Effectiveness of Implementing Process Improvement Strategies on Turnaround Time of Emergency Investigations, in Clinical Biochemistry Laboratory

Abstract

Background: Turnaround time (TAT) is one of the most noticeable signs of a laboratory service and is used by many clinicians as a benchmark to judge the quality of laboratory service. Despite automation and computerisation, delayed TAT of emergency department (ED) samples was a complaint received in our clinical biochemistry laboratory. After process mapping and root cause analysis, we designed an improvement strategy which included the introduction of emergency request forms (ERF), creating awareness in the technical staff by proper training and streamlining the work flow path. Aim: To compare the TAT of ED samples for electrolytes, received 1month before and after implementing the process improvement strategy. Materials and methods: Data regarding the number of electrolyte assays ordered from ED for 1 month before and after implementing the improvement strategy was obtained from hospital laboratory information system (LIS). TAT was calculated as the interval between sample accession in the laboratory and the time results were reported in LIS. Independent sample 't' test was used to compare the mean TAT before and after the intervention Results: Independent sample 't' test showed reduction in the TAT of ED electrolyte assays after intervention compared to before intervention (78.74 and 110.08 min respectively) with a statistically significant (p<0.001) difference of 31.34 min. Conclusion: Significant reduction in the TAT of ED samples after intervention highlighted the power of analytical phase intervention in the form of reallocation of resources and staff awareness in effectively reducing the TAT. The study also proved the usefulness of having separate colour coded ERF in early identification, segregation and processing of ED samples. Clinical Significance: Decreased laboratory turnaround time of ED investigations is clinically significant because along with customer satisfaction it also improves the efficiency of work by allowing the early diagnosis, treatment, patient discharge and provides a way of cost cutting. and population served. According to CAP Q probe assay, there are differences between clinicians and laboratories in their definition of TAT. 1 The term therapeutic TAT is used to describe the interval between the test order and the time when treatment decision is made. Perhaps many steps in the total testing cycle occur outside the laboratory and are not under direct control of the laboratory