European Journal of Cardiovascular Medicine

Laboratory personnel focus more on  maintenance of quality but physicians look for a rapid result which is reliable. So, reporting the results in time is an important indicator of laboratory efficiency. In  a laboratory , this is expressed as turn around time (TAT). TAT can be  defined in many ways. The time taken from test order to result reporting is considered as TAT by Clinicians. But  Laboratory personnel  define TAT as the time taken from sample collection to reporting of results 1 . TAT depends on many factors like the tests ordered, patients , availability of man power, efficiency of the staff, methods used for analysis , the extent of automation, documentation requirements etc.so, TAT varies from lab to lab. TAT can be divided into pre analytical, analytical & post analytical phases 2 .So, this study is taken up to analyse our lab TAT in different phases i.e., pre analytical, analytical & post analytical phases in order to find out where the delay is taking place.

This study is conducted in Clinical Biochemistry Laboratory of a tertiary care center for a period of 2 months from July 2025 to August 2025 after the approval of institutional ethics committee. The lab is well equipped with automated machines like AU 480 & Access 2 of Beckman Coulter & ABG analyser. Phlebotomy of IP & emergency samples is conducted by technicians of concerned departments & sent to laboratory. The OP samples are collected by lab technicians in a sample collection center & transported to lab. The samples received in the reception of laboratory are screened for pre analytical errors. The samples without any errors are sent for centrifugation. After obtaining proper QC , the samples are analysed in specific analysers. The results are then entered in the corresponding registers. Verification of results is carried out by concerned faculty & then dispatched to respective wards. The results of OP samples after analysis are dispatched to patients through OP collection center. In this study, we have evaluated time taken for various steps for IP, OP & emergency samples after excluding the samples rejected in reception. We also excluded uncommon causes like power failure, instrument breakdown etc. The important steps of laboratory work up are Sample collection in appropriate tubes Receiving & registering samples in the reception Manual Centrifugation Manual Loading of samples into autoanalyser Analysis of sample in automated machines Documentation of results in respective registers Verification Dispatching the reports The routine biochemical parameters included in our study are 1. Blood Glucose 2. Blood urea 3. S.Creatinine 4.S.Bilirubin 5.SGOT & SGPT 6.ALP 7.Total Cholesterol 8.S.Electrolytes 9.Total Proteins 10. S.Albumin The time taken for various steps is used to calculate TAT for I P, OP & emergency samples. The time taken for each phase is noted & expressed as percentage of TAT.

Table 1: Demographic Characteristics of Participants

Table 1 presents the demographic characteristics of the 50 participants. The majority (36%) were aged 60-69 years, followed by 30% in the 50-59 age group. Participants aged ≥70 years accounted for 18%, while those aged 40-49 years were the least (16%). Males comprised 54% of the study population, while females made up 46%.

Table 2: Primary Complaints during Adaptation Period

Table 2 highlights the primary complaints experienced by first-time complete denture wearers during the adaptation period. Pain or discomfort was the most common issue, reported by 44% of participants, followed by difficulty in chewing 36%. Speech problems affected 20%, while excessive salivation was noted in 16%. A gag reflex was experienced by 10% of patients, whereas 14% reported no complaints.

Table 3: Adaptation Time for Denture Usage

Table 3 illustrates the adaptation time among first-time complete denture wearers. The majority (36%) adapted within 1-2 weeks, while 34% required 3-4 weeks. A smaller proportion (20%) took more than a month to adjust, whereas 10% adapted within the first week.

Table 1 shows  time taken for   various steps

Table 2 : Average TAT for IP, OP & emergency samples

Table 3 : Percentage of TAT  contributed by each phase

Bar graph showing the Percentage contribution of 3 phases

According to our study,the majority of TAT was taken by  pre & post analytical                                   phases. The time for  analytical phase is comparatively less may be due to the introduction of automated instruments.  In a study conducted by Binitha Goswami et al ,pre & post analytical phases were the major contributors of TAT^3. In order to improve the performance of the lab & to pinpoint the delay we have used fault tree analysis.

   The reasons for delay are

Pre analytical phase

1. Lack of manpower for transport of samples
2. Poor phlebotomy techniques
3. Lack of bar coding system

Analytical phase

4. Insufficient instrumentation : Single auto analyser
5. Repeat  examinations in case of clot

Post analytical phase

Manual dispatch of reports

Measures / suggestions to decrease TAT

Pre analytical phase : 1.Training the technicians to use proper phlebotomy techniques

 2.Implementation of  bar coding system

3. implementation of pneumatic bag [4] for transport

4.Employ more personnel for sample transport

Analytical phase : Though analytical phase is better , we can still improve by  increasing number of instruments

Post Analytical phase :  1. incorporate LIS for faster dispatch of reports

Apart from these, establishment of satellite labs & POCT in emergency departments can be other alternatives to reduce TAT [5]

After analysis of TAT in our Clinical Biochemistry Laboratory , we conclude that more attention should be given to pre & post analytical phases to reduce TAT so that we can meet the clinicians’ demand of faster dispatch of reports. Source of funding : Nil Conflict of interest : None Acknowledgements : I thank my Professor & HOD Dr T. Durga for her guidance. I also acknowledge all the staff of our Clinical Biochemistry Laboratory for their cooperation

1.       Chhatriwala MN, Patel DSB, Patel D, Hitesh N , Shah .TAT for Clinical Biochemistry Laboratory a vital & effective parameter for patient care. JClin Diagn Res.2021 Feb,VOL-15(2): BC01-BC04

2.       Truchaud A, Neel T, Brochard H, Malvaux S, Moyon M, Cazaubiel M. New tools for laboratory design and management. Clin Chem. 1997;43:1709–1715.

3.       3.Goswami B, Singh B, Chawla R, Gupta VK, Mallika V.Turn Around Time  (TAT) as a benchmark of laboratory performance. Indian J Clin Biochem.2010;25(4): 376-379

4.       Lewandrowski K. How the clinical laboratory and the emergency department can work together to move patients through quickly. Clin Leadersh Manag Rev 2004;18:155–159.

5.       Lee W, Min WK, Chun S, Jang S, Chi HS, Park CJ et al. Reorganization of automated outpatient laboratory to improve total turn around time. Korean J Lab Med 2004;24:334–338.