How to improve laboratory turnaround time

Measure the segments, not the total

The provider's experience of turnaround runs from placing the order to seeing the result. Between those two points sit at least seven measurable segments, and the analytical mistake is treating them as one.

• Order placed → document or order received by the laboratory
• Received → order created in the system
• Order created → specimen received
• Specimen received → accessioned
• Accessioned → testing complete
• Testing complete → result verified
• Verified → released
• Released → delivered to the provider

Time is usually lost before the bench and after it

Analytical time is the segment laboratories manage most carefully, and it is frequently the shortest. The hours tend to accumulate in the pre-analytical stretch — a fax sitting in a queue, an order waiting on data entry, an eligibility check that has not been done — and in the post-analytical stretch between a result being verified and it actually reaching the provider.

A laboratory with a two-hour analytical turnaround and a fourteen-hour document intake queue does not have a two-hour turnaround. Its clients experience sixteen hours, and improving the assay will not change that.

If your TAT measurement starts at accession, you cannot see the segment that is most likely to be your worst.

The usual suspects

• Document queues checked at intervals rather than monitored continuously
• Manual data entry as a shift-bound activity while specimens arrive continuously
• Eligibility performed as a batch after the fact, holding orders that could have moved
• Verification concentrated on one or two authorized staff who become a bottleneck
• Release as a manual step performed periodically rather than as results become ready
• Delivery failures nobody sees because delivery is not recorded separately from release
• Send-outs tracked in a spreadsheet, where a missing result is discovered by a client phone call

What actually moves the number

Continuous intake beats batch intake. A document pipeline that processes as documents arrive removes the largest single block of pre-analytical delay in most laboratories.

Eligibility inside the order workflow removes a serialized step. Verification rules that require review only where review adds value keep authorized staff focused on the results that need judgement. Delivery recorded as its own event turns 'we never received it' from a dispute into a lookup.

Report it by segment and by client

Segment-level TAT tells you where to work. Client-level TAT tells you which relationships are at risk, and often reveals that a specific client's ordering behaviour — incomplete requisitions, unreadable faxes, missing insurance — is generating its own delay.

That is a solvable conversation to have with a client, and it is only possible if the measurement exists.