Lessons from the Field

Timely delivery of laboratory efficiency information, Part II: Assessing the impact of a turn-around time dashboard at a high-volume laboratory

Naseem Cassim, Lindi M. Coetzee, Manfred E. Tepper, Louella Perelson, Deborah K. Glencross
African Journal of Laboratory Medicine | Vol 9, No 2 | a948 | DOI: https://doi.org/10.4102/ajlm.v9i2.948 | © 2020 Naseem Cassim, Lindi M. Coetzee, Manfred E.E. Tepper, Louella Perelson, Deborah K. Glencross | This work is licensed under CC Attribution 4.0
Submitted: 18 December 2018 | Published: 29 April 2020

About the author(s)

Naseem Cassim, National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Lindi M. Coetzee, National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Manfred E. Tepper, National Health Laboratory Service (NHLS), Johannesburg, South Africa
Louella Perelson, National Health Laboratory Service (NHLS), Johannesburg, South Africa
Deborah K. Glencross, National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: In South Africa’s National Health Laboratory Service, ad hoc mean turn-around time (TAT) reporting is an important indicator of performance. However, historic static TAT reporting did not assess very long or very short times. An interactive TAT dashboard was developed using the following TAT measures; (1) median, (2) 75th percentile and (3) percentage of within cut-off TAT to allow for improved differentiation of TAT performance.

Objectives: The objective of our study was to demonstrate increased efficiency achieved by using an interactive TAT dashboard.

Methods: A retrospective descriptive study design was used. Creatinine TAT outcomes were reported over 122 weeks from a high-volume laboratory in Gauteng, South Africa. The percentage of within cut-off and 75th percentile TAT were analysed and reported using Microsoft Excel. A focus group session was used to populate a cause and effect diagram.

Results: The percentage of within cut-off TAT increased from 10% in week 4 to 90% and higher from week 81. The 75th percentile decreased from 10 hours in week 4 to under 5 h from week 71. Component TAT analysis revealed that the 75th percentile testing was 5 h or longer for weeks 4, 5 and 48. The 75th percentile review TAT ranged from 1 h to 15 h. From week 41, the review TAT was under 1 h.

Conclusion: Our study demonstrated that the use of an interactive TAT dashboard coupled with good management can dramatically improve TAT and efficiency in a high-volume laboratory.


Keywords

turn-around-time; laboratory efficiency; pathology; laboratory medicine

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