Improving Emergency Department Length of Stay by Reducing Laboratory Turnaround Times

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Dana Byrum (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: The purpose of this quality improvement project was to improve lab turnaround times to \r\ndecrease Emergency Department (ED) length of stay. The project participants included \r\nregistered nurses (RN) and medical doctors (MD) in the ED and medical technologists (MT), \r\nmedical laboratory technicians (MLT), and phlebotomists in the laboratory. EDs are challenged \r\nwith diagnosing and treating patients promptly and often encounter delays from outside factors. \r\nOne of those includes laboratory turnaround times (TAT). Using lean methodology, \r\ninterventions selected were put into place in an effort to decrease lab TAT. Standard workflows \r\nwere developed for lab and ED team members. ED RNs began using ED protocols to enter \r\npertinent lab orders during triage after assessing patients. ED RNs collected blood samples when \r\nstarting their intravenous line, and a 5S was carried out to improve workplace organization. ED \r\nRN protocol usage improved by 14.7% the first month of the project and continued to improve \r\nfor a final improvement of 68% compared to the 50% improvement target. The volume of blood \r\nsamples collected by RNs improved from an average of 476 per month to 535 per month for an \r\nincrease of 12% vs. a goal of 10%. Workplace organization improved from 8 points to 20 points \r\ncompared to a goal of 15-20 points. Lab TAT for arrival to first ordered lab for CBCs, BMPs, \r\nand Troponins improved from an average of 20.85 minutes to an average of 18.53 minutes. Lab \r\nTAT from labs ordered to collection time for CBCs, BMPs, and Troponins also improved from \r\nan average of 19.88 minutes to an average of 17.37 minutes. This project improved the overall \r\nlab TAT by 4.82 minutes\; however, it did not meet the ED LOS improvement target of 5%.

Additional Information

Publication

Other

Language: English

Date: 2023

Subjects

lab, emergency department, turnaround time, length of stay, improving laboratory turnaround time, improving ED LOS, throughput

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