Evaluating stat testing options in an academic health center: therapeutic turnaround time and staff satisfaction

Kilgore, Meredith L.; Steindel, Steven J.; Smith, John A.

doi:10.1093/clinchem/44.8.1597

Cited by 114 publications

(34 citation statements)

References 7 publications

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“…Turnaround time analysis was accomplished by identifying action points to be assessed [9] [38] [39], followed by detailed data collection. Moreover, the backlogged case-files, N cb , were also repeatedly captured at different action points by determining the number of case-files received and reported [5].…”

Section: Impact Of Process Variables On Fsl Competitivenessmentioning

confidence: 99%

Development of a Competitiveness Improvement Framework for Forensic Science Laboratories

Omari¹,

Manyele²,

Mwaluko³

2019

ENG

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This study presents a methodology used in developing the competitiveness improvement framework (CIF) for laboratories, in particular, Forensic Science Laboratories (FSLs). The cyclic nature of FSL processes allowed data collection for the purpose of identification of factors affecting FSL performance (cause factors). Flow charts were used to represent mathematical formulations for cause factor measurements and quantification of the baseline data on turnaround time (TAT), backlogs for case files (B g ), turnaround time in the supply chain (T sc ), and employee absenteeism (A b ). By quantifying the cause factors in addition to academic development coefficient (A d ) and complex longevity (L c ) for FSL employees, it was possible to establish the organizational design features requiring improvements. The relevance of cause factors to FSL stakeholders and means of improvement and sustainability were established. A detailed road map towards CIF was presented using D-MAIC methodology. The rated cause factors based on challenges in the FSL business environment were subjected to Pareto analysis to prioritize the challenges in order to improve FSLs' competitiveness. The interrelationship between the three dimensions of competitiveness improvement (process, performance and planning) was presented in terms of the affected six cause factors. Also, the potential lean practices for improving competitiveness of FSL based on measured cause factors have been presented. This paper introduced methods and measures for improving operational competitiveness of laboratories. The CIF was finally presented in a form of a series of three flow charts summarizing all steps implemented in its development with inputs and cause factors involved. Case-file backlogs were identified as one of the cause factors affecting the competitiveness of the (FSL). Backlogs represent case-files that remain unprocessed or unreported within a selected time interval (year, week or month) which leads to increased customer complaints, rework, cost of analysis, degradation of biological samples, etc. Case-file backlogging was quantified in three consecutive years (Y2014 to Y2016) to study variations as case files are processed [2] [3] [4] [5]. Data were collected for the case-files received and case-files processed, difference of which gives case-files backlogged. The time interval for a case-file to be regarded as backlogged was one week, which can translate into backlogged case-files per month or year. A data collection tool was established and used for three laboratory disciplines (forensic chemistry, biology/DNA and toxicology).

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Section: Impact Of Process Variables On Fsl Competitivenessmentioning

confidence: 99%

Development of a Competitiveness Improvement Framework for Forensic Science Laboratories

Omari¹,

Manyele²,

Mwaluko³

2019

ENG

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“…While the turn-around time for CLT can be significantly reduced with satellite laboratories, it still would not match that of POCT. [31][32][33]…”

Section: Turn-around Timementioning

confidence: 99%

Point-of-Care Blood Glucose Testing for Diabetes Care in Hospitalized Patients

Rajendran

Rayman

2014

J Diabetes Sci Technol

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Glycemic control in hospitalized patients with diabetes requires accurate near-patient glucose monitoring systems. In the past decade, point-of-care blood glucose monitoring devices have become the mainstay of near-patient glucose monitoring in hospitals across the world. In this article, we focus on its history, accuracy, clinical use, and cost-effectiveness. Point-of-care devices have evolved from 1.2 kg instruments with no informatics to handheld lightweight portable devices with advanced connectivity features. Their accuracy however remains a subject of debate, and new standards for their approval have now been issued by both the International Organization for Standardization and the Clinical and Laboratory Standards Institute. While their cost-effectiveness remains to be proved, their clinical value for managing inpatients with diabetes remains unchallenged. This evidence-based review provides an overall view of its use in the hospital setting.

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“…In Tabelle [4,5,6,9], sollten auch die meist um vieles ho Èheren Kosten [1] nicht auûer Acht gelassen werden.…”

Section: Poct-analysenspektrumunclassified

Point-of-Care Testing/Point-of-Care Testing

Heinschink¹,

Müller²

2002

LaboratoriumsMedizin

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Zusammenfassung: Point-of-Care-Testing (POCT), welches auûerhalb von zentralen oder dezentralen Laboratorien nahe dem Patienten durchgefu Èhrt wird, ist ein sta Èndig steigender Trend in der Labordiagnostik. Indem man die Analysen na Èher zum Patienten bringt, fallen einige Arbeitsschritte weg, und es werden raschere Resultate ermo Èglicht; dadurch kann schneller und gezielter reagiert werden, wodurch man ein besseres klinisches Ergebnis erreicht. Die Vorteile sind schnellere Turn-Around-Times (TAT), schnellere medizinische Entscheidungen, Vermeidung von langwierigem Probentransport und die Notwendigkeit von nur kleinen Probenmengen. Diese Vorteile werden zwar oft hervorgehoben, gehen aber nicht mit einem klar erkennbaren klinischen Nutzen einher. Die Nachteile des POCT wie unsachgema Èûe Wartung der Analysengera Ète durch das teils ungeschulte Stationspersonal, mangelnde oder fehlende Kalibration und/ oder Qualita Ètskontrolle, Kosten durch Vorhaltung mehrerer Gera Ète und teurerer Reagenzien, unzureichende Dokumentation und schwierige Vergleichbarkeit zwischen den POCT-Ergebnissen und den Zentrallaborergebnissen, sollten beru Ècksichtigt werden. Die Entscheidung zur Etablierung eines POCT sollte nur in enger Kooperation zwischen Klinikern und Labormedizinern erfolgen, um Sinnhaftigkeit und hohe Qualita Èt der Analysen zu gewa Èhrleisten. Unter Beru Ècksichtigung der lokalen Situation sollte sich das Analysenspektrum des POCT streng auf vitale Funktionen beschra Ènken. Obwohl das Analysenspektrum auf den ersten Blick sehr verlockend erscheint, sollten auch die bis zu 10-fach ho Èheren Kosten bei Einfu Èhrung des POCT nicht auûer Acht gelassen werden.Schlu È sselwo È rter: Point-of-Care Testing (POCT); Turn-Around-Time (TAT); Kostenrentabilita Èt; Qualita Ètssicherung.Summary: Point-of-Care Testing (POCT), which is defined as any laboratory test performed outside central or decentralized laboratories, is a continuously expanding trend in the practice of laboratory diagnosis. By bringing the analysis closer to the patient, several process steps have been eliminated, facilitating a shorter time to result and faster management response with improved outcomes. The advantages of POCT are faster turn-around-times (TAT), more rapid medical decisions, avoidance of long sample transport and the need of only small specimen volumes. These advantages are frequently emphasised but are not associated with a clear clinical benefit. The disadvantages of POCT such as incorrect maintenance of the analysers by partly non-trained clinical staff, inadequate or absent calibrations and/or quality controls, lack of cost-effectiveness because of an increased number of analysers and more expensive reagents, insufficient documentation, and difficult comparability of the obtained POCT-results with routine laboratory results should be taken into consideration. The decision for establishing or introducing POCT in a hospital environment has only to be made in close cooperation between physicians and laboratorians in order to vouch for necessit...

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Evaluating stat testing options in an academic health center: therapeutic turnaround time and staff satisfaction

Cited by 114 publications

References 7 publications

Development of a Competitiveness Improvement Framework for Forensic Science Laboratories

Development of a Competitiveness Improvement Framework for Forensic Science Laboratories

Point-of-Care Blood Glucose Testing for Diabetes Care in Hospitalized Patients

Point-of-Care Testing/Point-of-Care Testing

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