The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Gary R. Lowe, Yolanda Griffin; Respiratory Care Services, Arkansas Children's Hospital, Little Rock, AR

Introduction: Many hospitals are currently transitioning patient information to electronic medical records (EMR). EMR offer many advantages including improved quality, error prevention, cost reduction, and increased efficiency. Our institution converted to a new hospital information system (HIS) to enhance our EMR capabilities. This report relates the impact on turn-around-times (TAT) of specimens processed in our Stat Lab, which reports blood gases, electrolytes, metabolites, and co-oximetries. Methods: This retrospective review compared Stat Lab TAT before and after conversion to the new HIS. Prior to conversion, Stat Lab personnel received instruction and specimen processing training sessions using a test mode. A staff member from each shift received additional training. Personnel practiced using a test mode. Data sampling was conducted 4 times monthly, representing 11% of all samples processed. Post-conversion data (collected monthly for 6 months) was compared to a 3 month pre-conversion average. Compliance was gauged using an internal benchmark with a goal of reporting 95% of all specimens processed within 7 minutes (min) from receipt in the Stat Lab. Results: The average TAT for 3 months prior to the conversion was 4.15 min. Compared to baseline, post-conversion average TAT ranged from a high of 7.1 min for 9/10 to a low of 4.1 min (back to baseline) for 3/11 (see table). For each of 6 months post conversion, the goal of processing 95% of specimens within 7 min was not achieved. There has been an upward trend, but the 95% threshold has not been attained. Causes included system issues like difficulty accessing open patient records, and ordering tests within 6 min of a previous order were automatically cancelled by the system. Also, personnel issues like using a previously assigned password and callbacks for missing data or incomplete orders caused delays. To further confound the observations, the Stat Lab was physically moved in 1/11 which negatively impacted TAT. Conclusion: Significant efforts were made to ensure that staff was adequately trained to handle problems anticipated post-conversion. Actual TAT appear to have recovered, however attainment of processing 95% of specimens within 7 min has not returned to pre-conversion levels. Despite training and actual experience, it has taken significant time to assimilate the new system. Consistent performance has not been achieved compared to pre-conversion averages, and monitoring will be continued. Sponsored Research - None
Comparison of 3 month average pre-conversion TAT to Monthly Values Post Conversion