Increasing the Effectiveness in Critical Value Notifications in Chemical Pathology, Hospital Teluk Intan

Syazana Jan Shari; Nursyahirah Saleh; Nur Husna Shabaruddin

doi:10.56532/mjsat.v6i3.724

Authors

Syazana Jan Shari Pathology Department (Chemical Pathology Unit), Hospital Teluk Intan, Perak, Malaysia
Nursyahirah Saleh Pathology Department (Chemical Pathology Unit), Hospital Teluk Intan, Perak, Malaysia
Nur Husna Shabaruddin Pathology Department (Chemical Pathology Unit), Hospital Teluk Intan, Perak, Malaysia

DOI:

https://doi.org/10.56532/mjsat.v6i3.724

Keywords:

Critical value notification, Clinical audit, Laboratory quality assurance

Abstract

Objective: This clinical audit aimed to improve the communication of critical laboratory results in the Chemical Pathology Unit, Hospital Teluk Intan. Timely communication of critical laboratory results is essential for timely clinical interventions to reduce patient morbidity and mortality. Method: The audit was conducted from November 2023 to August 2024 in the Integrated Laboratory, Hospital Teluk Intan. It focused on five critical test parameters— sodium, potassium, calcium, bilirubin (paediatrics) and ammonia (paediatrics)— according to Ministry of Health (MOH) guideline (Lampiran A). Data was extracted monthly from the Laboratory Information System (LIS) and analyzed using Microsoft Excel. Results: A baseline audit (October–November 2023) revealed the notification rates and the common causes of failures. Based on these findings, interventions were implemented, including issuing memos on the forms completeness, introducing standard notification procedures, continuous medical education (CME) and enhanced documentation. A re-audit from December 2023 to August 2024 evaluated the effectiveness of these changes. The initial data showed that only 70–71.6% of critical values were successfully notified. Key barriers included incomplete request forms, unanswered phone lines and lack of staff awareness. Post-intervention analysis demonstrated significant improvement, with notification rates consistently rising above 90%, reaching 98.8% by July 2024. Conclusion: These improvements showed that staff are more compliant and have better system efficiency. Structured interventions, including standardized procedures, education and improved communication protocols, have significantly increased notification rates for critical values. The audit underscores the importance of continuous monitoring, staff training and clear guidelines in ensuring patient safety and effective laboratory practices.

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