Reducing Turnaround Time from Pathology Collection to Patient Awareness in Gastroenterology Practice
Abstract
Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.
Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project. A total of 633 retrospective charts in which physicians and nurse practitioners completed the pathology letters were reviewed. Time was measured in days for the specimen being collected to completed by pathology, the provider being tasked the results, task received to letter written, letter written to mailed, and the overall TAT from specimen collected to letter mailed.
Intervention: A team of nurse practitioners (ACNPs and FNPs) took over reviewing and writing pathology letters within a defined amount of time for completion. A chart review was completed for each of the twelve providers (MD, DO, NP), consisting of 50 charts each. Thirty-three charts were not included in the data interpretation due to missing information.
Results: When comparing the TATs between the team of NPs and the team of physicians, it was revealed the NP team completed the pathology letters 4.83 days sooner than the physician team. NP was team faster in all categories related to provider-completed actions. NPs were slower in the written to mailed category which is completed by an office staff member not a provider.
Conclusion: Utilizing a NP team to write and send pathology letters led to a pronounced reduction in TAT. Further areas to investigate related to decreased TAT include improved patient satisfaction and decreased workload for ancillary staff. This quality improvement project has initiated the much-needed investigation into improving TAT related to patients’ awareness of pathology results.