Timeliness in Notification of Critical Vascular Laboratory Test Results is Part of Quality Assurance

Abstract

Introduction

Regulatory and accrediting bodies, including Intersocietal Commission for the Accreditation of Vascular Laboratories, require a policy for timely notification of caregivers with potentially life-threatening or “critical” findings on vascular laboratory (VL) testing. However, the timeliness of notification with reference to VL tests is often not specified.

Objective

To audit all “critical” results as defined by our written policy requiring notification within 120 minutes of completion of a test.

Methods

The VL database, when queried for results between August 1, 2008, and December 31, 2009, showed that “critical” results constituted 6.1% (988/16,168) of all VL tests performed during that period. Reporting time was the time between test completion and contact with an appropriate caregiver. The type of test, indication, in or out-patient status, and after-hour or regular work hours testing was recorded during a separate focused audit.

Results

A focused audit performed during December 2009 showed 3.49% (31/888) of all tests reported as critical. The majority of critical results were abnormal venous studies (93.5%), performed in inpatients (61%), and during regular working hours (93.5%). The time to notification was a mean of 11.92 minutes (SD 9.51; range, 1–40 minutes).

Conclusions

Promptness of notification of “critical” VL results to caregivers must be part of an audit quality assurance program. A well-established protocol for communication and documentation of critical results must be instituted in all VLs.