Weekly laboratory turn-around time identifies poor performance masked by aggregated reporting

Coetzee, Lindi M.; Cassim, Naseem; Glencross, Deborah K.

doi:10.4102/ajlm.v9i1.1102

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…In Turkey, samples that ordered from family health medicine clinics are evaluated. As it mentioned, preanalytical stage is the most common problems that affected on prolonged TAT (8). Preanalytical errors are also hard to solve in the public health laboratory for some reasons such as transportation among suburbs, ineffective centrifugation etc.…”

Section: Resultsmentioning

confidence: 99%

Effect of the Pandemic on the Turnaround Time Intervals in the Public Health Laboratory

Cihan¹,

Kılınçkaya

2022

Acibadem Univ Saglik Bilim Derg

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Introduction Turnaround time is one of the most important signs of a laboratory service which many clinicians use to evaluate the quality of the laboratory. Pandemic has enlightened the importance of laboratory medicine in healthcare organizations. Each step in total testing process can be affected by errors essential in laboratory medicine. Our study aims to evaluate the impact of the COVID-19 pandemic on turnaround time. Material and Methods We evaluated turnaround time periods of the routine biochemistry, immunoassay, hematology, hemoglobinopathies, HbA1c and blood-typing. In our study, intra-laboratory turnaround time, which is starting from sample acceptance time to results’ verification time is determined. Defined turnaround time duration for all type of analytes are 1440 min. Time intervals in study as listed; Group 1 (pre-pandemic stage), Group 2 (pandemic stage), and Group 3 (post-pandemic stage). Frequency of samples with a TAT exceeded the laboratory’s cutoff time interval was determined and compared within groups. Results The percentage of exceeded turnaround time of all analytes, except blood typing, hematology and HbA1c in the Group 1 are significantly lower than other groups. With regards to comparing Group 2 and Group 3, percentage of exceeded turnaround times of HbA1c and hematology samples in the Group 3 are found significantly lower than the Group 2 Discussion: Turnaround time can be evaluated as a benchmark of the laboratory performance. Workload of the laboratories should be taken into consideration is specific situations, like pandemic. Giriş Test istem sonuç süresi, laboratuvar kalitesini değerlendirme amaçlı, çoğu klinisyenin kullandığı önemli bir parametredir. Pandemi dönemi, sağlık hizmeti organizasyonlarında laboratuvar tıbbının önemini bir kez daha göstermiştir. Toplam test sürecindeki her bir basamak, laboratuvar tıbbında önemli olan hatalardan etkilenebilmektedir. Çalışmamızın amacı test istem sonuç süresine COVID-19 pandemisinin etkisini göstermektir. Materyal ve Metot Rutin biyokimya, immünassay, hematoloji, hemoglobinopati değerlendirmesi, HbA1c ve kan gruplama parametrelerindeki test istem sonuç süresi değerlendirilmiştir. Çalışmamızda, örneğin kabul zamanı ile sonuçların onaylanma süresi arasındaki fark olarak da bilinen, laboratuvar içi test istem sonuç süresi kullanılmıştır. Laboratuvarımızda belirlenen test istem sonuç süresi, 1440 dk'dır. Çalışma grubundaki zaman aralıkları; Grup 1 (Pandemi öncesi dönem), Grup 2 (Pandemi dönemi) ve Grup 3 (Pandemi sonrası dönem) olarak gruplandırılmıştır. Laboratuvarın belirlediği test istem sonuç süresini aşan örneklerin sıklığı belirlenmiş ve gruplar arası karşılaştırması yapılmıştır. Sonuçlar Grup 1'deki Kan grubu, hematoloji ve HbA1c analizleri dışındaki diğer analizlerdeki test istem sonuç süresini aşan numune sıklıkları, diğer gruplara göre daha düşüktür. Grup 2 ve Grup 3 karşılaştırıldığında, HbA1c ve hematoloji örneklerindeki test istem sonuç süresi aşma sıklığı, Grup 3'de anlamlı düzeyde düşüktür. Tartışma: Test istem sonuç süresi, laboratuvar performansının bir belirteci olarak değerlendirilebilir. Laboratuvarların iş yükü, pandemi gibi spesifik durumlarda göz önünde bulundurulmalıdır.

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Section: Resultsmentioning

confidence: 99%

Effect of the Pandemic on the Turnaround Time Intervals in the Public Health Laboratory

Cihan¹,

Kılınçkaya

2022

Acibadem Univ Saglik Bilim Derg

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“…In order to deploy updated techniques and enhance patient outcomes, there is a requirement for periodic monitoring of delayed TATs. Coetzee et al [ 21 ] have recommended that weekly monitoring of TATs identifies poor performance more accurately than aggregate reporting. Future laboratory personnel needs to implement weekly analysis, thereby focusing on the identification of poorly performing laboratories that need immediate intervention.…”

Section: Discussionmentioning

confidence: 99%

Monitoring and Root Cause Analysis of Clinical Biochemistry Turnaround Time at a Tertiary Care Institute

Prasad¹,

Kumar²,

Kumar³

et al. 2023

Cureus

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Introduction: Most laboratories around the world have focused on improving the analytical quality of laboratory tests. Laboratory turnaround time (TAT) is often left unnoticed and under-recognised in the healthcare setting. Both patients and clinicians are more interested in receiving rapid, reliable, and accurate results. This can be achieved by improving the TAT through the identification of the causes that lead to delayed TAT. Materials and methods: This prospective study aims to identify the cause of delayed TATs within the outpatient department and implement corrective strategies to overcome them. A total of 214 samples were received. The study was conducted for a period of two years; of all the samples received, 154 were from the outpatient department, and 78 samples exceeded the expected TAT. The samples were analysed in the clinical biochemistry department of the hospital. The time spent at each station was determined using an internal computer system, which was also used to identify the samples that exceeded TATs. The primary outcome of the study was to identify the number of samples exceeding TAT and the causes of it. Results: Upon implementation of corrective measures and root cause analysis, the TATs were reduced from 80-88% to 11-33%. After analysing the duration of time for the samples that exceeded TAT, 45.1% and 37.5% exceeded 30 minutes in Year 1 and Year 2, respectively. Only 3.2% and 6.2% exceeded five hours in Year 1 and Year 2, respectively. Furthermore, using root cause analysis, it was found that 12% of the delay was due to increased waiting time or sample collection, 14% included other causes such as outsourcing of samples, and 18% of the delay was due to pre-analytic processing time. Conclusion: Our study concludes that TAT is an important quality assessment tool within the laboratory setting, and with proper identification of causes, it can be improved. Although monitoring TAT is a tedious process that mandates tremendous efforts, with the presence of real-time monitoring, improving TAT is an achievable goal. This, in turn, can improve patient treatment outcomes and clinician satisfaction.

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“…signify the good quality of Lab reports. 2,3 A good quality laboratory performance is depicted in the test reports it generates and is also equally reflected in the Quality Controls performed as its performance checks. Besides Internal Quality Control (IQC) and External Quality Control (EQC); their exhaustive interpretation has become quite indispensable in the present scenario.…”

Section: Introductionmentioning

confidence: 99%

Sigma Metrics Assessment as Quality Improvement Methodology in a Clinical Chemistry Laboratory

Garg

Sharma

2021

Preprint

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Background:The concept of sigma metrics & lean six sigma is well known in the field of healthcare. However not many labs utilize the six sigma metrics for maintenance of high quality laboratory performance. A minimum value of 3 σ is desired in any clinical laboratory & values of σ≥6 are regarded as gold standard for obtaining high quality lab reports. Aims &Objectives: To calculate bias, cv & sigma metrics from the IQC & EQC data in order to ascertain extent of quality management in our lab. Materials &Methods:An extensive study of sample processing and quality practices was carried out in the Central Laboratory of Department of Biochemistry; PGIMER &Dr. RML Hospital, New Delhi; from Feb 2020 to July 2020. The IQC used(both level I & level II) were from Biorad Laboratories India (lyphochek assayed chemistry control) & the EQC used was from Randox Laboratories, UK. All the controls were run on Beckman Coulter clinical chemistry analyser AU 680. Total 14 clinical parameters were analysed & subsequently; Mean, S.D., CV, bias & σ were calculated through their respective formulas. Results:Sigma level was more than 6 for both levels of IQC was observed for Amylase. It indicates world class performance. Total bilirubin, AST, Triglyceride & HDL depicted σ values between 3.1 to 6 for both L1 & L2. Iron showed σ value of 5.5 in L1 whereas it was 3.78 in L2. Conclusion:-:- Sigma metrics in clinical laboratory is an essential technique to ascertain poor assay performance, along with assessment of the efficiency of existing laboratory process.

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Weekly laboratory turn-around time identifies poor performance masked by aggregated reporting

Cited by 5 publications

References 14 publications

Effect of the Pandemic on the Turnaround Time Intervals in the Public Health Laboratory

Effect of the Pandemic on the Turnaround Time Intervals in the Public Health Laboratory

Monitoring and Root Cause Analysis of Clinical Biochemistry Turnaround Time at a Tertiary Care Institute

Sigma Metrics Assessment as Quality Improvement Methodology in a Clinical Chemistry Laboratory

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