Turnaround Times for Hematology and Chemistry Tests in the Emergency Department: Experience of a Teaching Hospital in Iran

Mahdaviazad, Hamideh; Javidialesaadi, Fatemeh; Hosseinzadeh, Massood; Masoompour, Seyed Masoom

doi:10.17795/semj37101

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…Our results showed that most samples were processed in the laboratory within 90 minutes and the median TAT-intra laboratory was 56 minutes (IQR: 36-80 minutes). These results are similar to the studies of Mutema et al [13] and Mahdaviazad et al [21]. In contrast, Winkelman et al stated that this median time was 35 minutes for urgent hospital tests [22].…”

Section: Discussionsupporting

confidence: 88%

Turnaround Time of the Hematology Results of Cancer Patients During the COVID-19 Pandemic: An Opportunity to Initiate a Quality Improvement Process

El Assil,

Benkirane,

El Kettani

et al. 2024

Cureus

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Introduction: Turnaround time (TAT) is a crucial clinical parameter that reflects the performance of a laboratory especially in the context of oncology and the COVID-19 pandemic. Based on the Lean Six Sigma methodology, we performed a retrospective analysis of the TAT of the complete blood count (CBC) of cancer patients with the aim of reducing this delay in the future.Materials and methods: Over one month of the COVID-19 pandemic, a retrospective evaluative audit was carried out on the TAT of the CBC in an oncology department. The root causes of failures of the overall analysis process were detected. The initiation of an improvement approach was implemented through the creation of an improvement flowchart and a new request form. The hospital information system (HIS) data were exported to Microsoft Excel® (Microsoft Corporation, Redmond, Washington, United States). Using the collected data, the mean, standard deviation, median, and interquartile range were calculated using IBM SPSS Statistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). All time intervals were expressed in minutes.Results: Among 263 intra-laboratory TATs analyzed, the median intra-lab TAT was 56 minutes (interquartile range (IQR): 36-80 minutes). A total of 82% of the analyses were performed in less than 90 minutes with a predominance of the interval 30-59 at 42.9%. The main causes of failures were essentially the lack of time stamping of the samples as well as the lack of real-time communication between the biologists and the clinicians. The proposed improvement model is currently being approved by all practitioners whose main items are as follows: At the clinical department level, distinguish the request forms but also the labels of the samples of the oncology hospital by a particular color, indication of clinical signs and sampling time on the request forms and on the HIS. At the laboratory level, create a specific chain for oncology department samples, alarm notification on the HIS, and rapid telecommunication of results for vital situations. Conclusion:The intra-lab TAT of our study is biologically acceptable. Because our work is limited by the phases outside the control of the laboratory, it should lead to a continuous improvement project.

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Section: Discussionsupporting

confidence: 88%

Turnaround Time of the Hematology Results of Cancer Patients During the COVID-19 Pandemic: An Opportunity to Initiate a Quality Improvement Process

El Assil,

Benkirane,

El Kettani

et al. 2024

Cureus

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“…Hence, in our study, the mean ± standard deviation overall TAT was 464.4 ± 31.05 minutes for hemogram, 549.1 ± 29.9 minutes for glucose, 483.1 ± 7.32 minutes for urea, 481 ± 6.2 minutes for creatinine and 536.7 ± 30.1 minutes for electrolytes (Table 1). Mahdaviazad., et al found that the mean overall TAT varied between 1.3 -3.1 hours [16]. Chung., et al demonstrate the average TAT of 43.6 ± 7.7 min for outpatient routine biochemistry samples [17].…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Clinical Laboratory Tests’ Turnaround Time in a Tertiary Hospital in Democratic Republic of the Congo

Alain¹,

Rostin²,

Joël³

et al. 2021

JBM

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The delay in the delivery of laboratory results can be fatal and can even lead to the death of patients. This study was conducted at the clinical laboratory of the University Hospital of Kinshasa (UHK) from October 2020 to April 2021, aimed to evaluate the laboratory tests' turnaround time (TAT) and to identify reasons for delay. TAT was quantified using a time and motion analysis approach. The evaluation of TAT consisted of comparing the overall intra-lab TAT with the suggested TAT using student t-test at 95% confidence intervals. Brainstorming was the root cause analysis tool used for identifying reasons for delay. In this study, the laboratory tests' TATs were significantly higher (p < 0.001) comparing to international guidelines (60 minutes) and customers' suggested TAT (120 minutes). Only 0.98% of the samples were reported within 60 minutes of patient reception and 1.47% within 120 minutes, i.e. an outlier rate of 98.5%. Root causes of delay related to Machinery, Management, Manpower, Materials, Method and Milieu. Because of many reasons, the laboratory is not meeting the established TAT. Preventive and curative measures must be undertaken to reduce the delay and improve the TAT.

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“…Our findings were similar to those previously reported. 5 , 20 The preanalytical and post-analytical phases accounted for a greater proportion of the total TAT, with a median of 60 min transportation time (preanalytical phase) and 48.9% of the post-analytical phase taking more than 120 min. In contrast, most of the samples were processed in the laboratory within 90 min.…”

Section: Discussionmentioning

confidence: 99%

In-depth investigation of turn-around time of full blood count tests requested from a clinical haematology outpatient department in Cape Town, South Africa

Mutema

Chapanduka

Musaigwa

et al. 2021

African Journal of Laboratory Medicine

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Background: The performance of laboratories can be objectively assessed using the overall turn-around time (TAT). However, TAT is defined differently by the laboratory and clinicians; therefore, it is important to determine the contribution of all the different components making up the laboratory test cycle.Objective: We carried out a retrospective analysis of the TAT of full blood count tests requested from the haematology outpatient department at Tygerberg Academic Hospital in Cape Town, South Africa, with an aim to assess laboratory performance and to identify critical steps influencing TAT.Methods: A retrospective audit was carried out, focused on the full blood count tests from the haematology outpatient department within a period of 3 months between 01 February and 30 April 2018. Data was extracted from the National Health Laboratory Service laboratory information system. The time intervals of all the phases of the test cycle were determined and total TAT and within-laboratory (intra-lab) TAT were calculated.Results: A total of 1176 tests were analysed. The total TAT median was 275 (interquartile range [IQR] 200.0–1537.7) min with the most prolonged phase being from authorisation to review by clinicians (median 114 min; IQR: 37.0–1338.5 min). The median intra-lab TAT was 55 (IQR 40–81) min and 90% of the samples were processed in the laboratory within 134 min of registration.Conclusion: Our findings showed that the intra-lab TAT was within the set internal benchmark of 3 h. Operational phases that were independent of the laboratory processes contributed the most to total TAT.

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Turnaround Times for Hematology and Chemistry Tests in the Emergency Department: Experience of a Teaching Hospital in Iran

Cited by 5 publications

References 10 publications

Turnaround Time of the Hematology Results of Cancer Patients During the COVID-19 Pandemic: An Opportunity to Initiate a Quality Improvement Process

Turnaround Time of the Hematology Results of Cancer Patients During the COVID-19 Pandemic: An Opportunity to Initiate a Quality Improvement Process

Evaluation of Clinical Laboratory Tests’ Turnaround Time in a Tertiary Hospital in Democratic Republic of the Congo

In-depth investigation of turn-around time of full blood count tests requested from a clinical haematology outpatient department in Cape Town, South Africa

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