Delay of Issuing Laboratory Test Reports of a State Sector Clinical Laboratory in Sri Lanka: A Case Study

Abstract

Medical treatment decisions are basically made based on the laboratory test reports. Therefore, rapid and accurate laboratory test report issuing is considered as one of the most noticeable signs of a clinical laboratory. Reducing the delay of issuing laboratory test reports will increase patients’ and clinicians’ satisfaction, reduce the hospital stays and indirect costs associated. Ultimately it increases the better image towards the institution. This study was a cumulative case study conducted at a state sector biochemical laboratory in Sri Lanka. Study tools were focus group discussions and review of secondary data sources. Turnaround time for a selected test was recorded as 3 days where the private sector laboratory benchmark is 24 hours. Three associated problems related to delay of issuing laboratory test reports were identified including non-value added laboratory procedure, increased number of laboratory occurrences and increasing staff focus on overtime. Found issues were brainstormed among few officials under three category labels including process management, quality management and people management to find out the root causes. Process Cycle Efficiency was recorded as 10.4%. Laboratory processes are not standardized and all the sample data management and report generation procedures are done manually. The number of incidences of sample missing and transcription errors was recorded as 12.6% and 9.6% respectively. Staff awareness on occurrence management seemed to be poor and self-audits were not being conducted which caused an increase in the number of occurrences. Annual overtime payment has exceeded the allocated amount by 29.9%. Laboratory staff trainings are not conducted and therefore they are not competent enough on new technology, staff supervision provided is limited and job descriptions are not available which ultimately has driven for high over time payment. Implementing solutions for the found issues will rectify the issue of delaying medical test reports.