Turnaround Time (TAT): Difference in Concept for Laboratory and Clinician

Abstract

Lab investigations are essential in patient management and qualities of the tests reports are emphasized. But there is another aspect of quality which is often overlooked and that is timeliness which is expressed as turnaround time (TAT). Mostly the laboratory services are directed at providing a rapid, reliable report at a reasonable cost. However, most laboratories put undue stress on only reliability, where as the clinician gives more stress on how soon (TAT) a report would be available to them. There is no clear definition of TAT, as to which period should be included in determining TAT for a specific test. For laboratory personnel, it would be from the time of receipt of sample in laboratory till report is generated. However, for a clinician, it would appropriate from the time of his/her requisition of a test till the report reaches him/her. The TAT would not be similar for routine tests versus in STAT/ urgent tests. TAT would be different for ICU/emergency services. The causes of poor satisfaction level from lab users includes stat and routine test TAT and stat test TAT is considered by majority as the most important indicator of laboratories functioning. Hospital computerization with record of time from test request, sample collection, report generation and receipt of report by clinician would help in generating TAT. Analyzing outliers in TAT in a lab gives insight of causes delay in TAT and the areas need improvement. Laboratories in developing countries are yet to use TAT and analyze them for laboratory improvement.

Using laboratory data to categorise CD4 laboratory turn-around-time performance across a national programme

“…Turn-around time is one of the most perceptible aspects noted by clinicians with respect to laboratory services 10 , 12 and is frequently used to gauge laboratory service performance. 9 It can also be used by the laboratory service provider to appraise efficiencies across a network of testing facilities.…”

“…Laboratory test TAT depends on the nature of test, the clinical significance and time to clinical intervention. 10 , 12 For example for CD4 services, determining an acceptable local TAT target is based on the standard of care for enrolling patients onto ART. In South Africa, this equates to ART initiation within 14 days of CD4 testing or seven days where a CD4 is < 200 cells/µL.…”

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

“…[5] However, somewhat similar to a TAT for the laboratory report, the TAT for a BT should be calculated from the time a physician orders a BT to the time the patient starts receiving the BT. [6]…”

Reducing delay in laboratory reports for outpatients from 16% to <3% at a non-profit hospital in New Delhi, India

“…The definition of TAT that needs to be applied should be based on the type of patient served (intensive care unit/emergency/casualty service), priority (STAT/urgent or routine service). They concluded that hospitals need to evolve their own TAT in consultation with both the laboratory personnel and the clinicians and clients (the users) for using TAT as a quality parameter for the laboratory services 7…”