I have posted a number of previous notes about the use of lab analytics software that is used to analyze LIS data to gain insights into the efficiency of lab operations (see: Lab Analytics Emerges as Hot Area for Software Development; Leveraging Lab Analytic Data to Include Actionable Details to Improve Quality; The Use of Lab Analytic Dashboards in Anatomic Pathology). These companies provide dashboards to clients for a set of preconfigured reports. Clients can also create customized reports by dragging lab variables into a work space. It's possible, for example, to assess employee work productivity such as medical technologists or phlebotomists. Below is a scenario submitted to me by Viewics that examines the TAT among five pathologists when examining specimens from high risk patients .
A Viewics client wanted to take a closer look at cases which encompassed a patient population that was designated high risk. These patients met pre-defined criteria that was established by lab leadership, criteria which required urgency in the analysis of the specimen. In depth analysis of data from 2012 revealed an opportunity to shift these high risk cases among the pathologists on staff in order take advantage of certain skill sets. Pathologists A-E all had an average TAT under the goal of 3,500 minutes, as illustrated by the blue bar. The decision was made to increase the volume of high risk cases assigned to these pathologists, as illustrated by the orange circle. Conversely, Pathologists F & G had higher than desired TAT, so their case volume was decreased for these high risk cases. The impact on the overall TAT of these high risk cases was significant, with an improvement of 622 minutes, or over 10 hours, per case in 2013.
Most lab professionals would include test TAT as a very important variable in terms of lab quality. Here's a brief discussion about the overall importance of TAT is lab operations: from an Australian article (see: Laboratory Turnaround Time):
...TAT is one of the most noticeable signs of a laboratory service and is used by many clinicians to judge the quality of the laboratory. Delays in TAT elicit immediate complaints from users while adequate TAT goes unremarked. Unsatisfactory TAT is a major source of complaints to the laboratory regarding poor service and consumes much time and effort from laboratory staff in complaint resolution and service improvement. Despite advances in analytical technology, transport systems and computerisation, many laboratories have had difficulties improving their TATs.....A College of American Pathologists (CAP) Q-Probes survey of ED TAT in 1998 showed low satisfaction rates concerning the laboratory’s sensitivity to urgent testing needs (39%) and meeting physician need (48%). Laboratory TAT was felt to cause delayed ED treatment more than 50% of the time (43%) and also increased ED length of stay (LOS) over half the time (61%).
I don't think, as in the example above, that it would be particularly controversial to examine pathologist TAT for what are defined as high risk cases. I assume that these were patients for whom rapid reporting was considered necessary. Among seven pathologists, it stands to reason that two will be slower in generating such reports than the others. It would be interesting to more about the nature of these high risk patients but that's not really necessary to understand the usefulness of such a report.