Reorganization of Automated Outpatient Laboratory to improve Total / 대한진단검사의학회지

ABSTRACT

BACKGROUND: Asan Medical Center ran a fully automated outpatient laboratory to serve outpatient departments with a rapid turnaround time (TAT; one hour from reception to reporting) for frequently requested test items and thus to make `one stop service' possible. As the number of samples increased, the TAT gradually became longer and eventually showed over one hour for almost all items. METHODS: In October 1998, reorganization of the outpatient laboratory took place. Newly introduced were a priority system for samples, a plasma separate tube instead of the serum separate tube, an on-line simultaneous sample reception system at the time of sampling, and a real-time monitoring system for TAT. RESULTS: With the sample priority system, samples processed for one stop service were 61.0% (476 priority samples out of 780 total samples) for routine hematology, 59.2% (527 out of 890) for routine chemistry, 40.1% (122 out of 304) for urinalysis, 43.2% (89 out of 206) for coagulation tests, and 47.9% (75 out of 157) for diabetic tests. We monitored samples processed as `one stop service' with the real time monitoring system for TAT; among the samples processed as such, 80.1% of rou-tine hematology, 91.9% of routine chemistry, 99.5% of urinalysis, 92.6% of coagulation tests, and 97.6% of diabetic tests showed TAT less than one hour. Average TAT, from the specimen acquisition to the reporting, decreased dramatically after introduction of the system. Average TAT of routine hematology decreased to 53.9 minutes, routine chemistry to 54.6 minutes, urinalysis to 35.2 minutes, coagulation tests to 46.6 minutes, and diabetic tests to 31.9 minutes. And the patient satisfaction index for the outpatient laboratory rose 15% from 81% to 96%. CONCLUSIONS: The outpatient laboratory of AMC shortened the TAT substantially without sacrificing quality and fully met the needs of patients and clinicians after reorganization.