I recently attended the DMT Conference sponsored by the University of Texas Medical Branch in Galveston, Texas. One of the conference faculty members was Dr. Christopher Zahner from UTMB. During his lecture, he referred to the diagnostic turnaround time (DTAT), a term he defined as the interval from the time that a clinician begins a diagnostic workup for a patient until he or she arrives at the correct diagnosis. Contrast this with the lab turnaround time (LTAT) which has been cited in the laboratory literature for decades and is defined as the time interval from when a specimen arrives in a clinical laboratory until the time when the result in uploaded to the LIS and EHR and thus made available to clinicians. This concept of a diagnostic turnaround time was totally new to me.
In a recent note, I observed that Clinical Pathology and Anatomic Pathology were both in the process of a major change (see: A Major Change Now Occurring in Both Clinical Pathology and Anatomic Pathology). The change in the former is the rising interest in clinical diagnoses by lab professionals on the basis of test results generated in the various hospital labs. This process in the past has been almost exclusively the domain of the test-ordering clinicians. The surge in interest is being fueled, in part, by the growing popularity of diagnostic management teams (DMTs) (see, for example: DMTs as an Example of a Team Approach to Clinical Lab Diagnostics). It's probably no accident, therefore, that a term like diagnostic turnaround time (DTAT) is being heard at pathology conferences.
The LTAT has been a useful laboratory performance indicator (see: Laboratory Turnaround Time) and I am sure that it will continue to be used in this context. However, it's a measurement based on the pathologist's wristwatch. The DTAT emphasizes the fact that the most important goal for hospital personnel is the diagnosis and treatment of patients' illnesses. For this, the clinicians' wrist watch is of paramount importance. If diagnostic management teams (DMTs) can contribute to the rapid diagnosis of disease and shorten the LOS and increase patient satisfaction, the healthcare industry will be much better off (see: Patient-Centered LOS Reduction Initiative Improves Outcomes, Saves Costs).
Will the use of DTAT from a patient’s perspective is even more important. It is also the component of the healthcare process that has received less attention from the quality improvement community.
Posted by: Doug Knapman | March 30, 2019 at 09:55 AM