An Evaluation Of Laboratory Efficiency In Emergency Laboratory By Turn Around Time

Abstract

Q uality can be defined as the ability of a product or service to satisfy the needs and expectations of the customer [1]. Laboratories have traditionally restricted discussion of quality to technical or analytical quality, focusing on imprecision and inaccuracy [2]. However, timeliness and accuracy are other terms of efficient laboratory management. While they share the concerns of laboratories, clinicians are also interested in the larger quality of service that laboratories offer, including areas such as the cumulative total of test errors, availability, cost, relevance , and timeliness. They need rapid and efficient laboratory service at a low cost [3]. Turnaround time (TAT) can be defined as a marker of timeliness; therefore, it can be used to evaluate the performance of laboratory. According to Lundberg [4], it is necessary to achieve the following steps to perform a laboratory test: ordering, collection, identification, transportation, preparation, analysis, reporting, interpretation, and action. Lundberg also identified the brainto-brain TAT or "total testing cycle" using that 9-step series [5]. Objectives: Accuracy, precision, timeliness, and authenticity are the 4 pillars of efficient laboratory services. Clinical biochemists generally overlook timeliness as an important attribute. However, turnaround time (TAT) is usually regarded by clinicians as the benchmark of laboratory performance. TAT can be classified by tests: priority, population served, etc. The aim of the current study was to both evaluate and compare the TAT of the test panels used in the emergency laboratory of Ankara Numune Training and Research Hospital. Methods: The TAT for tests carried out in the emergency laboratory in 2016 was recorded. The TAT limit for each analyte was determined by the hospital's quality control department. Routine biochemistry, arterial blood gas, troponin, erythrocyte sedimentation rate, complete blood count, beta-human chorionic gonadotropin, coagulation panel, and urinalysis tests were evaluated. Samples were grouped by admission time, day, and staff on duty. Samples that exceeded the TAT limit were determined and compared in terms of sample receipt time, day, and staffing. Statistical analysis was performed using SPSS for Windows, Version 15.0 (SPSS Inc., Chicago, IL, USA). P<0.05 was considered statistically significant. Results: A total of 286,577 samples were analyzed in 2016 in this laboratory. The TAT of 30,129 samples exceeded the established time limit. The mean TAT of the staff who worked a day shift on weekdays was significantly higher than that of other shifts, with the exception of arterial blood gas (ABG) testing (p=0.000 for all panels). The mean TAT of the staff who worked a night shift on weekdays and weekends was statistically different, excluding coagulation (p=0.08) and ABG (p=0.09) tests. Conclusion: It is strongly recommended that all of the staff who work in the laboratory be sufficiently informed and educated about TAT. Additionally, evaluation of TAT should be taken into consideration ...

Determining the turnaround time in a newly established biochemistry laboratory

“…The turnaround time is one of the important indicators of quality as well as the accuracy and reliability of the test results of laboratories (2)(3)(4). The longer turnaround time of the laboratory means the longer the patients' access to diagnosis and treatment and the longer the hospital stay (8)(9)(10).…”

“…To illustrate this, timeliness is one of the key attributes prepared to be assessed as one of the key quality steps. The TAT times described above are also one of the most important indicators (8)(9)(10)(11).…”

An Auto-Approval Approach for Laboratory Test Assessment

“…It may improve efficiency, reduce the overall turnaround time, and be accomplished within flexible regulatory frameworks [6], [7]. Ideally, it allows the analyzer to focus manual reviews on a small portion of potentially problematic specimens and test results instead of thousands of them, which can significantly reduce the total review time and effort [8], [9]. However, there are some concerns to be considered during the implementation of auto-approval procedures.…”

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

“…Turnaround time (TAT) is one of the most important signs of a laboratory service which many clinicians use to evaluate the quality of the laboratory (3). The definition of TAT can be varied by test, priority, or population-based.…”