Improvement of emergency and routine turnaround time by data processing and instrumentation changes

An Evaluation of Laboratory Information Systems in Medical Laboratories in Jamaica

This chapter seeks to find out information on the functionalities of the laboratory information systems available in medical laboratories in Jamaica and their ease of use and the overall performance and satisfaction of medical technologists using them. A cross-sectional descriptive survey involving the use of a 48-item questionnaire was conducted among medical laboratories with a LIS. There were a total of 14 completed questionnaires out of 15, giving a response rate of 93.3%. The findings reveal that the majority of the laboratories have a LIS that provides multi-level security, allows password protection at different levels, maintains a patient database, and generates records. The majority of the medical technologists agree or strongly agree that it is easy to use the LIS and experience improved overall performance on the job. The medical technologists clearly understand the existing features and functionality of the LIS. Additional functional features of the LIS should be customized, and adequate funding is needed, especially for hospital-based laboratories.

Mapping turnaround times (TAT) to a generic timeline: a systematic review of TAT definitions in clinical domains

BACKGROUND

Assessing turnaround times can help to analyse workflows in hospital information systems. This paper presents a systematic review of literature concerning different turnaround time definitions. Our objectives were to collect relevant literature with respect to this kind of process times in hospitals and their respective domains. We then analysed the existing definitions and summarised them in an appropriate format.

METHODS

Our search strategy was based on Pubmed queries and manual reviews of the bibliographies of retrieved articles. Studies were included if precise definitions of turnaround times were available. A generic timeline was designed through a consensus process to provide an overview of these definitions.

RESULTS

More than 1000 articles were analysed and resulted in 122 papers. Of those, 162 turnaround time definitions in different clinical domains were identified. Starting and end points vary between these domains. To illustrate those turnaround time definitions, a generic timeline was constructed using preferred terms derived from the identified definitions. The consensus process resulted in the following 15 terms: admission, order, biopsy/examination, receipt of specimen in laboratory, procedure completion, interpretation, dictation, transcription, verification, report available, delivery, physician views report, treatment, discharge and discharge letter sent. Based on this analysis, several standard terms for turnaround time definitions are proposed.

CONCLUSION

Using turnaround times to benchmark clinical workflows is still difficult, because even within the same clinical domain many different definitions exist. Mapping of turnaround time definitions to a generic timeline is feasible.

Association between the implementation of a laboratory information system and the revenue of a general hospital

CONTEXT

A laboratory information system (LIS) is a useful tool for the management of laboratory processes and data, as well as for improving quality.

OBJECTIVE

To examine the association between the implementation of a LIS with the outpatient and inpatient revenues of a general hospital.

DESIGN

This study analyzed the outpatient and inpatient revenue data of all 212 general hospitals in South Korea; data were obtained from the Korean National Health Insurance Corporation during the period from 1996 through 1999. The mixed model was used for the repeated measure data. The following listed variables were used in the analysis: LIS implementation status, the population size, the state of competition, average local income, the hospital location, the hospital size, whether or not the hospital was a teaching hospital, whether the hospital was private or public, and the effect of the implementation time.

RESULTS

The revenues from both the outpatient and inpatient departments were significantly higher 1 year after implementing a LIS, even after controlling for confounding variables.

CONCLUSIONS

Although the causality needs to be clarified, the implementation of a LIS was found to be significantly associated with higher outpatient and inpatient revenues.