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Cited by 23Clinical Laboratory Practices and Quality ControlEmergency and Acute Care StudiesHealthcare Quality and Management

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Decreasing troponin turnaround time in the emergency department using the central laboratory: A process improvement study

Boelstler, Arlene M., Rowland, Ralph, Theoret, Jennifer, Takla, Robert B., Szpunar, Susan, Patel, Shraddha P., Lowry, Andrew M., Pena, Margarita E.·2015·Clinical Biochemistry
DOI 10.1016/j.clinbiochem.2014.10.014
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Abstract

Objectives To implement collaborative process improvement measures to reduce emergency department (ED) troponin turnaround time (TAT) to less than 60min using central laboratory. Design and methods This was an observational, retrospective data study. A multidisciplinary team from the ED and laboratory identified opportunities and developed a new workflow model. Process changes were implemented in ED patient triage, staffing, lab collection and processing. Data collected included TAT of door-to-order, order-to-collect, collect-to-received, received-to-result, door-to-result, ED length of stay, and hemolysis rate before (January-August, 2011) and after (September 2011-June 2013) process improvement. Results After process improvement and implementation of the new workflow model, decreased median TAT (in min) was seen in door-to-order (54 [IQR43] vs. 11 [IQR20]), order-to-collect (15 [IQR 23] vs. 10 [IQR12]), collect-to-received (6 [IQR8] vs. 5 [IQR5]), received-to-result (30 [IQR12] vs. 24 [IQR11]), and overall door-to-result (117 [IQR60] vs. 60 [IQR40]). A troponin TAT of <60min was realized beginning in May 2012 (59 [IQR39]). Hemolysis rates decreased (14.63±0.74 vs. 3.36±1.99, p<0.0001), as did ED length of stay (5.87±2.73h vs. 5.15±2.34h, p<0.0001). Conclusion Troponin TAT of <60min using a central laboratory was achieved with collaboration between the ED and the laboratory; additional findings include a decreased ED length of stay.

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Metadata

Authors
Boelstler, A. M., Rowland, R., Theoret, J., Takla, R. B., Szpunar, S., Patel, S. P., Lowry, A. M., & Pena, M. E.
Affiliations
  • St. John Hospital & Medical Center (US)
  • Wayne State University (US)
ORCID
Venue
Clinical Biochemistry
Publisher
Elsevier BV
Published
2015-03
Volume
48
Issue
4-5
Pages
308-312
ISSN
0009-9120 (ISSN-L)
DOI
10.1016/j.clinbiochem.2014.10.014
OpenAlex
W2087274964
Cited by
23
References
34
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 3
FWCI
1.11
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Clinical Biochemistry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
Keywords
troponin, turnaround time, emergency department, central laboratory, process improvement, workflow redesign, hemolysis, emergency department length of stay, triage, laboratory staffing, cardiac biomarkers
MeSH terms
Emergency Service, Hospital, Humans, Laboratories, Hospital, Length of Stay, Retrospective Studies, Time Factors, Troponin, Process Assessment, Health Care, Workflow, Quality Improvement

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CoChat. (2026). Citation check: Decreasing troponin turnaround time in the emergency department using the central laboratory: A process improvement study. https://app.cochat.ai/papers/10.1016/j.clinbiochem.2014.10.014
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Boelstler, A. M., Rowland, R., Theoret, J., Takla, R. B., Szpunar, S., Patel, S. P., Lowry, A. M., & Pena, M. E. (2015). Decreasing troponin turnaround time in the emergency department using the central laboratory: A process improvement study. Clinical Biochemistry. https://doi.org/10.1016/j.clinbiochem.2014.10.014