Evaluation of switch from satellite laboratory to central laboratory for testing of intraoperative parathyroid hormone
Autor: | Scott R Davis, Jeff Kulhavy, Anna E. Merrill, Sonia L. Sugg, Matthew D. Krasowski, Denise Jacob, Dena R. Voss, Geeta Lal, Tami Bebber |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Parathyroidectomy
030213 general clinical medicine medicine.medical_specialty medicine.medical_treatment Clinical Biochemistry Parathyroid hormone 030204 cardiovascular system & hematology Turnaround time Article Central laboratory lcsh:Chemistry 03 medical and health sciences 0302 clinical medicine Intraoperative care Electronic health record medicine Clinical laboratory services lcsh:R5-920 Radiological and Ultrasound Technology business.industry Retrospective cohort study Surgery Multiple factors lcsh:QD1-999 Ambulatory Clinical chemistry tests business lcsh:Medicine (General) |
Zdroj: | Practical Laboratory Medicine, Vol 22, Iss, Pp e00176-(2020) Practical Laboratory Medicine |
ISSN: | 2352-5517 |
Popis: | Objectives The aim of this study was to evaluate testing turnaround time (TAT) and incision to close time in parathyroid surgeries before and after switching intraoperative parathyroid hormone (PTH) testing from a near point of care location to a central clinical laboratory. Design and Methods This retrospective study covered a ten-year period. Both testing locations used the same Roche Diagnostics PTH immunoassay but on different analyzers. The predominant site for surgeries was the main operating rooms (ORs) in an adjacent building, with a limited number of parathyroid surgeries performed at a more distant ambulatory surgery center (ASC). Under ideal conditions, TAT for near point-of-care testing was 20 min, although multiple factors could increase TAT. Incision to close time from the electronic health record was used to define time of surgery. Results A total of 897 unique patients were identified for which 3031 orders for intraoperative PTH were placed (383 unique patients and 1244 orders after switch in testing site). The average total TAT times for testing (mean ± SD) in the central laboratory were 23.9 ± 16.0 min (median, 22 min) for all specimens, 22.8 ± 7.9 min (median, 21 min) for main OR specimens, and 26.4 ± 7.1 min (median, 25 min) for ASC specimens. Incision to close time for parathyroidectomies showed decreases in mean, median, and standard deviation following testing change. Conclusions Surgery time for parathyroidectomies may remain consistent or decrease if intraoperative PTH testing is moved from a near point of care to a central laboratory. Highlights • Turnaround around time for intraoperative parathyroid hormone (PTH) analysis in a central laboratory was evaluated. • Surgery incision to close times were compared to 514 surgeries with intraoperative PTH performed as near point of care. • Pre-analytical factors, especially transport time, were the major variable impacting turnaround time. • The mean, median, and standard deviation for surgery incision to close times decreased in the switch to the central laboratory. |
Databáze: | OpenAIRE |
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