Push Notifications Can Be Used for Safe and Timely Communication of Critical Lab Results in the Emergency Department

Abstract

Background

Prompt notification of critical results is important for both patient safety and laboratory and hospital accreditation. Although many institutions still rely on manual pages and phone calls to notify care teams of critical results, automation could improve the efficacy of this process. Some electronic health records offer the ability to configure automatic push notifications to a provider’s secure text pager or clinical application that allows for a closed-loop result acknowledgment. It is not known if push notifications for critical results can successfully reach providers, improve acknowledgment times, or allow for sufficiently high acknowledgment rates to meet accreditation standards.

Methods

The authors conducted a continuous quality improvement initiative to develop a pathway that uses initial push notifications for critical results for patients in the emergency department (ED).

Results

A prior pathway of using solely phone calls for critical result notifications had a mean acknowledgment time of 2.93 minutes, and 97.5% of results were acknowledged within 30 minutes. The new pathway that used an initial push notification had a longer mean acknowledgment time (8.20 minutes), and fewer results acknowledged within 30 minutes (93.3%). Though the new pathway was slower than only using phone calls, it maintained an acknowledgment rate greater than 90%, in line with some accreditation standards. It also saved the medical laboratory scientist previously making these calls roughly 8.5 hours of phone calls over the five-month study period.

Conclusion

There are additional opportunities to iterate on this process. For the ED setting, push notifications represent a promising innovation for critical result notifications, but the best way to deploy them remains unknown and is likely clinical context dependent.