CHANGES IN EMERGENCY DEPARTMENT TURNAROUND TIME PERFORMANCE FROM 1990TO 1993 - A COMPARISON OF 2 COLLEGE-OF-AMERICAN-PATHOLOGISTS Q-PROBESSTUDIES

Objective.-To compare the results of a 1990 College of American Pathol ogists Q-Probes Emergency Department (ED) turnaround time (TAT) study with a similar study done in 1993 and to identify factors associated w ith TAT improvement. Design.-Participants gathered data over a 4-week period on the various times of day associated with the ordering, speci men-collection, laboratory-receipt, and result-reporting stages of sta t tests for potassium and hemoglobin levels, using a mail-in questionn aire that also included practice parameter questions.Participants.-Lab oratories enrolled in the 1990 College of American Pathologists Q-Prob es study on ED TAT and laboratories enrolled in the 1993 program ED TA T study. Main Outcome Measures.-Components associated with shorter ED TAT and, for those participating in both the 1990 and 1993 studies, co mparison with previous results. Results.-Six hundred fifteen hospital laboratories returned data on up to 43 521 hemoglobin and 41 989 potas sium specimens. Half of these laboratories collected and reported 90% of their ED potassium results in 53 minutes or less, compared to 61 mi nutes or less in 1990, and reduced the corresponding median collection -to-reporting TAT for 90% of hemoglobin results from 46 minutes or les s to 39 minutes or less. The fastest 10% of laboratories showed interl aboratory median order-to-report TATs of 36 and 50 minutes for potassi um and hemoglobin tests, respectively. Comparisons of TATs from 277 la boratories with 1990 and 1993 data were possible. Components found to contribute statistically to improvement of ED TAT between 1990 and 199 3 were laboratory control of specimen handling, rapid transport time, and monitoring. Active monitoring was particularly important when the laboratory did not control the specimen-handling process. Conclusions. -Laboratories improved their control of ED TAT from 1990 to 1993 and r educed the number of TAT events exceeding 70 minutes. Internally set T AT goals, however, were not met most of the time.