Purpose:

Patients' routine labs, including immunosuppression drug levels, are drawn with each clinic visit starting at 6am.

Because the drug levels are not reported by the time the patients leave clinic

mid-morning, the levels must be reviewed later in the day. Once review by the physician is

completed, transplant coordinators commence calling each patient with plan of care changes late

in the afternoon and early evening. We identified substantial delays in lab result turnaround

times, thus; the plan of care was unable to be relayed to the patient until end of day

and also resulted in inefficient use of staff time. This process was not in line

with standard practices in California transplant centers. The goal was to achieve completed lab

results in less than 2 hours on post kidney clinic days.

Method:

Specific electronic medical record-generated reports were created by our Quality Data Team.

The data collected was lab result turnaround times. The process included the time of blood draw

to the time of result in a post kidney/pancreas transplant clinic. This data was gathered and

analyzed from each step of the process involved between 2015 to 2017. This analysis was

completed monthly to identify trends in average result times. We met with

leadership to review the findings and seek support in improving lab result times.

Results:

The analysis revealed that there were significant time delays which were associated with the

pretreatment and processing of the immunosuppressive levels in the laboratory. Thus, the

laboratory implemented several changes to expedite the process including: decreased transport

times, internal tracking systems, laboratory staff education/competency and standardized

workflows. Weekly reports were reviewed to monitor the progress.

Conclusion:

Following the implementation of changes made by the laboratory, the lab result turnaround times

significantly improved. The two year data analysis revealed a 51% increase in completed lab

results within two hours, from 3 hours, 33 minutes to 1 hour, 45 minutes. The outcome of this

change resulted in efficiencies including: an increase in the number of patients discharged from

clinic with a complete plan of care, a decrease in the number of results for physician review after

clinic, a decrease in the number of calls to patients to relay plan of care. Also, this efficiency

improved staff satisfaction and achieved turnaround times in line with the community standard.

CITATION INFORMATION: Farrell M., Kapadia S. Lab Turnaround Times: A Performance Improvement Project in Post Kidney/Pancreas Transplant Clinic Am J Transplant. 2017;17 (suppl 3).

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