Thursday, April 28, 2005

Establishing Analytical Turnaround Time for Urine Cultures: A Project of the Canadian Coalition for Quality in Laboratory Medicine (CCQLM) Working Group

Deirdre L. Church, Elizabeth Melnyk, Cabrini Carmona Silva, and Pierre Turcotte.

As a requirement for provincial accreditation or licensing, clinical laboratories in Canada must routinely monitor microbiology test turnaround time (TAT), but there are no standards for this parameter.

The CCQLM Microbiology Working Group surveyed microbiology laboratories in Alberta (AB), British Columbia (BC) Saskatchewan (SK) and Québec (QUE) in 2001/02 to see if the TAT for a common test [i.e. urine culture and sensitivity (urine C& S)] was being routinely monitored and if so, to establish a standard quality indicator for a negative and positive test.

Participating laboratories completed a standard survey about the transportation, analysis and monitoring of urine C&S analytical TAT and quality indicators. Data was compared within and across different provinces and types of facilities. Minimum, average and maximum urine culture TAT including establishing quality indicators was determined.

Urine culture was done in all sites in BC, SK and 26/30 (87%) and 95/97 (98%) sites in AB and QUE respectively. TAT was most commonly defined as the time of collection of the specimen or the time of laboratory receipt to the final report. Only 12(46.2%) laboratories in AB, 21(27.3%) in BC, 18(64.3%) and 42(43.3%) in QUE routinely monitor TAT. Laboratories with an information system were more likely to monitor TAT routinely. The average TAT for negative and positive urine cultures across AB, BC, SK and QUE laboratories were similar. Most negative urine cultures were reported within 24h (range = 9h up to 108h) while most positive cultures were reported within 48h (range = 11h up to 140h). Minimal service laboratories had longer average TAT for urine cultures than larger laboratories with automated identification and antibiotic susceptibility systems. Only 4/25 (16%) AB, 21/79 (26.6%) BC 4/28 (16%) and 7/95 (7.4%) QUE laboratories have established quality indicators for urine culture TAT.

Most (i.e. >90%) negative and positive urine cultures should be reported within 24h and 48h respectively after receipt of the sample. Laboratories should routinely monitor that this standard is met.

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See more of The 2005 Institute for Quality in Laboratory Medicine Conference