Communication That Protects Patients: A Biomedical Scientist’s Guide to Clear Results and Effective Handover

Communication is part of the test

The analytical phase does not end when an analyser produces a technically valid result. The information must reach the right person, in the right form, at the right time, with enough context for safe action.

Poor communication can undo excellent laboratory science. A potassium result given without units, an urgent message left with an inappropriate recipient, a telephone number copied incorrectly at handover or a critical result recorded without the name of the person who accepted it can all delay treatment.

Communication is therefore part of laboratory quality. This article develops the IBMS Registration Training Portfolio module on Communication and connects it with clinical laboratory science, physiology, genetics, research and professional-development learning. The examples focus on everyday NHS Clinical Chemistry practice.

Learning outcomes

Knowledge: what you should understand

After reading this article, you should be able to explain:

• why communication is a safety-critical part of the sample-to-result pathway;
• the strengths and limitations of verbal, non-verbal, written and digital communication;
• how the audience, urgency, complexity, confidentiality and individual need affect the choice of method;
• what closed-loop communication means;
• the principles for communicating critical and unexpected pathology results;
• why valid consent, capacity, confidentiality and accessible information remain relevant; and
• how feedback and reflection improve communication.

Competence: what you should be able to demonstrate in practice

With supervised local training and assessment, you should be able to:

• select an appropriate authorised communication route;
• verify patient and recipient details before disclosing information;
• communicate a laboratory result accurately, including required units and context;
• use read-back or another confirmation method where the SOP requires it;
• adapt language for a scientist, clinician, service user or carer without losing accuracy;
• document the content, recipient, date, time, action and escalation clearly;
• recognise when an interpreter or accessible format is needed; and
• escalate when communication fails or the situation is outside your competence.

1. Start with the communication purpose

Before choosing a method, ask what needs to happen because of the message. Is the purpose to:

• provide a routine result;
• prompt urgent clinical review;
• obtain missing request information;
• explain why a sample cannot be analysed;
• hand over unresolved work;
• support a service user to collect a specimen correctly;
• discuss an analytical limitation or interference;
• report an incident or safety concern; or
• teach, supervise or give feedback?

The purpose determines the necessary speed, detail, recipient and evidence of receipt. A routine result released through an interfaced LIMS may be appropriate for one situation. A locally defined critical result may require immediate direct communication and documented confirmation.

2. The four main communication forms

Verbal communication

Telephone calls, face-to-face discussions, huddles and handovers allow questions and rapid clarification. They are valuable for urgent or complex matters, but are vulnerable to noise, interruption, accent differences, memory error and misunderstood numbers.

Reduce risk by using a structured message, speaking at a measured pace, stating numbers digit by digit where helpful, including units, avoiding unexplained abbreviations and asking the recipient to confirm key information.

Non-verbal communication

Tone, pace, facial expression, posture, silence and eye contact can change how a message is received. Non-verbal behaviour varies between individuals and cultures. Do not interpret lack of eye contact, a flat tone or delayed response as lack of interest or competence.

In telephone communication, tone and pace carry extra weight. A rushed or irritated voice may discourage a caller from sharing information that changes validation.

Written communication

SOPs, LIMS comments, emails, reports, notices, worksheets and handover records create a durable record. Written information can be reviewed, but unclear wording may persist and spread. A comment copied from an old result may be wrong for the current specimen.

Use approved standard comments where required. Write complete, unambiguous information. Proofread patient identifiers, numbers, units, date and time before saving or sending.

Digital communication

LIMS, electronic patient records, middleware, analyser interfaces, incident systems, secure email and approved collaboration tools support speed and traceability. Digital systems also introduce risks: wrong-patient selection, copy-and-paste error, alert fatigue, access failure, duplicate messages and false confidence that “sent” means “seen”.

Use only authorised systems, protect access credentials, confirm the intended recipient and follow downtime procedures when systems fail.

3. Match the message to the audience

Effective communication is accurate for the recipient, not merely accurate in the speaker’s mind.

With another laboratory scientist

Technical language may be efficient when both people understand it. Include the method, analyser, sample type, flags, QC position or interference information when it affects the decision.

With a clinician

Focus on information needed for clinical action: verified patient identifiers, test, result, units, specimen time where relevant, important limitation, urgency and whether the result is final, provisional, corrected or awaiting review. Stay within your scope; route clinical interpretation to a clinical scientist, duty biochemist or other authorised professional.

With a service user or carer

Use plain language, explain your role and confirm what information you are authorised and competent to give. Avoid jargon such as “aliquot”, “haemolysis index” or “non-conformance” unless you explain it. Do not provide clinical interpretation if that is outside your role. Give a clear route to the appropriate clinical team.

With a trainee

Explain the reason as well as the step. Check understanding through demonstration or teach-back, not only “Do you understand?” Encourage questions and make it safe to say “I am not sure”.

Professional English

Biomedical scientists must communicate in English to the standard required for the profession. The HCPC describes this as equivalent to International English Language Testing System level 7, with no individual element below 6.5. This is not about removing accent or demanding one communication style. It is about being able to understand and convey safety-critical information accurately in speaking, listening, reading and writing.

4. A structured message prevents omissions

For urgent or complex laboratory contact, a consistent structure reduces cognitive load. Your local service may use SBAR or another model. A chemistry-focused structure could be:

• Identify: your name, role, department and call-back number if needed;
• Verify: patient identifiers and the recipient’s identity and role;
• Situation: the result or problem and why you are contacting them now;
• Background: specimen time/type, relevant previous result, analytical flag or limitation;
• Action required: what acknowledgement, repeat sample, review or escalation is required under the SOP; and
• Confirm: read-back or acknowledgement, then document.

Do not overload an urgent call with every available detail. Include what is relevant to the action, and answer questions within your competence.

5. Closed-loop communication

Communication is “closed loop” when the sender confirms that the intended recipient received and understood the key message. In practice:

Closed-loop communication connects analytical validation, accurate disclosure, confirmation, documentation and escalation.

1. The biomedical scientist identifies the correct patient and authorised recipient.
2. The scientist states the result and required information clearly.
3. The recipient repeats back or otherwise confirms the critical information where required.
4. The scientist corrects any discrepancy immediately.
5. The contact and outcome are documented.

Read-back is particularly useful for names, identifiers, results, units and times. If a potassium of 6.7 mmol/L is repeated as 3.7 mmol/L, the loop has exposed a potentially serious error before action.

An unanswered voicemail, generic inbox or electronic transmission without evidence of receipt is not necessarily a closed communication loop. Follow the local escalation process.

6. Communicating critical and unexpected results

The Royal College of Pathologists’ current guidance emphasises a locally agreed system that is reliable, auditable and connected to clinical action. Laboratories should define which results require communication, who may receive them, timescales, escalation and documentation.

There is no safe universal list for a trainee to memorise from an article. Thresholds depend on the patient group, test, service and local agreement. Always use your current local critical-result SOP.

Before communicating, complete the authorised checks. These may include:

• correct patient and specimen identity;
• test, result, units and reference or decision information;
• acceptable QC and analyser status;
• sample type, collection time and integrity;
• analytical flags, haemolysis, icterus or lipaemia indices;
• possible contamination or pre-analytical error;
• previous results and significant change where policy permits;
• whether the result has already been communicated; and
• whether specialist review is required before release.

The communication record should normally include the result, recipient’s name and role, communicator, date and time, any confirmation/read-back and the action or escalation required by local policy.

7. Daily practice example: a high potassium result

A serum or plasma specimen produces a potassium result that meets the laboratory’s locally defined critical threshold. The haemolysis index is raised.

Step 1: validate within your competence

Confirm identity, analyser and QC status, specimen type, flags and relevant history according to the SOP. Haemolysis can raise potassium, but that does not justify silently cancelling or delaying a potentially urgent finding. Follow the approved rule for result handling, comment, repeat request and clinical review.

Look for other evidence only where authorised. For example, a pattern of high potassium with unexpectedly low calcium may raise concern about EDTA contamination. It is a clue, not proof. Escalate uncertain interpretation.

Step 2: contact the correct recipient

Use the authorised clinical area or professional identified by the SOP. Verify who you are speaking to and confirm the patient using the required identifiers. Do not disclose a result to an unverified caller simply because they know one piece of patient information.

Step 3: state the essential message

For example:

If specialist interpretation is needed, state that you will transfer or refer the call rather than guessing.

Step 4: close and document

Confirm the read-back, record the recipient, date and time, and complete the LIMS or critical-call record. If no authorised recipient can be reached, use the next escalation route immediately. Do not keep trying the same unanswered number while the clinical risk increases.

8. Daily practice example: a rejected sample

An urgent renal profile arrives with a patient name that does not match the electronic request. The ward asks the laboratory to “just run it” because the patient is unwell.

This conversation requires empathy and firmness. A useful response is:

The message acknowledges urgency, explains the safety reason, states what will happen and offers a route forward. Avoid blame. Record the discrepancy and decision through the local process.

9. Accessible communication and informed decisions

People need information they can understand and use. The NHS Accessible Information Standard requires services to identify, record, flag, share, meet and review communication needs. In pathology this may apply to collection instructions, appointment information, test preparation or explanations of why a repeat specimen is needed.

Adaptations may include:

• plain language and short sentences;
• large print, easy-read, audio or translated information;
• an approved interpreter;
• a hearing loop, text relay or another appropriate channel;
• additional processing time; and
• teach-back to check that your explanation was clear.

An interpreter should translate, not make the decision. Speak to the service user, not about them. Protect confidentiality and use only necessary information.

10. Consent, capacity and communication

Valid consent is voluntary, informed, given by a person with capacity for the decision, proportionate to the circumstances and appropriately documented. Routine pathology work is usually requested as part of direct clinical care, and biomedical scientists rarely obtain the original consent. They must still understand its importance.

If a person asks what will happen to a specimen, explain only what you are authorised and able to explain. If consent is disputed, withdrawn or unclear, stop and seek advice through the requesting clinical team or governance route.

Do not assume lack of capacity because communication is difficult. First support communication, for example by using an interpreter, accessible information or an appropriate aid. Capacity is decision-specific and may change over time.

11. Confidentiality: say enough, not everything

Before sharing a result or patient information, consider:

• Is there a legitimate purpose connected with care or another lawful duty?
• Am I using an approved and secure route?
• Have I verified the recipient?
• Is the information necessary and proportionate?
• Am I in a private enough setting?
• Does the communication need to be recorded?

Avoid discussing identifiable results in lifts, corridors, canteens or public messaging apps. Do not include patient data in teaching messages, photographs or personal notes. If a caller is not authorised, explain that you cannot disclose the information and direct them to the proper route.

12. Digital communication and downtime

Electronic systems can transmit results quickly and create an audit trail, but staff must know their limitations.

Safe digital practice

• Select the patient using required identifiers, not location alone.
• Recheck copied numbers and units.
• Use approved standard comments and remove irrelevant historical text.
• Do not share passwords or leave an unlocked session unattended.
• Confirm whether urgent electronic alerts require additional telephone communication.
• Use secure organisational email or approved tools only.
• Report wrong-patient selection, interface error or delayed transmission promptly.

During downtime

Follow the controlled downtime plan. This may define manual request numbering, paper worksheets, authorised result communication, reconciliation after recovery and who leads escalation. At handover, identify every outstanding critical call, unentered result, instrument issue and manual record. A vague note saying “LIMS down—some results pending” is not enough.

13. Handover that another person can safely continue

A good handover is concise, prioritised and actionable. It should state:

• what is outstanding;
• why it matters;
• what has already been done;
• the current status;
• the next required action and time;
• who has been informed; and
• where the supporting record can be found.

For example:

This is more useful than “Cortisol to check”.

14. Feedback improves communication

Communication competence develops through observed practice. Ask a supervisor to review a telephone call, handover or written comment against agreed criteria. Useful feedback is specific:

• Was identity verified correctly?
• Was the message accurate and concise?
• Were jargon and abbreviations appropriate for the audience?
• Was urgency clear without creating unnecessary alarm?
• Was understanding confirmed?
• Was the record complete?

Reflect on one change at a time. For example: “I used to begin critical calls with the result before verifying the recipient. Following feedback, I now complete identity checks first and use a prompt card. Three observed calls confirmed consistent use.”

15. What competent practice looks like

A competent trainee or biomedical scientist:

• chooses a communication method that matches risk and purpose;
• verifies patient and recipient identity before disclosure;
• communicates results, units, timing and limitations accurately;
• adapts language without becoming vague or patronising;
• uses closed-loop confirmation when required;
• documents contemporaneously and can find the record;
• protects confidentiality in verbal, written and digital settings;
• supports accessible communication and appropriate interpreter use;
• gives an actionable handover; and
• escalates promptly when contact fails or interpretation is outside scope.

16. Common mistakes and better alternatives

17. HCPC Standards of Proficiency covered

The following standards are mapped to the IBMS Communication module. The wording is summarised in plain English; use the current HCPC publication for the authoritative wording.

18. Portfolio and supervision prompts

Use anonymised examples and agree evidence requirements with your training officer.

1. Map the communication routes used in your department. Which are suitable for routine, urgent, confidential and downtime messages?
2. Ask a supervisor to observe a simulated or real authorised critical-result call. What one behaviour improved after feedback?
3. Compare a LIMS comment for a scientist with a plain-language explanation for a service user. What must remain the same?
4. How does your laboratory record recipient identity, read-back, date, time and escalation?
5. What happens if the first, second and third contact routes fail?
6. Identify one communication barrier in a patient instruction and propose an accessible change.

Key takeaways

• Communication is part of the test and part of patient safety.
• The method must match the purpose, urgency, audience and confidentiality risk.
• Critical-result limits and routes are local; use the current controlled SOP.
• Closed-loop communication confirms that essential information was received and understood.
• Accessible communication supports informed decisions and reliable specimen collection.
• Accurate documentation and actionable handover allow safe continuity of care.

Suggested references

• Health and Care Professions Council. Standards of proficiency: Biomedical scientists (effective 1 September 2023)
• Health and Care Professions Council. Standards of conduct, performance and ethics (effective 1 September 2024)
• Institute of Biomedical Science. Registration Training Portfolio V5: Module Descriptors, version 1.1, May 2025
• Royal College of Pathologists. The communication of critical and unexpected pathology results, G158, final, May 2026
• NHS England. Accessible Information Standard requirements
• NHS England. Consent to using and sharing patient information
• Institute of Biomedical Science. Good Professional Practice in Biomedical Science, updated 2025