Process Improvements to Reduce Cardiac Troponin Turnaround Time in the Emergency Department

An efficient testing process is a key to a timely diagnosis of acute myocardial infarction in the emergency department (ED). This includes a rapid evaluation cardiac biomarkers.

We conducted a quality and process improvement project to reduce troponin-T turnaround time (TAT) in the central laboratory at our facility. An interdisciplinary team, including front-line staff members, reviewed each step of troponin-T processing in both the ED and the central laboratory. A series of improvements were implemented during 2013, including changes to specimen labeling, elimination of duplicate test ordering, and efficiencies within the laboratory. Data from January 2013 to December 2014 on 31,496 patients with troponin tests were included in the analysis.

Over the 2-year period of the projects, median troponin-T TAT decreased from 74 minutes to consistently less than 60 minutes.

With an interdisciplinary team of health care professionals, we successfully reduced troponin-T TAT for possible acute coronary syndrome patients in our ED by 19%, consistently achieving laboratory results in less than 60 minutes.