Most laboratories get complaints about long turnaround times (TAT) for results—a situation that frustrates physicians and patients alike. However, as Bill Malone, managing editor of Clinical Laboratory News, reports in the July issue of CLN, some laboratorians have found solutions to reduce TAT for certain tests, yielding quicker results and reducing the need for satellite labs.
The problems surrounding chemotherapy patients and long wait times are what prompted K.T. Jerry Yeo, PhD, a professor of pathology and director of clinical chemistry laboratories at the University of Chicago, to seek out TAT improvements.
Oncologists routinely order complete blood counts (CBC) and comprehensive metabolic panels (CPNL) on the same day their patients arrive for a chemotherapy infusion, to determine if they’re healthy enough for treatment. Yet Yeo found that chemotherapy patients at his facility often had to endure long wait times for test results. This was frustrating some oncologists to the point where they were working on plans for a new satellite lab to better serve these chemotherapy patients, writes Malone.
Yeo analyzed the problem and, with his lab team, came up with a solution that reduced median CBC collection-to-result TAT from 50 to 20 minutes, and CPNL TAT from 74 to 54 minutes. In speaking with an oncology medical director, he found out it was possible to fast-track the two most time-sensitive tests, creatinine and bilirubin, within the same TAT as the CBCs. As the medical director explained to Yeo, this meant that chemo could begin “without further delay and catch up with the rest of the CPNL results later.”
Yeo subsequently set up a new, whole-blood gas analyzer that could turn around creatinine and bilirubin results within minutes. He also took a step out of the CBC and CPNL process, allowing those samples to bypass the central specimen processing center. Instead, they are now sent directly to an adjacent hematology lab and whole blood analyzers located nearby for immediate analysis.
As a result of these changes, TAT for whole blood creatinine, bilirubin, and CBC from sample collection to results has dropped dramatically, eliminating the need for a satellite lab.
Real-time TAT monitors or pending monitors have also caught the attention of laboratorians. Users say it saves time and makes it easier to track data on tube samples.
Geoffrey Baird, MD, PhD, who recently purchased such a device, says the monitor has become an essential part of his lab at Harborview Medical Center in Seattle.
Baird’s staff says the monitor has eliminated the time-consuming task of searching for lost tubes. “Back when we were printing out pending logs, someone had to go around with a piece of paper hunting tubes, not really knowing where its last location was,” says Baird, Harborview’s director of clinical chemistry and an assistant professor of laboratory medicine at the University of Washington.
“Now you can just look up at the monitor, see the name and location, and go find it,” he says.
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