Templates › Inspections › SEO page

Run: Critical Lab Value Notification Audit

Audit critical lab value notifications for timeliness, read-back, and provider acknowledgment. Use it to verify closed-loop communication and catch documenta...

Fill this out, get a PDF emailed to you. No account required. Want to run it with your team and track results? Sign up free →

Audit Context

Audit date and time recorded

Specimen or accession number documented critical (required)

Ordering location or service identified

Critical value policy or SOP referenced

Result Identification and Criticality

Result meets defined critical value criteria critical (required)

Verify the reported result is on the laboratory's approved critical value list or meets escalation criteria.

Yes No N/A

Critical result verified against source report critical (required)

Yes No N/A

Result timestamp documented

Critical value category identified

Communication Timeliness

Time from result verification to notification documented critical (required)

Enter elapsed minutes between verification of the critical result and first notification attempt.

Notification completed within policy timeframe critical (required)

Confirm the critical result was communicated within the laboratory or facility-defined timeframe.

Yes No N/A

First notification attempt time documented

Escalation performed when initial contact was unsuccessful critical (required)

Yes No N/A

Read-Back and Closed-Loop Communication

Read-back confirmation documented critical (required)

Verify the receiver repeated the patient identifier, test name, and critical result value back to the caller.

Yes No N/A

Receiver identity documented

Receiver role or title documented

Read-back included patient identifiers and result value critical (required)

Yes No N/A

Provider Acknowledgment and Documentation

Provider acknowledgment documented critical (required)

Confirm the responsible provider or designee acknowledged receipt of the critical result.

Yes No N/A

Acknowledgment time documented

Provider name or designee documented

Documentation complete in LIS/EHR or call log critical (required)

Verify the record contains the result, notification time, receiver, read-back, acknowledgment, and any escalation steps.

Yes No N/A

Get your results

Enter your email — we'll send you a PDF of your filled-out template, plus the occasional MangoScoop newsletter (templates, workflow tips, product updates). Unsubscribe anytime — link is in every email.

Email (required)

Your name (optional)

Generated with MangoApps Templates — browse 250+ free