Provider Forum
3rd May 2023
Out of Hours Reporting of Urgent and Abnormal Results
More recently, we have had a number of queries around Pathlabs criteria for dealing with abnormal or urgent results both during normal working hours and Out of Hours (between 5pm and 8am weekdays and on weekends).
Where results are outside agreed limits, there is a protocol to ensure results are accurately relayed to the health care practitioner.
This information should be applied to the first-time presentation of critical results (& critical results with worsening values & Delta check > 20 % change).
Critical results MUST be relayed to relevant health care practitionerwithin 1hr of result being available.
Depending on which departments, we have a strict criteria for those analytes being tested on whether they fall into one of the following categories for community requested samples;
Critical Limits
Any Abnormal Analyte results that fall into the Critical Limits are Phoned and Faxed/Emailed (depending on whether email process is setup in place of faxing for the practice).
Grossly Abnormal
Any Abnormal Analyte results that fall into the Grossly Abnormal Limits, that will not impact on the patients care pathway, are Faxed/Emailed (depending on whether email process is setup in place of faxing for the practice). Will be available at their practice for actioning if required.
During Normal General Practice Hours
Results falling outside the above limits (Critical Results) must be phoned (and faxed/emailed) immediately to the requesting doctor (or delegated nurse) and ideally the result brought to the attention of the charge person, where appropriate.
Phoned Results
(a) On answer of call, our staff are required to identify:
•Who you are.
•Service and department i.e. Pathlab, Haematology.
•What they intend to do. (Allowing time for provider to organise).
•The named person taking results.
(b) Before giving results, we positively identify patient by giving:
•Name, surname and forename.
•Date of birth or NHI number.
•Location / GP to who results are for, usually when phoning results to GP practice, external location.
•Investigations to be phoned i.e. FBC, INR etc.
(c) Our staff then state results of test 'X' from date sample taken:
(d) Staff will assure that these results have been accurately received e.g. by requesting values to be read back to yourself.
For Outside Normal General Practice Hours
• ALL critical results MUST be telephoned to the requesting clinician where-ever possible.
• All grossly abnormal results should be Faxed ASAP.
Procedure:
1. Telephone results to requesting Clinician (or GP practice).
2. If we are unable to make contact our staff will Telephone results to requesting GP via Mobile phone or Home phone.
3. If unable to reach the GP within 1 hour, we will try a practices afterhours service if one is available.
For Outside Normal General Practice Hours
4. If unable to make any contact with the Requesting Practitioner after 1hr and it is a critical result then:
• Our staff contact the Duty Pathologist – Ensuring all details are given to Pathologist (Patient name etc., together with results & potential contact phone number (After hour service / GP or Hospital AE phone number and 'hand over' issue.)
• From this point the Pathologist will follow up, reviewing the results and clinical information that has been supplied, then making a call as to whether the patient will require urgent medical intervention.
Please Note – a message maybe left on a clinicians cell phone stating:
- Who is call (e.g. Pathlab, Haematology)
- Patients NHI
- Critical result – noting parameter (e.g. Haemaglobin)
- Asking for a call back via Pathlab number and Extension Number
NOTE: All results will also be faxed to requesting clinician.