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Stepwise Success

Is Turnaround Time Important?

Published January 22, 2014 6:04 AM by Scott Warner

As the people who best know the variables that affect turnaround time, we exploit them to explain away variation. I hear this almost every day. “That culture took a long time because it was subbed again,” or “I knew the ED didn’t want that result finalized so I worked on other things,” or “We were busy!”

I don’t care about turnaround time if providers get results in time to treat patients. I say this every day I hear excuses. Fact is turnaround time does vary for good reasons. The techs are correct. So.

Is turnaround time important?

In a sense, no. A test takes however long it takes, and if a manager presses speed over accuracy that’s exactly what happens. It’s better to emphasize quality and an open dialogue with providers to make sure their needs are met. Lab techs all tend to see turnaround time as a fixed perception e.g. “We have an hour to do a STAT,” when providers see a treatment choice pending a result. Labs serve patients better by understanding time frames related to making those choices.

But turnaround time is a reliable metric that tells us something about a system. Question is what?

Last week I created a daily summary of turnaround times that prints outliers defined per test, excluding routine outpatient work. A script saves an information system report to a folder, a filter sorts and tallies it, and whatever exceeds predefined limits or arbitrary default values is printed.

Limits are broad. While the program filters lower and upper limits, we decided to ignore unusually short turnaround times by setting all lower limits to zero. Most of the upper limits are set to 120 minutes. The process essentially treats inpatients and ED, STAT and routine, as part of the same workflow. (Aren’t they?)

The idea is that techs will review and investigate unusual variation that clearly indicates a system failure. I don’t expect this happens often, because providers are generally happy. I’m interested in what emphasizing unusual variation to focus on quality over speed does.

NEXT: The Skinny on Fats

2 comments

CLIA 493.1101 (Facilities) refers to a lab having the means to perform testing, which implies established turnaround times. But I'm not aware of any definition of STAT, routine, etc. to hold feet to a fire. I'd be interested to learn of any.

Turnaround times are often skewed by the complexity of laboratory work, and pressing techs to get tests done under a target time essentially tells them, "Hurry up!" That's bound to cause errors. A battle worth fighting!

Scott Warner January 23, 2014 10:13 AM

This is a BIG argument at my work.  My managers howl about turn around times and it's a constant battle.  

What regulation (JACHO? CAP?) controls this?  Is there any standard procedure for measuring?  I don't think this is being measured accurately at my hospital and I'm hoping there is a better way to improve it.  

MLS January 22, 2014 11:13 AM

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About this Blog


    Scott Warner, MLT(ASCP)
    Occupation: Laboratory Manager
    Setting: Critical Access Hospital
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