Turnaround Time

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Bassam A Nassar - One of the best experts on this subject based on the ideXlab platform.

  • multiple pre and post analytical lean approaches to the improvement of the laboratory Turnaround Time in a large core laboratory
    Clinical Biochemistry, 2017
    Co-Authors: Manal O Elnenaei, Irene Sadek, Shauna Thompson, Bryan D Crocker, Bassam A Nassar
    Abstract:

    Abstract 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.

  • evaluation of the impact of a total automation system in a large core laboratory on Turnaround Time
    Clinical Biochemistry, 2016
    Co-Authors: Amy Lou, Manal O Elnenaei, Irene Sadek, Shauna Thompson, Bryan D Crocker, Bassam A Nassar
    Abstract:

    Abstract Background Growing financial and workload pressures on laboratories coupled with user demands for faster Turnaround Time (TAT) has steered the implementation of total laboratory automation (TLA). The current study evaluates the impact of a complex TLA on core laboratory efficiency through the analysis of the In-lab to Report TAT (IR-TAT) for five representative tests based on the different requested priorities. Methods Mean, median and outlier percentages (OP) for IR-TAT were determined following TLA implementation and where possible, compared to the pre-TLA era. Results The shortest mean IR-TAT via the priority lanes of the TLA was 22 min for Complete Blood Count (CBC), followed by 34 min, 39 min and 40 min for Prothrombin Time (PT), urea and potassium testing respectively. The mean IR-TAT for STAT CBC loaded directly on to the analyzers was 5 min shorter than that processed via the TLA. The mean IR-TATs for both STAT potassium and urea via offline centrifugation were comparable to that processed by the TLA. The longest mean IR-TAT via regular lanes of the TLA was 62 min for Thyroid-Stimulating Hormone (TSH) while the shortest was 17 min for CBC. All parameters for IR-TAT for CBC and PT tests decreased significantly post- TLA across all requested priorities in particular the outlier percentage (OP) at 30 and 60 min. Conclusions TLA helps to efficiently manage substantial volumes of samples across all requested priorities. Manual processing for small STAT volumes, at both the initial centrifugation stage and front loading directly on to analyzers, is however likely to yield the shortest IR-TAT.

Elizabeth Leelewandrowski - One of the best experts on this subject based on the ideXlab platform.

  • patient satisfaction with point of care laboratory testing report of a quality improvement program in an ambulatory practice of an academic medical center
    American Journal of Clinical Pathology, 2013
    Co-Authors: Kent B Lewandrowski, Benjamin Croker, Kimberly Gregory, Nicole Lewandrowski, Elizabeth Leelewandrowski
    Abstract:

    Background: Point-of-care laboratory testing (POCT) offers reduced Turnaround Time and may facilitate medical decision-making and improve clinical operations. However, there is very little published data concerning the impact of POCT …

  • implementation of a point of care satellite laboratory in the emergency department of an academic medical center impact on test Turnaround Time and patient emergency department length of stay
    Archives of Pathology & Laboratory Medicine, 2003
    Co-Authors: Elizabeth Leelewandrowski, Daniel Corboy, Kent B Lewandrowski, Julia Sinclair, Steven Mcdermot, Theodore I Benzer
    Abstract:

    Abstract Context.—Emergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS). Objectives.—To investigate the impact of a point-of-care testing (POCT) satellite laboratory in the ED of a large academic medical center. Setting.—The ED of the Massachusetts General Hospital, Boston, Mass. Design and Outcome Measures.—Evaluation of physician satisfaction, Turnaround Time (TAT), and ED LOS before and after implementation of a POCT laboratory. ED LOS was measured by patient chart audits. TAT was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test TAT and test accuracy. Results.—Blood glucose, urine human chorionic gonadotropin, urine dipstick, creatine kinase–MB, and troponin tests were performed in the ED POCT laboratory. Test TAT declined an average of 87% after the institution of POCT. The ED LOS decrease...

  • implementation of a point of care satellite laboratory in the emergency department of an academic medical center impact on test Turnaround Time and patient emergency department length of stay
    Archives of Pathology & Laboratory Medicine, 2003
    Co-Authors: Elizabeth Leelewandrowski, Daniel Corboy, Kent B Lewandrowski, Julia Sinclair, Steven Mcdermot, Theodore I Benzer
    Abstract:

    . Context.-Emergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS). Objectives.---To investigate the impact of a point-of-care testing (POCT) satellite laboratory in the ED of a large academic medical center. Setting.-The ED of the Massachusetts General Hospital, Boston, Mass. Design and Outcome Measures.-Evaluation of physician satisfaction, Turnaround Time (TAT), and ED LOS before and after implementation of a POCT laboratory. ED LOS was measured by patient chart audits. TAT was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test TAT and test accuracy. Results.-Blood glucose, urine human chorionic gonadotropin, urine dipstick, creatine kinase-MB, and troponin tests were performed in the ED POCT laboratory. Test TAT declined an average of 87% after the institution of POCT. The ED LOS decreased for patients who received pregnancy testing, urine dipstick, and cardiac markers. Although these differences were not significant for individual tests, when the tests were combined, the decreased LOS was, on average, 41.3 minutes (P =.006). Clinician satisfaction surveys documented equivalent satisfaction with test accuracy between the central laboratory and the POCT laboratory. These surveys also documented dissatisfaction with central laboratory TAT and increased satisfaction with TAT of the POCT program (P <.001). Conclusions.-The POCT satellite laboratory decreased test TAT and decreased ED LOS. There was excellent satisfaction with test accuracy and TAT.

Manal O Elnenaei - One of the best experts on this subject based on the ideXlab platform.

  • multiple pre and post analytical lean approaches to the improvement of the laboratory Turnaround Time in a large core laboratory
    Clinical Biochemistry, 2017
    Co-Authors: Manal O Elnenaei, Irene Sadek, Shauna Thompson, Bryan D Crocker, Bassam A Nassar
    Abstract:

    Abstract 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.

  • evaluation of the impact of a total automation system in a large core laboratory on Turnaround Time
    Clinical Biochemistry, 2016
    Co-Authors: Amy Lou, Manal O Elnenaei, Irene Sadek, Shauna Thompson, Bryan D Crocker, Bassam A Nassar
    Abstract:

    Abstract Background Growing financial and workload pressures on laboratories coupled with user demands for faster Turnaround Time (TAT) has steered the implementation of total laboratory automation (TLA). The current study evaluates the impact of a complex TLA on core laboratory efficiency through the analysis of the In-lab to Report TAT (IR-TAT) for five representative tests based on the different requested priorities. Methods Mean, median and outlier percentages (OP) for IR-TAT were determined following TLA implementation and where possible, compared to the pre-TLA era. Results The shortest mean IR-TAT via the priority lanes of the TLA was 22 min for Complete Blood Count (CBC), followed by 34 min, 39 min and 40 min for Prothrombin Time (PT), urea and potassium testing respectively. The mean IR-TAT for STAT CBC loaded directly on to the analyzers was 5 min shorter than that processed via the TLA. The mean IR-TATs for both STAT potassium and urea via offline centrifugation were comparable to that processed by the TLA. The longest mean IR-TAT via regular lanes of the TLA was 62 min for Thyroid-Stimulating Hormone (TSH) while the shortest was 17 min for CBC. All parameters for IR-TAT for CBC and PT tests decreased significantly post- TLA across all requested priorities in particular the outlier percentage (OP) at 30 and 60 min. Conclusions TLA helps to efficiently manage substantial volumes of samples across all requested priorities. Manual processing for small STAT volumes, at both the initial centrifugation stage and front loading directly on to analyzers, is however likely to yield the shortest IR-TAT.

Theodore I Benzer - One of the best experts on this subject based on the ideXlab platform.

  • implementation of a point of care satellite laboratory in the emergency department of an academic medical center impact on test Turnaround Time and patient emergency department length of stay
    Archives of Pathology & Laboratory Medicine, 2003
    Co-Authors: Elizabeth Leelewandrowski, Daniel Corboy, Kent B Lewandrowski, Julia Sinclair, Steven Mcdermot, Theodore I Benzer
    Abstract:

    Abstract Context.—Emergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS). Objectives.—To investigate the impact of a point-of-care testing (POCT) satellite laboratory in the ED of a large academic medical center. Setting.—The ED of the Massachusetts General Hospital, Boston, Mass. Design and Outcome Measures.—Evaluation of physician satisfaction, Turnaround Time (TAT), and ED LOS before and after implementation of a POCT laboratory. ED LOS was measured by patient chart audits. TAT was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test TAT and test accuracy. Results.—Blood glucose, urine human chorionic gonadotropin, urine dipstick, creatine kinase–MB, and troponin tests were performed in the ED POCT laboratory. Test TAT declined an average of 87% after the institution of POCT. The ED LOS decrease...

  • implementation of a point of care satellite laboratory in the emergency department of an academic medical center impact on test Turnaround Time and patient emergency department length of stay
    Archives of Pathology & Laboratory Medicine, 2003
    Co-Authors: Elizabeth Leelewandrowski, Daniel Corboy, Kent B Lewandrowski, Julia Sinclair, Steven Mcdermot, Theodore I Benzer
    Abstract:

    . Context.-Emergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS). Objectives.---To investigate the impact of a point-of-care testing (POCT) satellite laboratory in the ED of a large academic medical center. Setting.-The ED of the Massachusetts General Hospital, Boston, Mass. Design and Outcome Measures.-Evaluation of physician satisfaction, Turnaround Time (TAT), and ED LOS before and after implementation of a POCT laboratory. ED LOS was measured by patient chart audits. TAT was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test TAT and test accuracy. Results.-Blood glucose, urine human chorionic gonadotropin, urine dipstick, creatine kinase-MB, and troponin tests were performed in the ED POCT laboratory. Test TAT declined an average of 87% after the institution of POCT. The ED LOS decreased for patients who received pregnancy testing, urine dipstick, and cardiac markers. Although these differences were not significant for individual tests, when the tests were combined, the decreased LOS was, on average, 41.3 minutes (P =.006). Clinician satisfaction surveys documented equivalent satisfaction with test accuracy between the central laboratory and the POCT laboratory. These surveys also documented dissatisfaction with central laboratory TAT and increased satisfaction with TAT of the POCT program (P <.001). Conclusions.-The POCT satellite laboratory decreased test TAT and decreased ED LOS. There was excellent satisfaction with test accuracy and TAT.

Kent B Lewandrowski - One of the best experts on this subject based on the ideXlab platform.

  • patient satisfaction with point of care laboratory testing report of a quality improvement program in an ambulatory practice of an academic medical center
    American Journal of Clinical Pathology, 2013
    Co-Authors: Kent B Lewandrowski, Benjamin Croker, Kimberly Gregory, Nicole Lewandrowski, Elizabeth Leelewandrowski
    Abstract:

    Background: Point-of-care laboratory testing (POCT) offers reduced Turnaround Time and may facilitate medical decision-making and improve clinical operations. However, there is very little published data concerning the impact of POCT …

  • implementation of a point of care satellite laboratory in the emergency department of an academic medical center impact on test Turnaround Time and patient emergency department length of stay
    Archives of Pathology & Laboratory Medicine, 2003
    Co-Authors: Elizabeth Leelewandrowski, Daniel Corboy, Kent B Lewandrowski, Julia Sinclair, Steven Mcdermot, Theodore I Benzer
    Abstract:

    Abstract Context.—Emergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS). Objectives.—To investigate the impact of a point-of-care testing (POCT) satellite laboratory in the ED of a large academic medical center. Setting.—The ED of the Massachusetts General Hospital, Boston, Mass. Design and Outcome Measures.—Evaluation of physician satisfaction, Turnaround Time (TAT), and ED LOS before and after implementation of a POCT laboratory. ED LOS was measured by patient chart audits. TAT was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test TAT and test accuracy. Results.—Blood glucose, urine human chorionic gonadotropin, urine dipstick, creatine kinase–MB, and troponin tests were performed in the ED POCT laboratory. Test TAT declined an average of 87% after the institution of POCT. The ED LOS decrease...

  • implementation of a point of care satellite laboratory in the emergency department of an academic medical center impact on test Turnaround Time and patient emergency department length of stay
    Archives of Pathology & Laboratory Medicine, 2003
    Co-Authors: Elizabeth Leelewandrowski, Daniel Corboy, Kent B Lewandrowski, Julia Sinclair, Steven Mcdermot, Theodore I Benzer
    Abstract:

    . Context.-Emergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS). Objectives.---To investigate the impact of a point-of-care testing (POCT) satellite laboratory in the ED of a large academic medical center. Setting.-The ED of the Massachusetts General Hospital, Boston, Mass. Design and Outcome Measures.-Evaluation of physician satisfaction, Turnaround Time (TAT), and ED LOS before and after implementation of a POCT laboratory. ED LOS was measured by patient chart audits. TAT was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test TAT and test accuracy. Results.-Blood glucose, urine human chorionic gonadotropin, urine dipstick, creatine kinase-MB, and troponin tests were performed in the ED POCT laboratory. Test TAT declined an average of 87% after the institution of POCT. The ED LOS decreased for patients who received pregnancy testing, urine dipstick, and cardiac markers. Although these differences were not significant for individual tests, when the tests were combined, the decreased LOS was, on average, 41.3 minutes (P =.006). Clinician satisfaction surveys documented equivalent satisfaction with test accuracy between the central laboratory and the POCT laboratory. These surveys also documented dissatisfaction with central laboratory TAT and increased satisfaction with TAT of the POCT program (P <.001). Conclusions.-The POCT satellite laboratory decreased test TAT and decreased ED LOS. There was excellent satisfaction with test accuracy and TAT.