The three Ps of turnaround time

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Understanding turnaround time (TAT) from a more holistic perspective can help drive improved metrics and better connectivity between work and lab staff. It is the duty of a laboratory to continuously work towards improved TAT, and one way to get a fresh start on doing that is to ground our appreciation of TAT in clinical significance and practical management.

Why does TAT really matter?

Accurate, high-quality results are crucial to physicians and patient care, but the time they take to be delivered is also extremely important.

As a surgeon, I can appreciate the importance of trustworthy, fast results. When there is a patient with emergency abdominal pain, I send out samples to help make a diagnosis and determine the treatment plan. If I suspect appendicitis, TAT determines how quickly the patient can get into surgery for a life-saving operation. The longer the TAT, the more their prognosis may be affected.

Even in less dire circumstances, TAT has a significant impact on patients. When food and water are withheld due to electrolyte imbalances leading up to a surgery, a fast TAT can let a surgeon know when it’s okay for the patient to undergo an operation. The faster clinicians get the answers they need, the fewer tests they need to order, and the faster they can act in the best interest of the patient.

When this human facet is kept in mind by lab workers on a daily basis, it helps unite the “big picture” purpose behind their work with the practical steps that must be completed, in order to minimise TAT.

The three Ps: Place, People and Process

When it comes to the logistics of impacting TAT in the laboratory, there is more to it than a single number. There is total TAT—the time a sample takes throughout the process, from physical collection of the specimen to the lab’s reporting of a result. There is also laboratory TAT—the time it takes for the lab to process and report out a result, starting from the moment it is received by the lab. The first, overall metric is important, but laboratory TAT is where most lab staff can make the biggest impact.

Finding opportunities to improve TAT comes from understanding what goes into it, for every type of test you run and for every person in the lab. One way to think of it is with the “3Ps”: Place, People and Process.

Place

  • Think about the orientation of your laboratory. Set it up with the sequence in mind, so that when a sample is received and processed, the physical movement around the lab is orderly. Having people going back and forth not only wastes time, it can lead to errors and confusion.

People

  • The experience and competence of laboratory staff can make a huge difference in efficiency and laboratory TAT. No one wants TAT to include time spent being confused over a computer program or test read-outs.
  • Keeping your staff educated and professionally engaged can make a big difference in how committed they are to efficient, effective work. It can also help your lab generate ideas to implement to drive TAT down.

Process

  • Simplifying processes and having well-communicated standard procedures can make even complex work go smoothly and quickly.
  • Take time to plan your processes, in order to remove waste. Talk to staff to identify areas they believe can be improved, or consider calling in a consultant to study the lab’s processes and eliminate wasted time where feasible. 

Taking the time to foster an appreciation for the many inputs to TAT, as well as the end beneficiaries when TAT is well-managed, can result in new ideas for how—and why—it is so important. Bring your people, place and process ideas together to deliver positive changes for patients and physicians. Your TAT will show the benefits.

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