Evaluation of Laboratory Turnaround Time and Determinants for Hematology and Clinical Chemistry Tests in Emergency and Trauma Centers, Addis Ababa

Abstract

Abstract Background: Laboratory tests are a critical component of clinical decision-making in the emergency department. Reporting results within an acceptable turnaround time (TAT) is a vital indicator of laboratory quality. International standards recommend the laboratories to establish and periodically evaluate TAT benchmarks to ensure patient safety. Objective: To determine laboratory turnaround time and associated factors for complete blood count (CBC) and clinical chemistry tests at Addis Ababa Burn, Emergency and Trauma Hospital (AaBET). Method: A cross-sectional study was conducted from January to April, 2022. All emergency patient samples requiring at least a CBC and/or clinical chemistry panel were followed consecutively upon receipt. Statistical analysis was performed using version 23 SPSS. Bivariate and multivariate regression analyses were conducted to assess the relationship between turnaround time and the suggested associated factors. For all statistical tests, P < 0.05 was considered significant. Results: Data regarding the specimen receipt to verification time data were obtained for 4132 tests. Of which, 2309 (55.9%) of them were complete blood count, and 1823 (44.1%) were chemistry tests. The 90th percentile completion times were 105 minutes (SD: 53.9) for CBC and 457 minutes (SD: 257.4) for chemistry. Over 28% of the tests failed to meet the TAT benchmarks set by international standards. Significant contributors to delayed TAT included: Specimens received during Sunday night shifts ($P < 0.001$) for both test types. CBC tests requested without concurrent blood group or cross-match tests ($P = 0.009$). Equipment failure (chemistry analyzer breakdown). Conclusion: Laboratory turnaround times were prolonged and did not comply with established international benchmarks. Targeted improvements in personnel allocation and equipment maintenance are necessary to minimize delays in test results. Key words: Turnaround time (TAT), Complete Blood Count (CBC), Clinical chemistry, Emergency department