Assessment of Laboratory Test Report Delivery Time in

CPEIC, Multan
Aqsa NOOR
Maryam Niazi

Assessment of laboratory Test Report Delivery Time in CPEIC

Introduction
Chaudhary Pervaiz Elahi Institute of Cardiology is a tertiary care center concerning
for the heart patients. It was established in 2003 as a part of developmental
project directed by Chaudhary Pervaiz Elahi (chief minister of Punjab). It
progressed with the passage of time. At present, it is fully developed that many
departments are working independently. Some of them are pathology
department, emergency, cardiology, cardiac surgery, clinical psychology, dental
section, Blood bank, Pharmacy, academic affairs etc. It serves the patients
throughout 24 hours day and night. Almost 600 patients visit the hospital per day.
They are treated in different departments with great accuracy. Nearly, 40-50%
patients belong to emergency department. They are treated very quickly within
10 minutes of entering in the department.
Pathology department is one of the best department in this institution. It is
serving the purpose of diagnosis through blood tests. It is playing major role in
diagnosis of diseases. Now days, doctors are depending on different blood tests
to find out the original cause of disorder. Without a laboratory, a hospital may be
paralyzed to diagnose the disease. In other words, we can call it as the backbone
of a medical institution. For our research, we have deeply observed pathology
department in CPEIC. All type of blood tests either specialized or routine are
performed here. We find them loyal towards their purpose. Its results are
accurate and satisfactory. Its staff kindly deal with the patients. They all are
following the laboratory safety rules. All above, their management and stepwise
mechanism of sample testing is excellent. There is high level of discipline and
punctuality. It is working 24 hour a day. It provides services to the emergency
patients. Different emergency tests include:
Renal function tests
Cardiac function tests
Liver function tests
Troponin I
Prothrombin time with INR
HCT malaria
Glucose random
Anti HCV
Creatinine kinase
Creatinine kinase Mb
Blood urea
Uric acid
Serum electrolytes
TSH, T3, T4
HbA1c
Complete Blood Examination

Study design
This is a descriptive cross sectional study. It was carried out from 20 September to
18 October 2019 in pathology department of CPEIC. It aims to assess the report
delivery time to the emergency patients.
Methods
A Performa was designed to address different information about patient samples.
We select the samples at random basis from emergency department. We consider
morning, evening and night shifts randomly for accuracy. We used the method of
accidental sampling quota for sample distribution. Number of samples were 10
for one week during the survey. Some of them were from morning shift; few from
evening and other belong to night shift. According to random sampling method,
the percentage of samples from morning shift was 30%, evening shift 35% and
night shift 35%. The slip generated from reception counter has entry and report
time on it and were noted from the reception. In our survey, we consider
following important information:
 Name of the patient
 Category of the patient
 Medical record number
 Laboratory number
 Age
 Contact/address
 Entry time
 Report time
 Tests advised
 Report delivery time
 Delay time if any
 Reason for delay
Internee in this institution performed this survey under the guidance of head of
pathology department. We carefully entered all information about patient
samples. The entry and report time was carefully noted from test slip. This slip
provide all information for our study except report delivery time, delay and its
reason. After slip generation, samples are taken in sampling section. After
withdrawing, the samples are forwarded to the laboratory section. Different tests
performed according to the advised. We carefully noticed the time consumed in
performing different tests. After all tests, results are forwarded to the report-
generating computer. The generated report has all above information in addition
to delivery time. We noticed the delivery time from result report. We compared
the report time to the delivery time statistically.

Results
After complete analysis through excel and SPSS tools, results were recorded. The
average delivery time for 1st, 2nd, 3rd, 4th and 5th were determined. Sample
withdrawing take 7-8 minutes in phlebotomy section. Some tests like CBC take 30
minutes at average from sampling to report generation. Similarly some tests like
ESR take 2 hours.
samples Average age Performed tests Average report Delay (if any)
time
0-10 20-30 CBC, rpm ,LP ,trop 2-2.5 hrs Two reports
I, CP,SE, CK-Mb, delayed
HbsAg, Anti HCV
10-20 30-45 Trop I, RP, SE, CK, 2 hrs No delay
CP, CBC, LFT
20-30 45-50 RP, SE, CP, CBC, 2-2.5 hrs No delay
glucoe random,
Prothrombin time
with INR, APTT
30-40 50-60 RPM, CP, LFT, Anti 2 hrs No delay
HCV, SE, CBC,
APTT
40-50 Above 70 Trop I, HbsAg, 2-2.5 hrs One delay
CBC, ESR, T3,
T4,TSH, glucose
random, blood
urea

Average delay time is two hours.

Highest delay time is 7 hours.
Quickest report delivery time is 1 hour.
Average Report Delivery is 2.5 hours.

Discussion
Results have recorded after deeply studying and observing the laboratory
procedure. Every test requires different time for performing it. To understand
fluctuation in delivery time, we have to take a glance at laboratory procedure.
Samples are taken in phlebotomy section. Here, laboratory number is labelled on
each vial. It is proceeded by the segregation section. Several important steps are
performed here. First of all, coagulation tests vials and hematology vials are
separated and forwarded to their respective sections. Chemistry vials are
arranged in order to form a batch. Samples of a batch are entered in entry
register. It completely eliminates the risk of any vial to be lost. After this, samples
are kept in the centrifuge in order to get blood serum for chemistry tests. Then,
serum is filled in chemistry cups in the form of a batch. This batch is fed to the
machine and results are noted. In the same manner, hematology and coagulation
tests are performed with whole blood and results are obtained. There is a proper
system of communication between all sections in order to manage all tests for a
sample. The results obtained are directed towards report computer and through
scanning tool, report is generated. This whole process is time consuming.
Quantity of specimen differ among variety of tests.
To understand fluctuation in delivery time, we have to take a glance at laboratory
procedure. From above data, we can conclude that every test requires different
time to perform it. There are many reasons for test report delay. Some of them
are discussed here. Sometime, there are too much rush of patients in the hospital
like on Monday. Emergency samples are processed along with other from
different departments. Rush is the one reason for delay because too many
samples aggregate that cannot be processed at the same time. Secondly, sample
may lost while performing the test like in setting ESR; sample may leaked and
wasted. So, in this case, sample will be collected again. It may happen that patient
was not available that time. Thirdly, if there is small size of sample then batch will
not form and technicians will wait for the next sample in order to complete the
batch. They can feed incomplete batch to the machine, but they prefer to wait for
completion of batch and then feed. Forth, sample may lost due to some reason
and lead to a delay. Fifth, it may happen that the specific test to be performed
was not labelled on the vial. Technicians mostly rely over the label on vial. For
example, if ESR has to perform for a sample then ESR must be mentioned on the
vial. During sampling, they forget to mention and technician in the laboratory just
relied on the vial instead of looking on the slip. In this way after performing all
tests of the patient, when computer scan the results then they came to know that
ESR was not performed. In this process, they wasted almost 3 hours. Now, it will
take extra time for ESR and resultantly causes delay in report delivery.