Laboratory sample turnaround times: do they cause delays in the ED?

Gill, Dipender; Galvin, Sean D.; Ponsford, Mark; Bruce, David; Reicher, John; Preston, Laura; Bernard, Stephani; Lafferty, Jessica; Robertson, Andrew; Rose-Morris, Anna; Stoneham, Sarah J.; Rieu, Romelie; Pooley, Sophie; Weetch, Alison; McCann, Lloyd E.

doi:10.1111/j.1365-2753.2010.01545.x

Cited by 16 publications

(10 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, they generally require deeper investigations, diagnostic tests, or laboratory studies, which lengthens their ED treatment stay. 36,44 Clinical acuity has therefore been extensively studied as an ED-LOS determinant, with a majority reporting that it is a significant ED-LOS determinant. 5,[7][8][9]11,12,18,21,22,[28][29][30] Very few studies have reported a non-significant effect, 31 with the findings in the present study support the majority of the literature in that clinical acuity was a significant determiner of ED-LOS.…”

Section: Discussionmentioning

confidence: 99%

Analyzing Main and Interaction Effects of Length of Stay Determinants in Emergency Departments

Sarıyer

Ataman

Kızıloğlu

2019

Int J Health Policy Manag

View full text Add to dashboard Cite

Background: Measuring and understanding main determinants of length of stay (LOS) in emergency departments (EDs) is critical from an operations perspective, since LOS is one of the main performance indicators of ED operations. Therefore, this study analyzes both the main and interaction effects of four widely-used independent determinants of ED-LOS. Methods: The analysis was conducted using secondary data from an ED of a large urban hospital in Izmir, Turkey. Between-subject factorial analysis of variance (ANOVA) was used to test the main and interaction effects of the corresponding factors. P values <.05 were considered statistically significant. Results: While the main effect of gender was insignificant, age, mode of arrival, and clinical acuity had significant effects, whereby ED-LOS was significantly higher for the elderly, those arriving by ambulance, and clinically-categorized high-acuity patients. Additionally, there was an interaction between the age and clinical acuity in that, while ED-LOS increased with age for high acuity patients, the opposite trend occurred for low acuity patients. When ED-LOS was modeled using gender, age, and mode of arrival, there was a significant interaction between age and mode of arrival. However, this interaction was not significant when the model included age, mode of arrival, and clinical acuity. Conclusion: Significant interactions exist between commonly used ED-LOS determinants. Therefore, interaction effects should be considered in analyzing and modelling ED-LOS.

show abstract

Section: Discussionmentioning

confidence: 99%

Analyzing Main and Interaction Effects of Length of Stay Determinants in Emergency Departments

Sarıyer

Ataman

Kızıloğlu

2019

Int J Health Policy Manag

View full text Add to dashboard Cite

show abstract

“…A limitation of the study was the use of aggregated hospital-level data without adjustments for patient and ED presentation-related characteristics. In addition, most of above studies only focused on a subset of laboratory tests, 7,8 rather than all requested laboratory tests. We aimed to address several of the limitations of previous studies by assessing the relationship between all laboratory test TATs on ED LOS across four hospitals.…”

mentioning

confidence: 99%

“…5 A simulation study by Storrow et al 6 in 2008 suggested that decreased TAT could improve ED efficiency and reduce ED LOS. A small single-site study that examined 101 blood tests at one ED over a short period (27 hours) by Gill et al 7 in 2012 showed an association between prolonged LOS and TAT. Francis et al in 2009 8 reported a relationship between laboratory work process design and LOS in ED, but they were unable show a direct relationship between TAT and ED LOS.…”

mentioning

confidence: 99%

The Effect of Laboratory Testing on Emergency Department Length of Stay: A Multihospital Longitudinal Study Applying a Cross‐classified Random‐effect Modeling Approach

Georgiou

Vecellio

et al. 2015

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: The objective was to examine the relationship between laboratory testing (including test volume and turnaround time [TAT]) and emergency department (ED) length of stay (LOS), using linked patient-level data from four hospitals across 4 years.Methods: This was a retrospective, multisite cohort study of patients presenting to any one of four EDs in New South Wales, Australia, during a 2-month period (August and September) in 2008, 2009, 2010, and 2011. Data from ED information systems were linked to laboratory test data. A cross-classified random-effect modeling approach was applied to identify factors affecting ED LOS, taking into account the correlation between patients' presentations at the same hospital and/or in the same calendar year. Number of test order episodes (tests ordered at one point in time during the ED stay) and TAT (time from laboratory order receipt to result available) were examined.Results: As the number of test order episodes increased, so did the duration of patient ED LOS (p < 0.0001). For every five additional tests ordered per test order episode, the median ED LOS increased by 10 minutes (2.9%, p < 0.0001); each 30-minute increase in TAT was, on average, associated with a 5.1% (17 minutes; p < 0.0001) increase in ED LOS, after adjustment for other factors. Patients presenting to the ED at night (7 p.m. to 7 a.m.) had longer stays than those presenting during the daytime, although the median TATs at nights were shorter than those during the daytime.Conclusions: Laboratory testing has a direct effect on patients' LOS in ED. Laboratory TAT, number of testing episodes, and test volume influence ED LOS. Targeted increases of ED resources and staffing after-hours may also contribute to reductions in ED LOS.ACADEMIC EMERGENCY MEDICINE 2015;22:38-46

show abstract

“…13 Gill et al also showed a positive correlation between laboratory TAT and length of stay. 14 Regular monitoring of TAT itself acts as a very useful tool to improve the routine TAT as it aids to uncover and correct the unrecognised inefficiencies in laboratory operation. According to Peller GA et al daily monitoring and plotting of TAT in the form of freckle plot serves as a useful quality improvement tool.…”

Section: Before Intervention After Interventionmentioning

confidence: 99%

Effectiveness of Implementing Process Improvement Strategies on Turnaround Time of Emergency Investigations, in Clinical Biochemistry Laboratory

Patil¹,

Patil²,

Kulkarni³

et al. 2019

Indian Journal of Medical Biochemistry

View full text Add to dashboard Cite

Background: Turnaround time (TAT) is one of the most noticeable signs of a laboratory service and is used by many clinicians as a benchmark to judge the quality of laboratory service. Despite automation and computerisation, delayed TAT of emergency department (ED) samples was a complaint received in our clinical biochemistry laboratory. After process mapping and root cause analysis, we designed an improvement strategy which included the introduction of emergency request forms (ERF), creating awareness in the technical staff by proper training and streamlining the work flow path. Aim: To compare the TAT of ED samples for electrolytes, received 1month before and after implementing the process improvement strategy. Materials and methods: Data regarding the number of electrolyte assays ordered from ED for 1 month before and after implementing the improvement strategy was obtained from hospital laboratory information system (LIS). TAT was calculated as the interval between sample accession in the laboratory and the time results were reported in LIS. Independent sample 't' test was used to compare the mean TAT before and after the intervention Results: Independent sample 't' test showed reduction in the TAT of ED electrolyte assays after intervention compared to before intervention (78.74 and 110.08 min respectively) with a statistically significant (p<0.001) difference of 31.34 min. Conclusion: Significant reduction in the TAT of ED samples after intervention highlighted the power of analytical phase intervention in the form of reallocation of resources and staff awareness in effectively reducing the TAT. The study also proved the usefulness of having separate colour coded ERF in early identification, segregation and processing of ED samples. Clinical Significance: Decreased laboratory turnaround time of ED investigations is clinically significant because along with customer satisfaction it also improves the efficiency of work by allowing the early diagnosis, treatment, patient discharge and provides a way of cost cutting. and population served. According to CAP Q probe assay, there are differences between clinicians and laboratories in their definition of TAT. 1 The term therapeutic TAT is used to describe the interval between the test order and the time when treatment decision is made. Perhaps many steps in the total testing cycle occur outside the laboratory and are not under direct control of the laboratory

show abstract

Laboratory sample turnaround times: do they cause delays in the ED?

Cited by 16 publications

References 13 publications

Analyzing Main and Interaction Effects of Length of Stay Determinants in Emergency Departments

Analyzing Main and Interaction Effects of Length of Stay Determinants in Emergency Departments

The Effect of Laboratory Testing on Emergency Department Length of Stay: A Multihospital Longitudinal Study Applying a Cross‐classified Random‐effect Modeling Approach

Effectiveness of Implementing Process Improvement Strategies on Turnaround Time of Emergency Investigations, in Clinical Biochemistry Laboratory

Contact Info

Product

Resources

About