Timeliness and accuracy of reporting preliminary blood culture results: a College of American Pathologists Q-probes study of 65 institutions.
BACKGROUND
The speed and accuracy of preliminary blood culture reports impacts patient management and outcomes.


OBJECTIVE
To evaluate the accuracy and timeliness of preliminary blood culture results among multiple laboratories.


METHODS
Q-Probes participants collected turnaround time (TAT) data on preliminary Gram stains, compared accuracy of up to 100 preliminary to final culture Gram stain results, and described blood culture laboratory practices.


RESULTS
Sixty-four laboratories and 5031 blood cultures were evaluated. All participants used continuously monitoring blood culture systems. Median TAT from initial growth detection to notification of results was 45 minutes, with the longest component being preparation of Gram stains (median time = 25 minutes). Participants (N = 40) reporting a continuous schedule for processing blood cultures had significantly lower overall TAT (median= 37 minutes) compared with 15 participants with intermittent processing schedules (median= 124 minutes), P= .003. Time to complete Gram stain processing was lower (median time = 21 minutes) for 39 participants using continuous processing schedule compared with 14 others (median time= 67 minutes), P= .03. Goals for total TAT were used by 27 of 56 participants (48.2%). Having goals did not significantly affect TAT. A total of 4962 of 5021 Gram stain results (98.8%) agreed with final culture results. The highest discrepancy rates occurred among gram-positive bacilli (20 of 335; 6.0%) and mixed cultures (22 of 106; 20.8%).


CONCLUSIONS
This study provides benchmarks for assessing blood culture quality performance. Timeliness and accuracy of preliminary blood culture reports were excellent. However, nearly one-third of laboratories did not process blood cultures continuously. This significantly prolonged reporting results, which could affect patient outcomes.
From Diagnostics, Southern Arizona VA Healthcare System, University of Arizona College of Medicine, Tucson (Dr Schifman); the Department of Pathology, Massachusetts General Hospital, Boston (Dr Meier); and the Department of Biostatistics, College of American Pathologists, Northfield, Illinois (Ms Souers).
Ron B
RB
Schifman
Frederick A
FA
Meier
Rhona J
RJ
Souers
D016470:Bacteremia / Q000382:microbiology*; D019985:Benchmarking / Q000592:standards*; D001800:Blood Specimen Collection; D005840:Gentian Violet; D006801:Humans; D007753:Laboratories / Q000592:standards*; D008499:Medical Records / Q000592:standards*; D010338:Pathology, Clinical / Q000592:standards*; D010619:Phenazines; D011785:Quality Assurance, Health Care; D012107:Research Design / Q000592:standards* / Q000706:statistics & numerical data; D012955:Societies, Medical; D013997:Time Factors; D014481:United States
C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet