title: Laboratory sample turnaround times: do they cause delays in the ED?
abstract: 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.
authors.affiliation: Medical Sciences Division, University of Oxford, Oxford, UK.
authors.forename: Dipender
authors.initials: D
authors.lastname: Gill
authors.forename: Sean
authors.initials: S
authors.lastname: Galvin
authors.forename: Mark
authors.initials: M
authors.lastname: Ponsford
authors.forename: David
authors.initials: D
authors.lastname: Bruce
authors.forename: John
authors.initials: J
authors.lastname: Reicher
authors.forename: Laura
authors.initials: L
authors.lastname: Preston
authors.forename: Stephani
authors.initials: S
authors.lastname: Bernard
authors.forename: Jessica
authors.initials: J
authors.lastname: Lafferty
authors.forename: Andrew
authors.initials: A
authors.lastname: Robertson
authors.forename: Anna
authors.initials: A
authors.lastname: Rose-Morris
authors.forename: Simon
authors.initials: S
authors.lastname: Stoneham
authors.forename: Romelie
authors.initials: R
authors.lastname: Rieu
authors.forename: Sophie
authors.initials: S
authors.lastname: Pooley
authors.forename: Alison
authors.initials: A
authors.lastname: Weetch
authors.forename: Lloyd
authors.initials: L
authors.lastname: McCann
mesh_terms: 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