Journal of the Formosan Medical Association
Volume 106, Issue 7 , Pages 558-564, 2007

Evaluation and Improvement Strategy of Analytical Turnaround Time in the Stat Laboratory

  • Tzu-I Chien

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
    • ,
  • Jin-Ying Lu

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
    • ,
  • Jau-Tsuen Kao

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
    • Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
    • Corresponding Author InformationCorrespondence to: Professor Jau-Tsuen Kao, Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, 7 Chung-Shan South Road, Taipei 100, Taiwan
    • ,
  • Ya-Chih Cheng

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
    • ,
  • Ya-Fen Lee

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, Taipei 100, Taiwan

Received 5 September 2006; received in revised form 17 February 2007; accepted 10 April 2007.

Article Outline

Background/Purpose

Laboratory analytical turnaround time represents laboratory effectiveness. Our study aimed to evaluate laboratory analytical turnaround time to optimize workflow and shorten analytical turnaround time.

Methods

We used the laboratory information system in a 2000-bed teaching hospital to compute and analyze the 90th percentile turnaround time of the Stat Laboratory from 2001 to 2003.

Results

The overall 90th percentile turnaround time in the Stat Laboratory was 40–49 minutes and positively correlated with test volume. The daily test volume in the Stat Laboratory has grown significantly in the latter 2 half-years of the study as compared with the previous 2 half-years (p < 0.05 and p < 0.001, respectively). The daily longest turnaround time occurred in the early morning, and troponin-I testing contributed to the majority of incidences of prolongation of analytical turnaround time. We prioritized the performance of troponin-I testing, which resulted in a reduction of the analytical turnaround time by about 18 minutes (from 66 to 48 minutes) and no increment of overall turnaround time (42 to 44 minutes) despite continuously increasing test volume.

Conclusion

These findings demonstrated that a dedicated means of process control was able to significantly improve laboratory efficiency.

Key Words:  laboratory efficiency , quality improvement , troponin-I , turnaround time

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Fowler DG . Development of a computer simulation for laboratory planning . Clin Lab Sci . 1998;11:280–284
  2. Fleisher M , Schwartz MK . Automated approaches to rapid-response testing: a comparative evaluation of point-of-care and centralized laboratory testing . Am J Clin Pathol . 1995;104(Suppl 1):S18–S25
  3. Jacobs E , Laudin AG . The satellite laboratory and point-of-care testing: integration of information . Am J Clin Pathol . 1995;104(Suppl 1):S33–S39
  4. Castro HJ , Oropello JM , Halpern N . Point-of-care testing in the intensive care unit: the intensive care physician's perspective . Am J Clin Pathol . 1995;104(Suppl 1):S95–S99
  5. Ramirez O , Lawhon J . Quality management series: quality improvement team uses FOCUS–PDCA method to reduce laboratory stat volume and turnaround time . Clin Lab Manag Rev . 1994;2:130–141
  6. Inamura K , Umeda T , Harauchi H , et al.   Time and flow study results before and after installation of a hospital information system and radiology information system and before clinical use of a picture archiving and communication system . J Dig Imag . 1997;10:1–9
  7. Ratcliffe N , Blume C , John P , et al.   Shorter turn-around-time and improved patient care in peripheral blood progenitor cell collection procedures . J Clin Apheresis . 1999;14:35–41
  8. Kenagy JW , Berwick DM , Shore MF . Service quality in health care . JAMA . 1999;281:661–665
  9. Valenstein P . Laboratory turnaround time . Am J Clin Pathol . 1996;105:676–688
  10. Shewhart WA . Economic Control of Quality of Manufactured Product . New York: D. Van Nostrand; 1931;
  11. Hawker CD , Garr SB , Hamilton LT , et al.   Automated transport and sorting system in a large reference laboratory: part 1. Evaluation of needs and alternatives and development of a plan . Clin Chem . 2002;48:1751–1760
  12. Hawker CD , Roberts WL , Garr SB , et al.   Automated transport and sorting system in a large reference laboratory: part 2. Implementation of the system and performance measures over three years . Clin Chem . 2002;48:1761–1767
  13. Barnett RN . Medical significance of laboratory results . Am J Clin Pathol . 1968;50:671–676
  14. Howanitz P , Steindel S , Cembrowski G , Long T . Emergency department stat test turnaround times . Arch Pathol Lab Med . 1992;116:122–128
  15. Vacek JL . Classic Q wave myocardial infarction: aggressive, early intervention has dramatic results . Postgrad Med . 2002;112:71–77
  16. Montalescot G , Borentain M , Payot L , et al.   Early vs. late administration of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention of acute ST-segment elevation myocardial infarction: a meta-analysis . JAMA . 2004;292:362–366
  17. Singer AJ , Ardise J , Gulla J , Cangro J . Point-of-care testing reduces length of stay in emergency department chest pain patients . Ann Emerg Med . 2005;45:587–591
  18. Keshgegian A , Bull G . Evaluation of a soft-handling computerized pneumatic tube specimen delivery system . Am J Clin Pathol . 1992;97:535–540
  19. Valenstein PN , Emancipator K . Sensitivity, specificity, and reproducibility of four measures of laboratory turnaround time . Am J Clin Pathol . 1989;91:452–457
  20. Holland LL , Smith LL , Blick KE . Reducing laboratory turnaround time outliers reduces emergency department (ED) patient length of stay (LOS): an 11-hospital study . Am J Clin Pathol . 2005;124:672–674
  21. Steven JS , Peter JH . Physician satisfaction and emergency department laboratory test turnaround time . Arch Pathol Lab Med . 2001;125:863–871

 Tzu-I Chien and Jin-Ying Lu contributed equally to this work.

PII: S0929-6646(07)60006-0

doi:10.1016/S0929-6646(07)60006-0

Journal of the Formosan Medical Association
Volume 106, Issue 7 , Pages 558-564, 2007

Article Tools