Thursday, April 28, 2005

Laboratory Turnaround Time Improvement for Emergency Department Services Using Innovative Solutions

Gloria Zuroff, Marjorie Merkey, and Susan Yost.

Consumers of emergency services do not have the expertise to judge the quality of care but are competent to judge the quality of service. The Emergency Department (ED) of CJW Medical Center, a 748-bed acute care hospital, serves as a first impression of the hospital and accounts for 55% of admissions. In our highly competitive market, the ability to meet patient and physician turnaround time expectations is necessary.

An interdisciplinary hospital team was formed to analyze ancillary services and processes, gather precise information for decision-making, and address two of the Gallup Survey First Quarter ED Patient Satisfaction Primary Focus Priorities, Speed of Service, and Wait Time. One specific goal of the ED Turnaround Time (TAT) Initiative was to reduce Length of Stay (LOS) by 15% (267 min. to 227 min.). We reviewed all steps in processing emergency department specimens and recommended changes that would have the greatest impact.

Innovative robotics and a specimen tracking system using highly visible plasma screens are the primary tools employed by the lab. The intelligent tracking software installed in the robotics is further enhanced by automated hemolysis indicator technology, improved cardiac test utilization, more effective specimen identification labeling and strategic placement of high speed centrifugation.

Initial improvements in turnaround time of 9% on selected highly utilized tests are being realized. In addition, the variability of turnaround time decreases resulting in improved consistency. These departmental improvements feed directly back to the main outcomes measures of ED Length of Stay and Gallup Survey patient satisfaction scores.

A combination of innovative technology and basic process improvement techniques can result in significant improvements in turnaround time.

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