Improving Laboratory & Emergency Department Specimen Turnaround Times
In an effort to improve service between the Laboratory (Lab) and the Emergency Department (ED) staff, a multidisciplinary Lean team was assigned to improve the turnaround time (TAT) for lab specimens. The team uncovered several key factors resulting in the delay of results. The main factor was the number of specimens that arrived in the lab without orders.
Process failures were studied and solutions were implemented to ensure orders accompanied specimens from the ED to the Lab. A process was created to manage specimens without orders. Staff was educated, collection guides were developed, and blue specimen bio-hazard bags were implemented.
By March 31, 2012, the facility will improve intradepartmental service between the ED and the Lab by ensuring that specimens are obtained correctly and processed in a timely manner. This will be evidenced by a 5% reduction in specimen turnaround times for comprehensive metabolic profile, complete blood count, and urinalysis.
- Processed changes in both the ED and Lab to ensure orders are entered before specimen leaves the ED.
- Improved recognition and prioritization of ED specimens by development of visual cues.
- Educated ED and Lab staff related to correct tube and quantity of blood required for each test.
After the interventions were implemented, a decrease in turnaround time (in minutes) was observed for Comprehensive Metabolic Profile (from 63 to 46 or 27%); Complete Blood Count (from 38 to 26 or 32%); and Urinalysis (from 17 to 11 or 35%). These results suggest that changes such as staff education, development of visual cues, and order entry process improvements can decrease turnaround specimen times and improve service between ED and Lab staff.