Reengineering Critical Laboratory Testing for Timely Chemotherapeutic Management
| Autor: | Charles Van Slambrouck, Edward Ki Yun Leung, Kiang-Teck J. Yeo, Rebecca J. Wolsky, Xin Yi, Diane Mika, Chadi Nabhan, Julie H. Leanse |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
030213 general clinical medicine medicine.medical_specialty Hematology medicine.diagnostic_test business.industry Comprehensive metabolic panel Complete blood count General Medicine Turnaround time Laboratory testing 03 medical and health sciences 0302 clinical medicine Specimen collection Chemotherapy Drugs Internal medicine medicine Work flow 030212 general & internal medicine business |
| Zdroj: | The journal of applied laboratory medicine. 3(2) |
| ISSN: | 2576-9456 |
| Popis: | Background Delivery of cytotoxic therapy is a complex multifaceted process that involves harmonized collaboration between all systems involved. Optimizing laboratory turnaround time (TAT) ensures timely delivery of chemotherapy, which potentially translates into improved patient outcomes and satisfaction. In this study, we aimed to reduce the laboratory TAT for key laboratory tests to optimize the timely administration of chemotherapy. Methods TAT data for complete blood count (CBC) and comprehensive metabolic panel (CMP) included specimen collection to receipt (Col-Rcv), specimen receipt to result release (Rcv-Res), and the overall TAT from specimen collection to result release (Col-Res). Work flows were reconfigured to transport CBC specimens directly to the hematology laboratory after collection and to treat all CMP samples from chemotherapy clinics as urgent [i.e., shortest turnaround time (STAT)]. From the CMP, total bilirubin and creatinine—the 2 key analytes for liver and renal toxicity assessment before chemotherapy drug administration—were analyzed on ABL 800 whole blood analyzers to further improve the laboratory TAT. Results CBC showed a significant reduction in the median (Col-Res) TAT to 16 min (P < 0.0001). For CMP, by processing all specimens as STAT samples, the median (Col-Res) TAT was reduced from 74 min to 54 min (P < 0.0001), and it was further reduced to 9 min (P < 0.0001) for total bilirubin and creatinine. Conclusion Careful work flow analysis and reengineering of preanalytical and analytical process for key laboratory tests significantly reduced median overall TAT to |
| Databáze: | OpenAIRE |
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