Phases of the testing cycle:
(1) selecting and ordering the test
(2) collecting the specimen and delivering it to the laboratory
(3) accessioning the specimen and deliverying the specimen within the laboratory
(4) testing the specimen and finalizing the result
(5) communicating the report to the clinician
Factors affecting the time taken to select and order a test:
(1) difficulty finding the correct test name
(2) manual system for ordering the test
(3) delay in communicating the order
(4) error in ordering the test
Factors affecting specimen collection and delivery:
(1) lack of personnel to collect the specimen immediately
(2) order missed
(3) prolonged travel time to patient
(4) difficulty in finding or reaching the patient
(5) difficulty in specimen collection
(6) difficulty in getting labels
(7) delay in delivering the specimen to the laboratory
(8) delay because the patient was not properly prepared (fasted, etc)
Factors affecting specimen accessioning and intra-laboratory delivery:
(1) specimen overlooked
(2) specimen received but order delayed
(3) failure to order the test STAT
(4) manual accessioning system, including computer downtime
(5) problem with order or specimen
(6) need to centrifuge or process specimen
(7) delay in distributing the specimen
(8) loss of or damage to the specimen
(9) need to send the specimen to a distant testing site
(10) additional orders placed on specimen already sent to the laboratory
Factors that may slow specimen testing:
(1) instrumentation down or not available
(2) need to get or prepare reagents
(3) problem with the assay or the quality controls
(4) lack of testing personnel
(5) need to perform a calculation
(6) need to recollect the specimen
(7) excessive workload in the laboratory at the time
Factors that may slow the delivery of the test results:
(1) manual result delivery
(2) finding the appropriate clinician
(3) problem with communication systems for deliverying results
