Izvorni znanstveni članak

https://doi.org/10.11613/BM.2016.021

Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital.

Lucius C. Imoh ; Department of Chemical Pathology, Tygerberg Hospital, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa
Mubanga Mutale ; Department of Chemical Pathology, Tygerberg Hospital, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa
Christopher T. Parker ; Department of Chemical Pathology, Tygerberg Hospital, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa
Rajiv T. Erasmus ; Department of Chemical Pathology, Tygerberg Hospital, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa
Annalise E. Zemlin orcid.org/0000-0001-7621-4679 ; Department of Chemical Pathology, Tygerberg Hospital, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa

Sažetak

Introduction: Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory.
Materials and methods: A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance.
Results: A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P < 0.05). CSF chemistry requests without the appropriate number of CSF sample tubes were significantly associated with delays in movement of samples from the labelling area to the technologist’s work station (caused by a preference for microbiological testing prior to CSF chemistry).
Conclusion: A laboratory-based clinical audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction.

Ključne riječi

turnaround time; laboratory audit; quality indicator; continual improvement; CSF chemistry

Hrčak ID:

161686

URI

https://hrcak.srce.hr/161686

Datum izdavanja:

15.6.2016.

Posjeta: 1.773 *