Evolution beyond the shared services model of consolidated hospital clinical laboratories

To compare the operational and financial outcomes of the transition from shared laboratory services to a recentralized model, in a consolidated hospital system.

United Health Services Hospitals (Binghamton General, Wilson Memorial, and Ideal hospitals, New York State).

Consolidation of hospital services and recentralization of laboratory testing to a single site (Wilson Memorial Hospital).

Laboratory workload, testing efficiency, personnel and nonpersonnel expenses, analytic error rate, turnaround time, and proficiency-testing scores.

The postintervention period (1988 to 1992) was characterized by a 51% and a 10% increase in the out- and inpatient workloads, respectively, with a concomitant 24% increase in testing efficiency. The salary expenses were 26% lower, while the total true cost savings ranged from $1,544,000 (11.6%) to $2,500,000 (21.9%) compared with the shared services model. The recentralization produced decreased analytic error rates and improved testing turnaround time.

The total costs per test have been lowered in the recentralized model. Recentralization may provide further true cost savings over the shared services model while maintaining high-quality service.