Lou Amy H, Elnenaei Manal O, Sadek Irene, Thompson Shauna, Crocker Bryan D, Nassar Bassam A
Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority-Central Zone, Canada; Dalhousie University, Halifax, Canada.
Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority-Central Zone, Canada; Dalhousie University, Halifax, Canada.
Clin Biochem. 2017 Oct;50(15):864-869. doi: 10.1016/j.clinbiochem.2017.04.019. Epub 2017 Apr 28.
Core laboratory (CL), as a new business model, facilitates consolidation and integration of laboratory services to enhance efficiency and reduce costs. This study evaluates the impact of total laboratory automation system (TLA), electric track vehicle (ETV) system and auto-verification (AV) of results on overall turnaround time (TAT) (phlebotomy to reporting TAT: PR-TAT) within a CL setting.
Mean, median and percentage of outlier (OP) for PR-TAT were compared for pre- and post-CL eras using five representative tests based on different request priorities. Comparison studies were also carried out on the intra-laboratory TAT (in-lab to reporting TAT: IR-TAT) and the delivery TAT (phlebotomy to in-lab TAT: PI-TAT) to reflect the efficiency of the TLA (both before and after introducing result AV) and ETV systems respectively.
Median PR-TATs for the urgent samples were reduced on average by 16% across all representative analytes. Median PR-TATs for the routine samples were curtailed by 51%, 50%, 49%, 34% and 22% for urea, potassium, thyroid stimulating hormone (TSH), complete blood count (CBC) and prothrombin time (PT) respectively. The shorter PR-TAT was attributed to a significant reduction of IR-TAT through the TLA. However, the median PI-TAT was delayed when the ETV was used. Application of various AV rules shortened the median IR-TATs for potassium and urea. However, the OP of PR-TAT for the STAT requests exceeding 60min were all higher than those from the pre-CL era.
TLA and auto-verification rules help to efficiently manage substantial volumes of urgent and routine samples. However, the ETV application as it stands shows a negative impact on the PR-TAT.
核心实验室（CL）作为一种新的商业模式，有助于整合和集成实验室服务，以提高效率和降低成本。本研究评估了全实验室自动化系统（TLA）、电动轨道车辆（ETV）系统以及结果自动验证（AV）对核心实验室环境下总体周转时间（TAT）（采血到报告TAT：PR-TAT）的影响。
基于不同的申请优先级，使用五项代表性检测，比较了CL时代前后PR-TAT的均值、中位数和异常值百分比（OP）。还对实验室内TAT（实验室内到报告TAT：IR-TAT）和运送TAT（采血到实验室内TAT：PI-TAT）进行了比较研究，以分别反映TLA（引入结果AV前后）和ETV系统的效率。
所有代表性分析物的紧急样本PR-TAT中位数平均降低了16%。尿素、钾、促甲状腺激素（TSH）、全血细胞计数（CBC）和凝血酶原时间（PT）的常规样本PR-TAT中位数分别减少了51%、50%、49%、34%和22%。PR-TAT缩短归因于通过TLA使IR-TAT显著缩短。然而，使用ETV时PI-TAT中位数延迟。各种AV规则的应用缩短了钾和尿素的IR-TAT中位数。然而，超过60分钟的STAT申请的PR-TAT的OP均高于CL时代之前。
TLA和自动验证规则有助于高效管理大量紧急和常规样本。然而，目前ETV的应用对PR-TAT有负面影响。
