Evaluation of switch from satellite laboratory to central laboratory for testing of intraoperative parathyroid hormone

Improving Intraoperative Parathyroid Hormone Specimen Handling and Processing

Surgeons request intraoperative parathyroid hormone (PTH) monitoring during parathyroidectomy procedures to confirm identification of abnormal gland tissue. Generally, a 50% decrease in the baseline PTH level indicates the abnormal tissue has been removed. A delay in collecting and processing PTH blood samples can complicate intraoperative decision making and prolong the procedure. The purpose of this quality improvement project was to develop tools to facilitate the specimen management process (eg, requesting, transporting, analyzing) for PTH blood samples and decrease the average total time required for transit and assay. We implemented a two-pronged initiative that involved improving the laboratory requisition form and creating a parathyroid tote box to contain all the needed information and supplies. The average total time for transit and assay decreased from 31.36 minutes before implementation to 22.06 minutes after implementation. Perioperative nurses expressed satisfaction with the changes and continue to use the revised process.

Data on length of parathyroidectomy surgery and intraoperative parathyroid hormone (PTH) assay turnaround times following a switch in the location for intraoperative PTH testing from near point-of-care to central laboratory

Intraoperative monitoring of parathyroid hormone (PTH) is commonly used during parathyroidectomies. There are a number of practical challenges in achieving rapid turnaround time (TAT) for intraoperative PTH testing, whether the testing is performed point-of-care, near point-of-care, or in a central clinical laboratory. In the related research article, we analyzed a decade of data from 3025 intraoperative PTH tests on 897 unique patients. Of these, 1787 tests on 514 unique patients (375 female, 139 male) occurred while intraoperative PTH measurement was done as near point-of-care testing; the remaining 1238 tests on 383 unique patients (282 female, 101 male) occurred after a switch to intraoperative PTH measurement by the hospital central laboratory. The data in this article provides the patient age, gender, location of surgery (main operating rooms vs. ambulatory surgery center), incision to close time for surgery, and operation start to end times. For the central laboratory testing, additional data are provided for the intraoperative PTH TAT. The analyzed data is provided in the supplementary tables included in this article. Plots of operation start and end times are also included. The dataset reported is related to the research article entitled "Evaluation of Switch from Satellite Laboratory to Central Laboratory for Testing of Intraoperative Parathyroid Hormone" [D. Jacob, G. Lal, D.R. Voss, T. Bebber, S.R. David, J. Kulhavy, S.L. Sugg, A.E. Merrill, M.D. Krasowski, Evaluation of Switch from Satellite Laboratory to Central Laboratory for Testing of Intraoperative Parathyroid Hormone, Pract. Lab. Med. (2020) 22: e00176] [1].