What we have seen is that there is a difference of opinion between the labs and A&E as to when the clock starts ticking. As far as they are concerned, it starts when someopne thinks about taking a sample, we then have to await it's arrival in the department before we start our clock ticking.
We have seen examples of a sample coming in by airtube, Haematology taking their sample, and then leaving the Biochemistry sample sitting there until someone finds it, this means the delay for A&E does become significant, especially when the get the FBC 1 hour before the Biochemistry.
Equally, are all A&E sample "Urgent", if they truely are, usually the doctor rings and someone keeps a lookout for the sample, but with generic workers taking blood samples, as it is then easier for the doctor to just write a request, these "routine" samples may be dalayed, as until they arrive, nobody knows about them.
We are trying to sort out these problems, but get bogged down in the insistance that they need the results to discharge/move on the patient. A few years ago this did not appear to be the case, but now it saeems that you can't be signed off as fit to leave without all the results, even if the Troponin was taken 30 mins after pain, it is still waited for, hence increased A&E waiting times.
Will be good when these stats are no longer used as performance indicators.
Gary Mascall (Consultant in Clinical Biochemistry)
Clinical Biochemistry Department
Kidderminster Hospital
Worcestershire Acute Hospitals NHS Trust
Tel : 01562 823424 Extn 53465
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-----Original Message-----
From: GARETH DAVIES [mailto:[log in to unmask]]
Sent: 27 September 2003 09:27
To: [log in to unmask]
Subject: Re: A/E samples TAT
At the risk of going off the main track, do different labs offer a different or "restricted" range of tests for A&E?
We can obviously turn around a U&E in a very short time, adding LFTs,CRP, troponin etc will delay the completed report.
A quick look at our performance in September to date shows the following times in minutes from sample registration to electronic reporting on a live screen in A&E:
mean median
Normal hours 41 36 (91% <60mins)
Out-of-hours 34 24 (92% <60mins)
There was a report from Liverpool several years ago, in Clin Chem I think, showing that the availability of pathology results was not the limiting factor in the length of stay in A&E departments. If anyone can remind me of the reference, I would be most grateful.
Gareth Davies
Wrexham Maelor Hospital
> -----Original Message-----
> From: Mohammad Al-Jubouri [SMTP:[log in to unmask]]
> Sent: 26 September 2003 4:45 pm
> To: [log in to unmask]
> Subject: Re: A/E samples TAT
>
> Thanks guys for prompt reply
>
> Our TATs, is 70% of A/E requests within 1 hour and 90%
> within 2 hours. I suppose if you recieve 20 samples
> from A/E, which one you put first on the analyser is
> not going to matter as the last sample (no. 20) will
> be only delayed by 18 minutes from sample no. 1.
> However 18 minutes could be a long precious time in a
> life and death situation, hence my question about
> prioritisation which I know doesn't make sense if the
> lab is not informed by A/E about such serious cases
> upfront.
> It is reassuring that no lab using plain gel tubes is
> claiming 30 min TAT for A/E samples, a benchmark that
> we can't comply with. It is amazing how the 4 hour A/E
> waiting time compliance put unreasonable demands on
> the lab.
>
> regards
>
> Mohammad
>
>
> --- Jonathan Kay <[log in to unmask]> wrote:
> > TaT (specimen despatched to report on intranet) 90%
> > in 60 minutes 24 x
> > 7, using Vacutainer PST.
> >
> > Why would you want to "prioritise" if you know it's
> > from A and E?
> >
> > Jonathan
> >
> >
> > On Friday, Sep 26, 2003, at 15:21 Europe/London,
> > Mohammad Al-Jubouri
> > wrote:
> >
> > > Dear All
> > >
> > > What would be a reasonable turn around times for
> > A/E
> > > samples collected in plain gel tubes for common
> > > analytes? Is there any chance of prioritisation of
> > > such samples by laboratory staff based on clinical
> > > details (assuming that all requests carry accurate
> > and
> > > legible clinical details)?
> > >
> > > Thanks in advance for your help.
> > >
> > > Mohammad
> > >
> > > =====
> > > Dr. M A Al-Jubouri
> > > Consultant Chemical Pathologist
> > >
> > >
> >
> _______________________________________________________________________
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> =====
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> Consultant Chemical Pathologist
>
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