The Impact of Electronic Order Communications on Laboratory Turnaround Times in Acute Hospital Care

Abstract

ObjectiveTo examine the impact of computerised physician order entry (CPOE) systems upon laboratory turnaround times (LTAT), namely the time from recording the collection of a blood sample to the results being reported, within a large acute hospital.Materials and methods1,810,311 blood samples taken between 1stJanuary 2014 and 31stDecember 2019 were included. Changes in LTAT over the 24 months pre- and 18 months post-CPOE implementation were analysed using a segmented regression approach. The primary analysis assessed the median LTAT across the whole hospital, with secondary analyses assessing subgroups defined by clinical settings.ResultsCPOE implementation was associated with a step-change reduction in the median LTAT of 31.7 minutes (95% CI: 25.5-37.9, p<0.001). This was sustained over eighteen months post- implementation of CPOE despite the number of samples increasing by an average of 31% in this post-implementation period. Analysis by broad clinical specialty found all subgroups of wards considered to have a significant reduction in LTAT post-CPOE, either in the form of a step-change reduction, or an increasing rate of change.Discussion and ConclusionThe implementation of CPOE within an acute hospital improves the average LTAT over a prolonged period, despite an increase in the number of samples collected. This could improve care efficiencies. Understanding the likely reduction in LTAT also provides information to support an economic evaluation of the implementation of such a system into a new setting.