Many labs seek to reduce turnaround time while maintaining accuracy and safety. Here are three practical approaches to achieving this goal in blood sampling based on lessons learned from our lab at Hamamatsu University School of Medicine in Japan.

To optimise operational effectiveness and patient satisfaction, many labs seek to reduce turnaround time (TAT) while maintaining accuracy and safety. Here are three practical approaches to achieving this goal in blood sampling based on lessons learned from our lab at Hamamatsu University School of Medicine in Japan.

Switch to automatically-printed barcodes

Rather than requiring phlebotomists to manually affix a patient label onto the tube, consider a system that automatically prints barcodes. These systems allow the entire process of blood sampling to be completed within three to four minutes per patient, including the time taken for the changing of gloves. They also minimise the risk of patient misidentification, which can be easily avoided by a visual verification of the label and bar code already on the test tube.

Use an automated carrier system and back-up analyser

Automated carrier systems transport samples directly into analysers for simultaneous automated biochemical analysis and immunoanalysis. In our lab, the results are sent to the laboratory information system online and the interim results are sent to the hospital information system. The confirmed results are then dispatched following quality control and checks for outliers.

As a contingency against equipment failure, consider having a back-up analyser on standby for use to avoid major delays or unreliable results. Although this method means a lower processing capability, its strength is reliability. In our hospital, we have had very few complaints from clinical units with such a system in place. Occasionally, we see long TAT for certain samples, but these are generally special cases where the samples have fibrin precipitation or contain M-protein.

Conduct regular TAT audits

In our laboratory we conduct biannual weeklong TAT investigations twice a year, each time for one week to ensure we review different sample collection methods, which vary from one day to another. This auditing enables us to identify points of weakness using a data-driven review of existing practice. The information gathered is also exchanged between the laboratory and hospital clinical units so that the mean total TAT is publicly shared.

The importance of maintaining service quality

Successfully reducing TAT can help improve the cost-effectiveness of laboratory testing, thereby reducing contributions to total hospital expenditure. The key, of course, is to improve efficiency and cost-effectiveness without compromising accuracy of results or satisfaction of the laboratory staff. This can be avoided by adopting regimented processes, using high-quality reagents and devices, and getting into the daily habit of adhering to ISO15189 plan–do–check–act (PDCA) practices.

Efficient and accurate testing is of the utmost importance, particularly when diagnoses and treatment decisions hinge upon on lab data. Poor-quality testing – at which does not use sufficiently validated methods – leads to inadequate reproducibility, a narrow range of measurement and low analytical specificity.

The immediate effects are often time-consuming: samples may need to be re-tested for internal quality control and after dilution, and haemolysis may necessitate repeat blood sampling, both inconveniencing the patient and incurring re-testing costs for a hospital or healthcare system.

Poor processes can also have lasting broader repercussions that result in adverse patient outcomes. Inaccurate test results or delays in receiving them may cause a patient to experience unnecessary or insufficient treatment, treatment complications, or a lag in receiving the correct diagnosis.

If test results are not reliable due to problems with your equipment, processes or workers, the costs will almost certainly negate the benefits of reduced TAT. Fortunately, our experience shows that it is possible to improve operational efficiencies without sacrificing service quality.