Improving Laboratory Turnaround Time in a High Throughput Medical Laboratory



One measure of efficiency in a diagnostic laboratory is promptness in producing results. With this in mind, turnaround time (TAT) has become a conspicuous indicator reflecting a lab’s efficiency. Delays in TAT in a high throughput laboratory such as Quantum Diagnostics were identified.

Urgent and non-urgent tests TAT which includes H. pylori and EBV tests alongside routine biochemistry were collected from July 2017 till January 2019. Prior to August 2017, samples were run for biochemistry tests on Cobas 8000 (Roche Diagnostics, Germany) prior to processing serology H. pylori (Immulite 2000, Siemens) and EBV (Snibe, BMS) tests. Delayed TAT was identified to originate from a holdup at the biochemistry section. Work processes were then reorganized to prioritize serology tests first, where samples were loaded on respective analyzers and transferred to the biochemistry analyzer immediately upon aspiration of samples. In addition, installation and activation of 1) p512 pre-analytical system, 2) two Cobas 8000 modules and upgradation and installation of additional endocrine modules was done to improve throughput time.

Clinical laboratory is a significant component in aiding healthcareproviders in the diagnosis, management and assessing outcome ofdisease of patients based on the tests requested by the health careproviders on their patients' specimens [1]. These results must beavailable and accessible whenever they are needed by the healthcareproviders [2]. The precision, accuracy and timeliness in releasingresults to clinicians are vital to ensure that patient gets the best carepossible. Clinical laboratories are very data driven through variousQuality Indicators (QI) which tend to be more focused on accuracyand precision of test results through the monitoring of internal qualitycontrol as well as external quality assurance data. Because so muchemphasis is directed towards these aspects of quality, timeliness ofreporting tend to take second place.

Establishing a close working relationship with key vendors indeveloping a dashboard that could capture routine and urgent LTATalong with validation statistics and critical results alert can improvemonitoring of these critical data and subsequently improve efficiencyof the laboratory. TAT monitoring is the ideal choice of activity thathas been illustrated that the laboratory’s commitment to providing ahigh quality service.Mapping out work processes helps in determining the root cause ofdelays in TAT. In this retrospective study, we identified a failure inachieving LTAT target which was then extensively investigated throughthe charting of work processes and identifying areas within the processthat can be reorganized, updated or intervened to reduce processingtime. Synergistic partnerships with key vendors that are in line withthe laboratory’s performance index are vital to ensure efficiency of anyimprovement strategies.

Media Contact: 
Allison Grey 
Journal Manager 
Journal of Clinical chemistry and Laboratory Medicne