In phase 2 the biological reference interval are determined and documented for each examination performed by the laboratory. If applicable, alert/critical intervals are also established for certain examinations in consultation with clinicians. When the result of an examination falls within this interval the requester should immediately be notified before sending the final, official Result Report, as this has direct consequences for the way a patient must be treated.

This applies also to samples marked as urgent: the examination results of these samples must also be notified directly to the requester before sending the final official Result Report.

The laboratory has to implement a system that ensures that requesters are indeed immediately notified by an authorized staff member when examination results fall within critical intervals or are marked urgent. This system must also ensure that when the laboratory was not able to contact the requester with the first attempt, the laboratory keeps trying to contact the clinician until contact has been made (of course: this should not delay transmission of the official Result Report). It also needs to be verifiable that the results have indeed been transmitted to the requester.

Make an Immediate Notification Form. On this form the following details need to be filled-out:

• Patient details
• Requester details
• Sample collection date
• Examinations performed
• Critical result to be reported
• Signature for review and authorization of results
• Dates and times of attempts to contact the requester without success (proves that you have tried to contact the requester)
• Name of the laboratory staff member notifying the requester
• Date and time of the notification
• Signature of the staff member when the results have been notified to the requester

If no contact was made with the requester the last three points (name of laboratory staff member notifying the clinician, date and time of notification and signature of the staff member notifying the clinician) must not be filled-out. This way it is visible that the laboratory was not yet able to contact the requester and that it must continue with attempting to contact the requester.

The Immediate Notification Form will be an appendix of the SOP for Recording, Reporting and Archiving of Results that must be written later in phase 2.