Multiple pre- and post-analytical lean approaches to the improvement of the laboratory turnaround time in a large core laboratory

Amy H. Lou, Manal O. Elnenaei, Irene Sadek, Shauna Thompson, Bryan D. Crocker, Bassam A. Nassar

Résultat de recherche: Articleexamen par les pairs

25 Citations (Scopus)

Résumé

Background Core laboratory (CL), as a new business model, facilitates consolidation and integration of laboratory services to enhance efficiency and reduce costs. This study evaluates the impact of total laboratory automation system (TLA), electric track vehicle (ETV) system and auto-verification (AV) of results on overall turnaround time (TAT) (phlebotomy to reporting TAT: PR-TAT) within a CL setting. Methods Mean, median and percentage of outlier (OP) for PR-TAT were compared for pre- and post-CL eras using five representative tests based on different request priorities. Comparison studies were also carried out on the intra-laboratory TAT (in-lab to reporting TAT: IR-TAT) and the delivery TAT (phlebotomy to in-lab TAT: PI-TAT) to reflect the efficiency of the TLA (both before and after introducing result AV) and ETV systems respectively. Results Median PR-TATs for the urgent samples were reduced on average by 16% across all representative analytes. Median PR-TATs for the routine samples were curtailed by 51%, 50%, 49%, 34% and 22% for urea, potassium, thyroid stimulating hormone (TSH), complete blood count (CBC) and prothrombin time (PT) respectively. The shorter PR-TAT was attributed to a significant reduction of IR-TAT through the TLA. However, the median PI-TAT was delayed when the ETV was used. Application of various AV rules shortened the median IR-TATs for potassium and urea. However, the OP of PR-TAT for the STAT requests exceeding 60 min were all higher than those from the pre-CL era. Conclusions TLA and auto-verification rules help to efficiently manage substantial volumes of urgent and routine samples. However, the ETV application as it stands shows a negative impact on the PR-TAT.

Langue d'origineEnglish
Pages (de-à)864-869
Nombre de pages6
JournalClinical Biochemistry
Volume50
Numéro de publication15
DOI
Statut de publicationPublished - oct. 2017

Note bibliographique

Publisher Copyright:
© 2017 The Canadian Society of Clinical Chemists

ASJC Scopus Subject Areas

  • Clinical Biochemistry

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