Improving laboratory results turnaround time.

Background: Physicians need prompt results of laboratory tests before early morning rounds or on a stat basis to support time-critical decisions that can impact patient care or length of stay. At The Methodist Hospital, we formed a multidisciplinary performance improvement team that was successful in reducing the length of time between collection of specimen and availability of laboratory test results (turnaround time). Our goals were to have Stat results available in less than 60 minutes, and results for morning blood tests available by 8 AM for acute care units and 7 AM for critical care units.

Methods: Before making changes, we first devised a system of measurement. The most efficient way to obtain data was to query the mainframe laboratory information system for times of specimen collection, times for reception in the laboratory, and times for results verification. We also decided that patient-specific information on specimens that did not meet the goals-exceptions-would be crucial for effective follow-up and corrective action. During several measurement and assessment cycles, we identified opportunities to improve our process.

Results: The percentage of early morning specimens meeting the specified turnaround time improved from 60% in August 1995, to greater than 90% in May 1996. The average turnaround time for early morning specimens takes only 95 minutes rather than 186 minutes. The average turnaround time for a stat specimen declined from 69 minutes to 45 minutes during this process. The volume of stat specimens has also declined significantly.

Conclusion: Laboratory test results turnaround time is impacted by a variety of health-care providers, and a multidisciplinary team can work together to improve prompt availability of test results to support time-critical decisions.