Dropped calls, Turnaround time and Document Retention Time: Crucial parameters to monitor the effective implementation of laboratory Critical alert policy for critically ill patients

Abstract

Context: Critical alert policy adopted under laboratory accreditation guidelines [1] and under the National Patient Safety Goals (NPSGs) has prioritized safe and timely communication of critical alert [2] so that immediate treatment can be done as soon as the sample showing critical value is communicated by the laboratory. Laboratories are burdened with the analysis of samples not only from emergency and intensive care units but also from outdoor and wards; require to frame a policy, which meets the need of the critical patients. Most of the studies conducted to analyze the effective implementation of the critical alert policy look at the tip of iceberg as the percentage of critical alerts reported by laboratory and the turn- around time. Aim: The present study was conducted to analyze the various components of critical alert policy framed by the laboratory under study. Setting and Design: Study was conducted at a tertiary care hospital in a NABL accreditation of laboratory running since 3 years. We assessed not only the policy and procedure documented and followed by the laboratory under study as laid down under the guidelines [1],[2] but also certain issue (Dropped calls), which are encountered during implementation of the critical alert policy and procedure. Statistical Analysis: Study was a retrospective, cross-sectional. Results: The outcome of the study highlighted the hidden component of the iceberg causing obstacle in implementation of the critical alert policy as increased dropped calls, the turnaround time of which till the writing of the manuscript was infinite. Moreover, short storage time of the document maintained by a laboratory as evidence of communication of critical alert to the caretaker by the hospital-based laboratory leaves the hospital with no evidence if required later on. Conclusions: Detecting and correcting hidden components of critical alert policy can lead to immediate attention and treatment of critical patients and prevent mortality and mortality on one hand and on the other hand the hospital that implements this system can be prevented from the burden of medico legal cases to an extent.