Evaluating stat testing options in an academic health center: therapeutic turnaround time and staff satisfaction.

We compared centralized vs distributed methods for delivering "stat" test results for blood gas, glucose, and electrolyte assays. The parameters for comparison were as follows: (a) laboratory turnaround time (TAT), (b) therapeutic TAT, and (c) staff satisfaction. Therapeutic TAT, defined as the time from the initiating order to the receipt of the result and the implementation of any indicated change in treatment, was obtained by direct observation of testing procedures at the bedside and timing each step in the process. Observing therapeutic TAT yields information on the impact of laboratory testing methods in the context of clinical decision making. Therapeutic TAT was 1-2 min shorter for bedside testing compared with a satellite laboratory and 9-14 min shorter in the satellite laboratory compared with centralized testing. Satellite laboratories received the highest staff satisfaction scores, followed by bedside testing, with the central laboratory receiving the lowest scores.

[1]  B. Chernow,et al.  Blood conservation—A critical care imperative , 1991, Critical care medicine.

[2]  P J Howanitz,et al.  Changes in emergency department turnaround time performance from 1990 to 1993. A comparison of two College of American Pathologists Q-probes studies. , 1997, Archives of pathology & laboratory medicine.

[3]  G. Kost,et al.  Multisite point-of-care potassium testing for patient-focused care. , 1994, Archives of Pathology & Laboratory Medicine.

[4]  D. Seligson,et al.  Clinical Chemistry , 1965, Bulletin de la Societe de chimie biologique.

[5]  C A Parvin,et al.  Impact of point-of-care testing on patients' length of stay in a large emergency department. , 1996, Clinical chemistry.

[6]  J W Winkelman,et al.  The fiscal consequences of central vs distributed testing of glucose. , 1994, Clinical chemistry.

[7]  D. Nathan,et al.  Utilization and cost analysis of bedside capillary glucose testing in a large teaching hospital: implications for managing point of care testing. , 1994, The American journal of medicine.

[8]  J H Keffer.  Economic considerations of point-of-care testing. , 1995, American journal of clinical pathology.

[9]  M. L. Mitchell,et al.  Medical Uses of Statistics , 1992 .

[10]  G. Kost,et al.  Guidelines for point-of-care testing. Improving patient outcomes. , 1995, American journal of clinical pathology.

[11]  J W Winkelman,et al.  How fast is fast enough for clinical laboratory turnaround time? Measurement of the interval between result entry and inquiries for reports. , 1997, American journal of clinical pathology.

[12]  Anthony Walsh,et al.  Statistics for the Social Sciences: With Computer Applications , 1990 .

[13]  P N Valenstein,et al.  Sensitivity, specificity, and reproducibility of four measures of laboratory turnaround time. , 1989, American journal of clinical pathology.

[14]  T. Zerbe,et al.  Laboratory process improvement through point-of-care testing. , 1997, The Joint Commission journal on quality improvement.

[15]  B. Luce,et al.  The Economic and Clinical Efficiency of Point-of-Care Testing for Critically Ill Patients: A Decision-Analysis Model , 1998, American journal of medical quality : the official journal of the American College of Medical Quality.