Stat Turn Around Times

[brobinson]

We have been using 60 minutes forever at our institution. This was when we were using manual tube testing. We currently use two ProVues for processing and it takes almost 60 minutes to log a sample in, get it on (when we have one not being used) and get the results across our computer interface. We have been trying several new processes. Stat Spin centrifuges, running double runs, etc. for several months and still can not meet 60 minutes 90% of the time. We have been monitoring TAT for 60, 70 and 75 minutes. Excluding patients with antibodies we still have some trouble making the 75 minutes 90% of the time. I have been hunting for benchmarking all over the place and only found two articles and they are using 60 minutes but do testing manually in order to make the 60 minutes. We really do not want to do manual testing. Any ideas out there?

[Mabel Adams]

Ortho is coming out with a new machine next year that is supposed to be faster with better stat access. At least that's what the rep tells me. With Bio-Rad being poised to start marketing Diamed gel in the US by 2013 the competition should be starting to pick up and maybe solve some of these problems.

[Liz]

I agree with Mabel be patient, stay automated and the new equipment (the upgraded platforms)are coming. Bio-Rad (Diamed) have promised us a short TAT.

[brobinson]

Yes, we were to help beta test it here. So from things I am hearing it appears that people using automation really can not meet 60 minutes at this time.

[Townsend]

Wow, that is disappointing. We still do manual gel and manage less than 45 minutes for ER type and screens, usually more than 95% of the time. We have just over 400 beds and are looking forward to the new automated options we will have in just a few more years!

Stephanie Townsend, MT(ASCP)SBB

[Eagle Eye]

We have two ProVue and able to finish >90% in <60 mins.

[Mabel Adams]

Do you all count from the same starting point? Is it specimen collection time or receipt in Blood Bank? If the latter, is the specimen already spun?

[Generic]

We also have two provues and our stat turn around time is 75 minutes, starting from when the specimen is received in the blood bank. We generally don't have any problem staying within that time limit and often result out in under 65. If there is a situation in which a T&S is needed superstat, I'll perform one manually in the gel. You can get the gel cards pipetted while the sample is centrifuging to cut the time down. If the provue hasn't been used in awhile (not sure how often that happens during day shift, but it happens occasionally at night) I'll have it prime while I'm centrifuging the sample so it doesn't have to prime before it starts pipetting. That'll save about 5 minutes.

[Likewine99]

I'd also suggest not to move away from automation. In my experience automation provides a level of safety for the patient that isn't achieved with manual testing (mostly the opportunity to make a clerical error when labeling tubes or cards).

I've never been able to find any benchmarking data on stat TAT's for T&S but I think it is difficult to put a time on a T&S since there is more prep time involved in getting a sample ready. Remember, we are not like Chem and Hem, just put it on an analyzer and go.

Not that TAT's shouldn't be monitored but how about a TAT for a crossmatch, how long does it take to get an ISXM done from the time you pull the sample from the rack until the product is ready.

60 minutes is a good benchmark and if your lab is having trouble making it maybe it's time to really examine your processes or try and decide if this is truly attainable in your lab. In looking at all of this data keep the patient and patient safety in mind.

[AMcCord]

We average turnaround times of 53 minutes from time of specimen receipt with our Echo. 95% of our STAT T&S orders are out in 90 minutes, with almost all of our outliers from evenings and nites (sometimes a challenge with a very small evening and nite crew of generalists - there are some big outliers on occasion). Approximately 90% of T&S orders are reported in less than 90 minutes from the time the order was placed. A large majority of tests are out in less than 75 minutes from time of order.

[EDibble]

I do not have access to exact data, but I know that we make our TAT over 90-95% of the time. We use an ECHO. The TAT starts from the time the specimen is received, and the specimen is not usually spun. However, we can prep the instrument etc, while the tube spins. We also do EXM, and that has helped greatly.

[Eagle Eye]

Our TAT is measured from the specimen receipt in blood bank....

[jlemmons]

If you are using the ProVue, check with your Transfusion Technical Specialist (if you don't know who this is, ask your sales person, they'll let you know) about changing the way your menu is configured. When we first got our first of three ProVues, they configured them differently than they do now and the new way is meant to make your TAT better.

[bbonnema]

We achieve <60 minutes 98% of the time from receipt of an unspun specimen.

[Auntie-D]

In my last lab we had a Diamed Gelstation and it was able to complete everything in 40 minutes from receipt of the sample, allowing us to achieve TAT of 45 minutes which is comparable to a manual crossmatch. You can also pause the analyser mid-run to put an urgent crossmatch on ahead of the current batch.

If the TAT is so poor could you not use manual methods in an emergency situation with two groups done on separate aliquots for reassurance?

I'm surprised at a TAT of less than 60 minutes - everywhere I have worked has stated less than 45 for an emergency full xm and if analysers couldn't match this they weren't purchased.