Define the list, then defend it
The critical-value list — which analytes, at which thresholds — is a medical decision made once by committee, not per-shift by whoever is on the bench. Published, it removes ambiguity at 2 am.
Acknowledgement, not notification
A result faxed, messaged, or told to “someone on the ward” is not communicated. The loop closes when a named clinician acknowledges by name, and the log records who, when, and what was read back.
| Item | Standard | Consequence / owner |
|---|---|---|
| Critical list | Committee-defined thresholds | Published, versioned |
| First contact | Treating clinician, direct | Within minutes |
| Read-back | Value repeated, recorded | Log entry |
| Silence escalation | Next name, automatically | Defined ladder |
| Monthly review | Misses and near-misses | Quality meeting |
Escalate on silence
No acknowledgement within the defined window triggers the next contact automatically: registrar, consultant, duty officer. The protocol’s value is precisely that it does not depend on the night technician’s persistence.
What to do on Monday
- Ratify the critical list with the committee.
- Add read-back and named acknowledgement to the log.
- Define the silence window and the next-name ladder.
Worked examples on this page are illustrative arithmetic on stated assumptions, not measured market statistics.