Laboratory sample turnaround times: do they cause delays in the ED?
OBJECTIVE
Blood tests are requested for approximately 50% of patients attending the emergency department (ED). The time taken to obtain the results is perceived as a common reason for delay. The objective of this study was therefore to investigate the turnaround time (TAT) for blood results and whether this affects patient length of stay (LOS) and to identify potential areas for improvement.


METHODS
A time-in-motion study was performed at the ED of the John Radcliffe Hospital (JRH), Oxford, UK. The duration of each of the stages leading up to receipt of 101 biochemistry and haematology results was recorded, along with the corresponding patient's LOS.


RESULTS
The findings reveal that the mean time for haematology results to become available was 1 hour 6 minutes (95% CI: 29 minutes to 2 hours 13 minutes), while biochemistry samples took 1 hour 42 minutes (95% CI: 1 hour 1 minute to 4 hours 21 minutes), with some positive correlation noted with the patient LOS, but no significant variation between different days or shifts.


CONCLUSIONS
With the fastest 10% of samples being reported within 35 minutes (haematology) and 1 hour 5 minutes (biochemistry) of request, our study showed that delays can be attributable to laboratory TAT. Given the limited ability to further improve laboratory processes, the solutions to improving TAT need to come from a collaborative and integrated approach that includes strategies before samples reach the laboratory and downstream review of results.
Gill
Dipender
D
Medical Sciences Division, University of Oxford, Oxford, UK.
Galvin
Sean
S
Ponsford
Mark
M
Bruce
David
D
Reicher
John
J
Preston
Laura
L
Bernard
Stephani
S
Lafferty
Jessica
J
Robertson
Andrew
A
Rose-Morris
Anna
A
Stoneham
Simon
S
Rieu
Romelie
R
Pooley
Sophie
S
Weetch
Alison
A
McCann
Lloyd
L
D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital; D004739:England; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D007902:Length of Stay; D013997:Time Factors; D013996:Time and Motion Studies