EXPEDITED-REQUESTS-AND-CRITICAL-and-ALERT-VALUES - Urgent and expedited lab test reporting protocol

Oct 5, 2026

LifeLabs urgent and expedited lab test communications define how requested assays are prioritized, scheduled, and reported based on geography and conditions. The document explains how “URGENT” orders may be downgraded when samples arrive with inappropriate urgent labeling, and when laboratory leadership must be contacted to run unavailable urgent tests. It specifies critical and alert value definitions, calling time windows, and reporting exceptions, including microbiology preliminaries, recurrent results, and thresholds for hemoglobin, platelet counts, and related urinalysis critical glucose/ketones.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Urgent basis test requests

Downgrading URGENT to ASAP

Contact requirements for unavailable URGENT tests

ASAP and expedited result communication

Delivery modality and turnaround timing

Routine vs alert/critical handling

Reporting of critical & alert values

Critical value definition and calling window

Alert value definition and calling window

Reporting exceptions and recurrent results

Hemoglobin and platelet recurrence rules

Urinalysis critical glucose/ketones rule

LIST OF TESTS HANDLED ON AN URGENT BASIS The following list of tests is available on an urgent basis from LifeLabs. Depending on geography and weather conditions, results will be available with a period of 6 to greater than 12 hours. AMYLASE NEONATAL BILIRUBIN CALCIUM CHLORIDE CREATININE ESTRADIOL (IVF only) GLUCOSE LIPASE MALARIA SMEAR POTASSIUM PROTHROMBIN TIME/INR SODIUM UREA CBC It is important that office staff understand that ordering a test as urgent may result in an attempt to report during the night. Please note: when an inappropriate “URGENT” order sample is received (either as a HCPcollected or patient presenting at a PSC), the test will automatically be downgraded to “ASAP”status. The HCP must contact the Laboratory Director or the Medical Director on call through the Customer Care Centre at 1-877-404-0637 to have a non-available URGENT test performed on an URGENT basis. It may not be possible to comply with the request, depending on the nature of the test required. ASAP (AS SOON AS POSSIBLE) You may request a special communication of test results as soon as these are available. This request will result in delivery of results to you at the first opportunity during your normal office hours. Autofax is the preferred modality of delivery. Turn around time will depend upon the type of assay requested; however routine tests will be communicated in less than 24 hours. To ensure prompt communication, contact numbers must be provided. If these are not available the results will be reported in a routine fashion unless the results are alert or critical values. REPORTING OF CRITICAL & ALERT VALUES EXPEDITED REPORTING BASED ON TEST RESULTS LifeLabs and other OAML Laboratories have agreed to a defined schedule of test results that must be communicated directly to physicians based upon the two result categories described below. These reporting limits have been defined specifically for a community laboratory environment and are based on published literature as well as laboratory experience. Laboratories have an obligation to communicate these abnormal results. The ordering physicians have the professional responsibility to provide the laboratory with contact information, which will allow direct communication of these results to the physician (or delegate providing coverage during absences) . If we do not already have this information, please complete the Client Information Form and return to your local LifeLabs location or fax to 905-795-9891. There will be situation when a markedly abnormal result is not expected. Certain critical values may be frequently expected in certain types of specialist practice. Under these circumstances an exception to a calling protocol may be made when a physician communicates this on the laboratory requisition or in writing to the laboratory. Specific exception to calling guidelines maybe made on written requests to the Laboratory Director. Note: Blanket exception to calling is considered medically unacceptable by the College of Physicians and Surgeons of Ontario and can not be honored by LifeLabs. CRITICAL VALUE A critical value is identified as a result that will cause the patient to suffer a life-threatening event if not communicated and treated immediately. These results show marked deviation from reference ranges suggesting that, if unexpected, a patient’s life is in danger and prompt medical action may be required. These must be called as soon as results are available 24 hours per day. Exceptions to the Reporting protocol: Microbiology When a preliminary report which is considered critical is successfully communicated by the laboratory, further preliminary and the final microbiology report will not be communicated asa second critical value. It is the responsibility of the ordering physician to obtain additional information from the final report when away from the office or when this is required for confirmation of the appropriateness of treatme

FAQs

What happens if an inappropriate “URGENT” order sample is received?

If an “URGENT” order sample is received but does not meet the required criteria, the test is automatically downgraded to “ASAP” status.

When must critical values be communicated to physicians?

Critical values are results indicating immediate life-threatening risk if not treated, and they must be called as soon as results are available, 24 hours per day.

How are recurrent critical and alert results handled outside normal office hours?

Critical and alert values marked with an asterisk are not communicated outside normal office hours when recurrent within four months; such results may be communicated by fax. Exceptions apply for specific hemoglobin and platelet thresholds.

Oct 5, 2026

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