東華大學圖書館 |

Language: English

Help

回圖書館首頁

手機版館藏查詢

Back

Switch To: Labeled | MARC Mode | ISBD

The Effectiveness of Laboratory Inte...

Mendoza, Romulo.

Linked to FindBook

Google Book

Amazon

博客來

The Effectiveness of Laboratory Interventions During the Pre-Analytical Phase of Laboratory Test Workflow in Decreasing Emergency Department Disposition Time.

Record Type:	Electronic resources : Monograph/item
Title/Author:	The Effectiveness of Laboratory Interventions During the Pre-Analytical Phase of Laboratory Test Workflow in Decreasing Emergency Department Disposition Time./
Author:	Mendoza, Romulo.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
Description:	119 p.
Notes:	Source: Dissertations Abstracts International, Volume: 82-06, Section: B.
Contained By:	Dissertations Abstracts International82-06B.
Subject:	Health sciences. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28259859
ISBN:	9798698579991

The Effectiveness of Laboratory Interventions During the Pre-Analytical Phase of Laboratory Test Workflow in Decreasing Emergency Department Disposition Time.
Mendoza, Romulo.

The Effectiveness of Laboratory Interventions During the Pre-Analytical Phase of Laboratory Test Workflow in Decreasing Emergency Department Disposition Time. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 119 p.

Source: Dissertations Abstracts International, Volume: 82-06, Section: B.

Thesis (D.H.A.)--Central Michigan University, 2020.

This item must not be sold to any third party vendors.

Threats to human health are inevitable, and everyone must have sought emergency care at least once in their lifetime. The clinical pathology laboratory is one of the ancillary services that the emergency department (ED) relies on to make a disposition, so monitoring the turnaround time (TAT) of the specimen workflow is a regular process improvement metric. There are three phases in specimen workflow: 1) the pre-analytical phase, 2) the analytical phase, and 3) the post-analytical phase. Technological innovations such as automation on analysis and auto verification of results have significantly improved the workflow in the analytical and post-analytical phases, respectively, leaving the pre-analytical phase the most common source of delays. This dissertation investigates the effects of a work system change through a field experiment between ED and lab, focusing on the effects of interventions in the pre-analytical phase. The first study investigated the relationship of the common reasons for specimen transport delays from the ED to the laboratory with the work shift through a four-month joint field experiment that resulted in 133 interventions (number of phone calls made by CPA clerks to the collector of specimens that were not submitted to the lab after 21 minutes of collection to inquire about the submission delay). The study found that the multi-tasking ED treatment team got interrupted equally on both day and night shifts and was responsible for 76% of pre-analytical TAT outliers. However, the study identified causes of unavoidable delays (14/82 = 17%), such as difficult blood draw, patient unable to void urine, or the patient underwent medical procedures at other ancillary departments such as Radiology and Respiratory.The second study aimed to measure the effectiveness of laboratory interventions on two variables: (a) TAT from specimen collection to laboratory specimen receipt (TAT on COLREC), i.e., the time span (in minutes) from the time the ED health care worker (HCW) collected the specimens to the time the Central Processing Area (CPA) department of the lab received the specimens, and (b) TAT from ED arrival to disposition (TAT on DISPO), i.e., the time span (in minutes) from the arrival of the ED patient to the time the ED provider made a disposition. The hospital information system (HIS) provided TAT on DISPO, and the Laboratory Information System (LIS) provided TAT on COLREC. We analyzed and compared the TAT on DISPO (M = 291.94, SD = 151.35) and COLREC (M = 14.07, SD = 14.90) in the intervention months of August to November 2018 with the same range of months in 2017 (pre-intervention) TAT on DISPO (M = 350.12, SD = 178.26) and TAT on COLREC (M = 31.61, SD = 23.27) and 2019 (post-intervention) TAT on DISPO (M = 316.08, SD = 162.56) and TAT on COLREC (M=15.02; SD=21.95). The results uncovered significant opportunities for improvement in the TAT on both DISPO and COLREC during the intervention period. This dissertation supports evidence that a small amount of time invested by ED and laboratory staff using new technology for intervention in the pre-analytical phase raised enough awareness to minimize delays on specimen submission that eventually improved ED throughput.

ISBN: 9798698579991Subjects--Topical Terms:

3168359
Health sciences.
Subjects--Index Terms:

Disposition

The Effectiveness of Laboratory Interventions During the Pre-Analytical Phase of Laboratory Test Workflow in Decreasing Emergency Department Disposition Time.
LDR:04713nmm a2200445 4500 001 2281912
005 20210927083427.5
008 220723s2020 ||||||||||||||||| ||eng d
020 $a 9798698579991
035 $a (MiAaPQ)AAI28259859
035 $a AAI28259859
040 $a MiAaPQ $c MiAaPQ
100 1 $a Mendoza, Romulo. $3 3560618
245 1 4 $a The Effectiveness of Laboratory Interventions During the Pre-Analytical Phase of Laboratory Test Workflow in Decreasing Emergency Department Disposition Time.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2020
300 $a 119 p.
500 $a Source: Dissertations Abstracts International, Volume: 82-06, Section: B.
500 $a Advisor: Delellis, Nailya.
502 $a Thesis (D.H.A.)--Central Michigan University, 2020.
506 $a This item must not be sold to any third party vendors.
520 $a Threats to human health are inevitable, and everyone must have sought emergency care at least once in their lifetime. The clinical pathology laboratory is one of the ancillary services that the emergency department (ED) relies on to make a disposition, so monitoring the turnaround time (TAT) of the specimen workflow is a regular process improvement metric. There are three phases in specimen workflow: 1) the pre-analytical phase, 2) the analytical phase, and 3) the post-analytical phase. Technological innovations such as automation on analysis and auto verification of results have significantly improved the workflow in the analytical and post-analytical phases, respectively, leaving the pre-analytical phase the most common source of delays. This dissertation investigates the effects of a work system change through a field experiment between ED and lab, focusing on the effects of interventions in the pre-analytical phase. The first study investigated the relationship of the common reasons for specimen transport delays from the ED to the laboratory with the work shift through a four-month joint field experiment that resulted in 133 interventions (number of phone calls made by CPA clerks to the collector of specimens that were not submitted to the lab after 21 minutes of collection to inquire about the submission delay). The study found that the multi-tasking ED treatment team got interrupted equally on both day and night shifts and was responsible for 76% of pre-analytical TAT outliers. However, the study identified causes of unavoidable delays (14/82 = 17%), such as difficult blood draw, patient unable to void urine, or the patient underwent medical procedures at other ancillary departments such as Radiology and Respiratory.The second study aimed to measure the effectiveness of laboratory interventions on two variables: (a) TAT from specimen collection to laboratory specimen receipt (TAT on COLREC), i.e., the time span (in minutes) from the time the ED health care worker (HCW) collected the specimens to the time the Central Processing Area (CPA) department of the lab received the specimens, and (b) TAT from ED arrival to disposition (TAT on DISPO), i.e., the time span (in minutes) from the arrival of the ED patient to the time the ED provider made a disposition. The hospital information system (HIS) provided TAT on DISPO, and the Laboratory Information System (LIS) provided TAT on COLREC. We analyzed and compared the TAT on DISPO (M = 291.94, SD = 151.35) and COLREC (M = 14.07, SD = 14.90) in the intervention months of August to November 2018 with the same range of months in 2017 (pre-intervention) TAT on DISPO (M = 350.12, SD = 178.26) and TAT on COLREC (M = 31.61, SD = 23.27) and 2019 (post-intervention) TAT on DISPO (M = 316.08, SD = 162.56) and TAT on COLREC (M=15.02; SD=21.95). The results uncovered significant opportunities for improvement in the TAT on both DISPO and COLREC during the intervention period. This dissertation supports evidence that a small amount of time invested by ED and laboratory staff using new technology for intervention in the pre-analytical phase raised enough awareness to minimize delays on specimen submission that eventually improved ED throughput.
590 $a School code: 6006.
650 4 $a Health sciences. $3 3168359
650 4 $a Health care management. $3 2122906
650 4 $a Pathology. $3 643180
650 4 $a Information technology. $3 532993
653 $a Disposition
653 $a Distracted healthcare workers
653 $a Epic rover
653 $a Laboratory errors
653 $a Laboratory specimen workflow
653 $a Pre-analytical errors
653 $a Threats to human health
653 $a Emergency care
653 $a Work system change
653 $a Hospital information system
690 $a 0566
690 $a 0769
690 $a 0489
690 $a 0571
710 2 $a Central Michigan University. $b DHA - Health Administration/School of Health Sciences. $3 2092010
773 0 $t Dissertations Abstracts International $g 82-06B.
790 $a 6006
791 $a D.H.A.
792 $a 2020
793 $a English
856 4 0 $u https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28259859