Background: Many laboratories restrict their definition of turnaround time (TAT) to intra-laboratory activities. However, such an approach will underestimate TAT since nonanalytical delays may be responsible for up to 96% of total TATs. With this in mind, we aimed to conduct a quality analysis on the impact on turnaround times since in-house testing of EGFR, BRAF, NRAS, KRAS, HPV, and CT/NG, as well as a quality analysis of completion times for sequential process steps for FFPE tissue mutational testing from order to result generation to account for possible non-analytical delays.
Objective: This quality analysis focused on three main objectives: (1) Study the TAT for current in-house molecular tests vs prior TAT for molecular test send outs; (2) Study completion time processes for main steps in FFPE tumor mutation testing for current in-house testing; (3) Gauge clinicians’ satisfaction since the introduction of in-house molecular testing.
Methods: Turnaround time points are defined as the time the order is placed to result generation, whether in laboratory section in CPRS, anatomic pathology supplementary report (APS), or cytology integrated report. Analysis of sequential steps of laboratory completion times of order-tomolecular accession to testing analysis to release of lab result to CPRS to APS report results integration for FFPE tissue mutation testing was conducted. Lastly, hematology/oncology clinicians and clinicians involved with HPV testing were surveyed on their satisfaction with TATs.
Results: Comparing prior vs current TATs, there was a decrease in mean TAT of 31.6% for EGFR, 56.4% for KRAS, 54.6% for BRAF, 61.5% for NRAS, 42.1% for CT/NG, 82.6% BCR-ABL, and 29.3% for HPV. Completion time process analysis revealed the longest completion time was order-tomolecular accession. Survey showed that clinicians reported greater satisfaction with TATs since in-house testing for FFPE mutation testing and HPV testing.
Conclusions: We noted marked improvement in TATs since in-house molecular mutational testing with greater clinician satisfaction. Future endeavors may include quality analysis of the order-to-molecular accession step to elucidate ways to improve completion times to further improve TATs.
