Review and release results

What review protects

Review and release is the final clinical gate before a patient, doctor, portal user, or WhatsApp recipient can see results. The page is not just a printable worksheet. It brings together patient identity, sample status, result values, previous result context, reference intervals, abnormal flags, approval state, release groups, QC checks, print actions, and WhatsApp delivery.

Only staff with result permissions should work here. If a receptionist needs to know whether a report is ready, they can check order status, but they should not approve or release clinical rows.

Result entry and review follow your selected Kashef interface language, and Arabic uses a right-to-left layout. The rule is simple: anything that prints on the patient report stays in English. That covers the results table headers, test names, section and lab unit titles, values, units, flags, reference ranges, interpretation notes, culture organisms and antibiotics, and the unit manager signature. These tables read left to right, exactly like the printed report. Everything else, including buttons, statuses, hints, notes, comment tools, and the Override range editor, appears in your language. The standalone released-result sheet and PDF are English left-to-right documents.

Reference ranges use the patient’s age at the order date. When correcting an older order, verify the date of birth and order date before reviewing its ranges.

Switching between entry and review

Saving checks the current order and sample again. Cancelled orders and uncollected or rejected samples cannot accept measurements. If a save stops after earlier rows were saved, the message gives their count. Review the remaining edits on the sheet before retrying; a value visible in an input is not saved until saving succeeds.

Use Enter Results at the top to enter or correct values for the same order. Save with Save All Results, then use Review Results at the top of the entry page to return here. Release results from this review worksheet using the existing Release controls; Enter Results has no release buttons.

Culture details and their result line save together. If final validation fails, the previously saved culture stays unchanged. Review the failure message and the remaining input before retrying.

Using connected AI tools

A connected AI tool can inspect a permitted sample's expected result rows, saved values, reference intervals and review state. Staff need the same result-entry, approval or release access as this page. A receiving branch can inspect only its assigned samples. Private device payloads are not included.

With approval permission, the tool can preview returning saved results for correction, rerun or recollection. Review the reason, every affected row and whether you selected one parameter or the whole test. Correction keeps the saved value for checking and explicit resubmission. Rerun archives and clears the selected values on the current sample. Recollection creates an uncollected replacement sample; unaffected sibling parameters keep their values, approval and source-sample history. Collect the replacement before entering new values. If a result or sample changes, review a new preview before confirming. Released results are protected. After an uncertain response, inspect the current rows before retrying.

With result-entry permission, the tool can inspect an ordinary numeric, text or list row and preview a supplied measurement. Check the value that will be stored, including three-decimal numeric precision, its reference, flag and approval impact before saving. Save any results used by conditional choices first. A changed approved or released measurement becomes an entered revision requiring review; an unchanged approved value stays approved. Saving a checked rejected value resubmits it. If the preview changes, review it again. Inspect the saved row after an uncertain response.

CBC measurements are also supported. For a calculated row, choose whether to use the configured calculation or a supplied manual value. Save source measurements first, then review the formula, its saved inputs and the proposed value. Missing inputs or an invalid formula cannot produce a result. Manual numeric overrides of test calculations follow the catalog setting; parameter formulas and absolute counts allow manual entry. Review and save each dependent calculated row again after changing its inputs; saving one observation does not recalculate other rows.

With result-entry permission, you can also preview skipping a parameter of a multi-parameter test, with a reason, or restoring an existing skip. Check the current value and report impact before confirming: skipping clears the measurement, removes approval and leaves the parameter off reports pending review. Restoring removes the skip and leaves a blank pending row for entry. Released rows and uncollected/rejected samples are protected. Review a fresh preview if anything changes.

For image parameters, the tool can inspect or read the saved image and preview a supplied image attachment, replacement or removal. Check its format, size, checksum and review impact before confirming. Images up to 10 MB are supported in PNG, JPG, GIF, WebP or BMP format. Preview saves nothing. Changed approved images require review again; identical content keeps its approval. Released and skipped rows cannot be changed this way. Removing an attachment keeps files already used by other reports. Inspect the current row if a response is uncertain.

For cultures, inspect the current findings and available organisms, antibiotics and panels, then preview a complete supplied culture state. Review specimen, conditions, growth, isolates, S/I/R, MIC and notes before saving. Default or selected panels add antibiotic rows with blank sensitivity results; provide the observed findings before approval. An incomplete culture can be saved for later completion, with remaining review requirements shown. Changed approved findings return for review; unchanged findings keep approval. No-growth or contamination clears isolates only after you submit an empty isolate list and review the preview. Released cultures are protected. If findings or catalog choices change, review a new preview.

With approval permission, the tool can preview and approve selected saved rows. Review the patient identity, each measurement, sample state, culture findings, image or skip reason, and any approval blocker before confirming. All selected rows must be ready; a blocker or changed preview leaves the whole selection unchanged. Approval records you as the reviewer and does not edit the measurements.

With release permission at the source branch, you can also inspect release groups, preview the complete selected groups and confirm release. Review all saved rows, including cultures and images, and every payment or QC requirement. A permitted QC override needs your explicit reason and a new preview. Missing parameters, invalid or unapproved values, incomplete cultures, unresolved demographic ranges, unbalanced CBC and unavailable samples block release; inventory checks still apply at confirmation. A stale preview or failed group leaves the whole selection unchanged. Release records the verifier, queues private reports and checks order completion. Sending a report to a recipient remains a separate action in Kashef. After an uncertain response, inspect current saved rows before retrying.

Result images open only from the order and samples available to your selected branch. A receiving branch can view images attached to its assigned samples when you have order-viewing or clinical result access.

Replacing an approved result image returns it for review. Reattaching the same image content keeps its approval; check the saved row status after uploading.

Header summary

The top card shows the patient details the way the report prints them (name, age and date of birth, gender, referring doctor, order ID, and registration time), the critical and abnormal counts, and progress bars for entered, approved, and released rows. The order's Reason for Tests appears directly below it so reviewers can keep the clinical question in view.

Use these bars before reading individual rows. If entered results are not complete, the order is not ready. If approval is incomplete, a reviewer still has work. If released count is lower than total, the patient may not see every test yet.

Warnings at the top of the worksheet, including QC release requires attention, start collapsed. Select a warning heading to read its details. Errors and release blockers stay expanded; collapsing a warning does not remove its requirements.

Working like the report

The review sheet uses the same layout as the printed report. A CBC is shown as its own block with the differential percentages and absolute counts side by side. Other tests are grouped under their lab unit in the unit's report order, each ordered profile has its own card after its unit's other tests, and each card ends with the unit manager who will sign it. Approve and release each profile card on its own, like a lab unit. Tests without a unit appear under Other tests.

Each unit is one table with the sample barcode and type under every test name. The unit header shows its approval count with Approve all and Release, which release the whole unit at once, and the unit's comment sits under the table. Because one order can include several samples, check the sample on each row; if a sample is still pending or not received, do not release its results.

Each culture has its own block with the antibiogram shown as on the report: one column per organism, with S, I, or R and the MIC. A culture can be approved only when the growth result is chosen, a growth names its organism, and every antibiotic has S, I, or R. Changing anything after approval sends the culture back for approval. Its Release button releases that culture alone, so routine results do not wait for a culture that takes days.

Row details

Each result row shows the test or parameter, the result (with the previous result for this patient when available), the flag, the unit, the applicable reference range with its interpretation, and the review status with approve, reject, and select controls. Hover the status to see who approved, rejected, or released the row and when.

Columns follow the configured reference type. A list of expected values has no unit. A free-text result has no unit, range, flag, or interpretation; an em dash marks a cell that does not apply.

The released report prints a letter beside each abnormal result, exactly like the CBC page: H (High), L (Low), HH or LL (Critical), and * (Abnormal); normal results have no letter and abnormal values are printed in colour. The Reference Range column shows only the ranges that match the patient's sex and age. When more than one applies (for example a male range and an all-sexes range, or the labelled bands of a List of Ranges), they print one under another and the line that was applied to the result is in bold.

Previous result context helps reviewers spot large changes. It should not be used to hide a true new result, but it can help decide whether rerun, dilution, phone confirmation, or doctor communication is needed.

Approving and rejecting

Reviewers can approve a row, a whole test, all rows, or the selected rows, and reject a row or the selected rows. A CBC whose differential does not total 100% cannot be released until it is corrected. A parameter skipped during entry shows Skipped — not on report with its reason; approve it to accept the skip, or reject it with a note if the result should be entered. A rejected row needs a note that tells the technician what to correct. Good notes mention the exact issue: wrong unit, suspicious delta, instrument rerun required, sample quality concern, missing comment, or range mismatch.

When rejecting a row or using Reject Selected, choose Rejection action and enter a clear reason:

• Correct the entered result keeps the existing value and returns it to the technician for checking or retyping in Enter Results. Save the checked value, even if it is unchanged, then approve it again.
• Repeat sample work offers Rerun on the current sample or Recollect a new sample. Choose Selected parameter(s) only to repeat the selected rows, or Whole test with all parameters to repeat every parameter of each selected test on that sample. Other tests on the tube are unaffected.

A rerun clears the affected values and returns a sample in Results to Processing. Enter new measurements after repeating the work. Recollection creates a new sample with a different barcode that must be collected before new results can be entered. For a parameter-only recollection, unaffected parameter results are retained on the new worksheet with their original sample recorded. Previous values and rejection reasons remain in the history. Released results are protected; recollection cannot move a test that already has a released parameter. Refresh the worksheet if another reviewer has released a result since you opened it. Once a test has a new sample, the rejected or disposed tube's rows leave the review sheet, and an uncollected duplicate tube is hidden while another tube with that test is already collected, so each test is approved and released once. A test with no new sample yet keeps its rejected rows on the sheet. Only one active new sample can be created per test.

If the patient has estimated or unknown age, or sex at birth is unknown/diverse, the review sheet displays Patient demographic verification required. Kashef will not guess an age- or sex-specific range. A numeric row can be approved only when the patient has exact required demographics or the catalog contains a deliberate all-age, all-sex range for that test. Correct the patient profile when verified; otherwise ask the catalog owner to configure a clinically valid universal range.

Do not use rejection for administrative delay. If a row is clinically fine but payment or delivery is blocked, solve that blocker in the relevant workflow.

Approval checks the saved measurement and current sample, including when you have approval access without entry access. Uncollected or rejected samples and blank results cannot be approved. Culture completeness is checked from saved findings. After patient demographics change, save the result with a reference range valid for those demographics before approving it; an old range link is not enough.

Who can approve and release

Orders: Approve Results allows approving and rejecting results. Orders: Release Results allows releasing previously approved results. An administrator can grant either permission independently through a custom role or a direct user grant. Staff with either permission can open the review sheet without result-entry access. Managers have both by default; technicians have neither by default. Release permission does not bypass approval, payment, sample, or QC checks.

Escalate for release

If you cannot approve or release the results yourself, press Escalate for release at the top of the page. Choose a colleague from Send to (only people allowed to approve or release results at this branch are listed), add a note, and press Send escalation. They are notified right away, and an Open escalation banner appears on the page.

The escalation closes automatically when results on the order are released, and you get a notification. Either of you can also press Mark resolved on the banner. Press Notify me on updates at the top of the page if you also want to hear about later changes to the order.

Release checks the saved results again at confirmation. Every expected parameter must still exist and have a valid approved value or reviewed skip; cultures must be complete and CBC percentages balanced. A sample, demographic, payment or QC change since opening the sheet may block release. Refresh and resolve the reported issue before retrying.

Release groups

Kashef can group rows for release. A group is releasable when every row in that group is entered and approved, and at least one row is not already released. This supports controlled release for tests that can be reported together.

Release only the group that is ready. If another group still needs review, leave it unreleased until the rows are complete.

QC gate and override reason

Before release, Kashef evaluates every release group and shows the current gate state on the review sheet. The message identifies the affected test and, when available, the QC control, lot, instrument, and run time. A rejected QC run is a hard block and disables Release. Missing, stale, or warning QC follows the configured policy and the user's authority. Kashef checks the QC run of the branch that analysed the sample, so a sample sent to another branch or a central lab is released using that branch's QC.

When the policy permits a manager override, an accessible QC override reason (required) field appears beside that release group. The system will not release the group with an empty reason. A successful override records the manager, reason, QC warning context, affected tests, branch, order, and released-result count in the quality audit log.

Write an override reason like a clinical note. Include what was checked and why release is safe. Example: "Urgent potassium confirmed by repeat run; control trend reviewed by manager." Avoid vague notes such as "urgent" or "manager said ok." A recorded QC disposition does not automatically clear this gate; enter a new acceptable QC run when required by the lab SOP.

Print and WhatsApp

On the printed report, each profile ordered for the patient prints on its own page, under its lab unit's heading and the profile name, even if its tests belong to different catalog categories. The unit's individually ordered tests print first, under their own category headings, and each profile page ends with the unit manager's signature. Long profiles can continue onto another page with the same profile heading.

After results are released, the header can show Print Released Tests. This opens the print page in a new tab, with the report preview on the left and the print settings on the right. Review the printed report for patient identity, test names, units, ranges, signatures, QR code, footer, and branch information.

Choose the Tests to print using the checkboxes; only released tests are available. Use Select all or Clear when needed. The actual report pages and page breaks update automatically. With no tests selected, printing is disabled.

Keep Print header and footer on for the lab’s letterhead, or turn it off for preprinted stationery. When off, every page reserves the blank top and bottom spaces configured in Report Builder > Print Settings; patient details, results, and clinical signatures remain. Select Print once the preview is ready. Kashef prepares the report as an A4 PDF and opens the print dialog, so the browser never adds its own date, title, web address, or page numbers, and its margin settings cannot shrink the report. Choose your printer and A4 paper. These choices affect this print only; they do not change saved results or patient portal reports.

Every released report identifies whether it is the original or an amended report, prints a REV- version marker, and shows the latest approval time. A configured signature block prints the actual releasing staff member, their role, the block's configured credential/approval label, and that signer's approval time. If the report says Approval identity not recorded, do not treat it as complete evidence; investigate the legacy result record before delivery.

Kashef reserves a small A4 print boundary so a compact report footer stays on its clinical page instead of creating a footer-only sheet. In Chrome's print preview, confirm that a compact report shows one page before saving or printing. A genuinely long report may have multiple content-bearing pages; no page should contain only the footer.

If an order has no released results, the direct report route shows a protected empty state instead of a printable report. There is no Print action. Use Return to order, confirm whether the order is cancelled or still awaiting review, and complete the correct workflow; never treat the empty screen as a clinical report.

WhatsApp delivery is handled from the order header after clinical review. Return to the order, choose Send WhatsApp, and select an active results template. Kashef enables a results-link template only when a released result and secure portal link are available. Confirm the saved recipient and prepared Arabic message in WhatsApp before pressing Send; the final send is always the employee's action.

Routed orders

For routed orders, result release is available only from the source branch context. This protects ownership and prevents a receiving branch from publishing a report before the source branch has completed its review responsibilities.

What to do after release

After release, confirm the order status and released count. If all required results are released and samples have reached their final state, the order can close. If the patient cannot see results in the portal or did not receive WhatsApp delivery, check portal visibility, phone number, release status, and report settings before re-entering clinical data.