Root Cause Analysis (RCA) of Prolonged Laboratory Turnaround Time in a Tertiary Care Set up

Among the multitude of daily administrative problems which are faced by the modern hospitals today, prolonged Turnaround Time (TAT) of laboratory investigations is a crucial one, which affects patient care as well as patient satisfaction adversely.

The specific objectives were to observe the TAT of common laboratory investigations, to identify cause of increased turnaround time and to formulate action plans to rectify increased TAT.

An observational, RCA study was performed on 100 randomly selected patients. A separate group of 50 patients were assisted to get their investigations done and to reduce the time intervals without actively interfering with the steps. The results which were obtained were accepted as standards. Root cause analysis of the delays which were detected in TAT was done. Time intervals of TAT in the two groups were compared by 2 tailed t-tests done for equality of means. Result and Analysis: All time intervals were high in the study group and they were found to be statistically significant (p<0.05) within a 95% confidence interval of the difference. The maximum time which was needed in the control group was within the interval between the prescription of the investigation by the doctor and writing of the requisition by the Out-patient Department (OPD) staff. For the study population, it was the interval between the writing of the requisition by the OPD staff and the reaching of the patient at the central Laboratory. The standard deviation (27.665) and range (102) were also exceptionally high for this interval in the study group.

This study revealed that easy to implement administrative steps would help in reducing the TAT significantly and in improving the quality of services of the central laboratory. These include the setting up of sample collection counters at the outpatient department (OPD) and inpatient department (IPD), employment of minor methods like printing the directions for reaching the laboratory on the OPD ticket, the start of a single prick policy, declaring central laboratory as a separate department and integration of the administrative control under one authority.