An Evaluation of Laboratory Efficiency in Shanghai Emergency by Turn Around Times Level

Lu, Yiming; Leong, Waiian; Wei, Bohua; Yu, Peiwu; Wang, Cuicui; Ying, Yilin; Ting-song, Wang; Tong, Jinlu; Zhu, Dingliang; Ye, Jing

doi:10.1002/jcla.21775

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…Clinical biochemists should pay more attention to improving laboratory efficiency. It is of critical importance to know that the pre-and post-analytical phases are just as important as the analytical phase [9].…”

Section: Discussionmentioning

confidence: 99%

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An Evaluation Of Laboratory Efficiency In Emergency Laboratory By Turn Around Time

Kılınçkaya¹

2018

Int J Med Biochem

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Q uality can be defined as the ability of a product or service to satisfy the needs and expectations of the customer [1]. Laboratories have traditionally restricted discussion of quality to technical or analytical quality, focusing on imprecision and inaccuracy [2]. However, timeliness and accuracy are other terms of efficient laboratory management. While they share the concerns of laboratories, clinicians are also interested in the larger quality of service that laboratories offer, including areas such as the cumulative total of test errors, availability, cost, relevance , and timeliness. They need rapid and efficient laboratory service at a low cost [3]. Turnaround time (TAT) can be defined as a marker of timeliness; therefore, it can be used to evaluate the performance of laboratory. According to Lundberg [4], it is necessary to achieve the following steps to perform a laboratory test: ordering, collection, identification, transportation, preparation, analysis, reporting, interpretation, and action. Lundberg also identified the brainto-brain TAT or "total testing cycle" using that 9-step series [5]. Objectives: Accuracy, precision, timeliness, and authenticity are the 4 pillars of efficient laboratory services. Clinical biochemists generally overlook timeliness as an important attribute. However, turnaround time (TAT) is usually regarded by clinicians as the benchmark of laboratory performance. TAT can be classified by tests: priority, population served, etc. The aim of the current study was to both evaluate and compare the TAT of the test panels used in the emergency laboratory of Ankara Numune Training and Research Hospital. Methods: The TAT for tests carried out in the emergency laboratory in 2016 was recorded. The TAT limit for each analyte was determined by the hospital's quality control department. Routine biochemistry, arterial blood gas, troponin, erythrocyte sedimentation rate, complete blood count, beta-human chorionic gonadotropin, coagulation panel, and urinalysis tests were evaluated. Samples were grouped by admission time, day, and staff on duty. Samples that exceeded the TAT limit were determined and compared in terms of sample receipt time, day, and staffing. Statistical analysis was performed using SPSS for Windows, Version 15.0 (SPSS Inc., Chicago, IL, USA). P<0.05 was considered statistically significant. Results: A total of 286,577 samples were analyzed in 2016 in this laboratory. The TAT of 30,129 samples exceeded the established time limit. The mean TAT of the staff who worked a day shift on weekdays was significantly higher than that of other shifts, with the exception of arterial blood gas (ABG) testing (p=0.000 for all panels). The mean TAT of the staff who worked a night shift on weekdays and weekends was statistically different, excluding coagulation (p=0.08) and ABG (p=0.09) tests. Conclusion: It is strongly recommended that all of the staff who work in the laboratory be sufficiently informed and educated about TAT. Additionally, evaluation of TAT should be taken into consideration ...

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Section: Discussionmentioning

confidence: 99%

“…Following that, in 2004, the TAT of myocardial injury biochemical markers was investigated by both clinicians and laboratory personnel [8]. Recently, Lu et al [9] and Chien et al [10] evaluated turnaround time in a stat laboratory. ED overcrowding is always one of the most severe health problems in medical care systems worldwide.…”

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confidence: 99%

An Evaluation Of Laboratory Efficiency In Emergency Laboratory By Turn Around Time

Kılınçkaya¹

2018

Int J Med Biochem

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“…An important factor in the evaluation of laboratory efficiency is the turnaround time as reported by Lu et al 15,16 and Hawkins 16 . Delay in turnaround time is an indication of lab performance and has adverse clinical consequences.…”

Section: Introductionmentioning

confidence: 99%

“…An important factor in the evaluation of laboratory efficiency is the turnaround time as reported by Lu et al 15,16 and Hawkins. 16 A significant step of the process of pooling assays is to determine the stratification of grouping of the initial samples.…”

Section: Introductionmentioning

confidence: 99%

A reduction of the number of assays and turnaround time by optimizing polymerase chain reaction (PCR) pooled testing for SARS‐CoV‐2

Perivolaropoulos

Vlacha

2021

Journal of Medical Virology

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Early detection of the severe acute respiratory syndrome coronavirus 2 infection can decrease the spread of the disease and provide therapeutic options promptly in affected individuals. However, the diagnosis by reverse-transcription polymerase chain reaction is costly and time-consuming. Several methods of group testing have been developed to overcome this problem. The proposed strategy offers optimization of group testing according to the available resources by decreasing not only the number of the assays but also the turnaround time. The initial classification of the samples would be done according to the intention of testing defined as diagnostic or screening/surveillance, achieving the best possible homogeneity. The proposed stratification of pooling is based on branching (divisions) and depth (levels of re-pooling) of the original group in association with the estimated probability of a positive sample. The dilutional effect of the grouped samples has also been considered. The margins of minimum and maximum conservation of assays of pooled specimens are calculated and the optimum strategy can be selected in association with the probability of positive samples in the original group. This algorithm intends to be a useful tool for group testing offering a choice of strategies according to the requirements.

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The development of autoverification system of lymphocyte subset assays on the flow cytometry platform

Shi

Wang

et al. 2021

Clinical Chemistry and Laboratory Medicine (CCLM)

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Objectives Peripheral blood lymphocyte subsets are important parameters for monitoring immune status; however, lymphocyte subset detection is time-consuming and error-prone. This study aimed to explore a highly efficient and clinically useful autoverification system for lymphocyte subset assays performed on the flow cytometry platform. Methods A total of 94,402 lymphocyte subset test results were collected. To establish the limited-range rules, 80,427 results were first used (69,135 T lymphocyte subset tests and 11,292 NK, B, T lymphocyte tests), of which 15,000 T lymphocyte subset tests from human immunodeficiency virus (HIV) infected patients were used to set customized limited-range rules for HIV infected patients. Subsequently, 13,975 results were used for historical data validation and online test validation. Results Three key autoverification rules were established, including limited-range, delta-check, and logical rules. Guidelines for addressing the issues that trigger these rules were summarized. The historical data during the validation phase showed that the total autoverification passing rate of lymphocyte subset assays was 69.65% (6,941/9,966), with a 67.93% (5,268/7,755) passing rate for T lymphocyte subset tests and 75.67% (1,673/2,211) for NK, B, T lymphocyte tests. For online test validation, the total autoverification passing rate was 75.26% (3,017/4,009), with 73.23% (2,191/2,992) for the T lymphocyte subset test and 81.22% (826/1,017) for the NK, B, T lymphocyte test. The turnaround time (TAT) was reduced from 228 to 167 min using the autoverification system. Conclusions The autoverification system based on the laboratory information system for lymphocyte subset assays reduced TAT and the number of error reports and helped in the identification of abnormal cell populations that may offer clues for clinical interventions.

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An Evaluation of Laboratory Efficiency in Shanghai Emergency by Turn Around Times Level

Cited by 4 publications

References 13 publications

An Evaluation Of Laboratory Efficiency In Emergency Laboratory By Turn Around Time

An Evaluation Of Laboratory Efficiency In Emergency Laboratory By Turn Around Time

A reduction of the number of assays and turnaround time by optimizing polymerase chain reaction (PCR) pooled testing for SARS‐CoV‐2

The development of autoverification system of lymphocyte subset assays on the flow cytometry platform

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