arshad , Devanath Anitha , Prakash Shubha 
Published: November 2022

Background Critical value is an urgent notifiable result suggestive of immediate medical attention requirement within a defined timescale. Follow-up action reflects clinical effectiveness patient safety and coordinated operational efficiency. To have an effective critical value reporting process the organization must understand and address all the variables involved in the process.Aims and Objectives To evaluate the perception of critical alerts and audit its implementation by lab staff and critical care team.Materials and Methods Mixed method study design was conducted in a tertiary care hospital in two phases for a period of one year. First perception about awareness of critical alerts by lab staff and critical care team were recorded. Second Implementation was audited at two different timeframes of all the notified critical alerts. All those participants unwilling to complete the questionnaire andor not a part of immediate point of contact for critical alerts were excluded. Responses to questionnaire were exported to Microsoft Excel version 2105 to analyse for percentage frequency to describe the outcome of the study.Results Although lab staff and critical care team were aware of critical alerts there were major deficits in documentation. Auditing revealed 9.6 of critical results were not notified by lab staff. Subsequent retraining and re-auditing after six months revealed a decline in lsquomissed-outrsquo critical alert notifications.Conclusion Majority of lab staff and critical care team were aware of critical value reporting process. Although there was a gap in the critical alert notification it improved with monitoring. Frequent retraining and monitoring would be needed for continuous implementation of critical care protocol.