QUALITY MANAGEMENT
Risk-based turnaround time management: a look at some important issues
In this fifth article in his series, Stephen MacDonald focuses on the implementation of risk-based turnaround time management, which requires collaboration across laboratory and clinical teams, supported by robust IT infrastructure and real-time monitoring tools, and, most importantly, cultural change.
Turnaround time (TAT) is often viewed as an operational performance metric, reported in key performance indicator (KPI) dashboards and service-level agreements (SLAs). However, within a risk management framework, TAT should be recognised as a clinical risk directly linked to patient outcomes. Delays in laboratory test reporting can result in missed therapeutic opportunities, prolonged hospital stays, and, in some cases, direct patient harm. A risk-based approach to TAT management is therefore essential – not just for operational efficiency but as a central patient safety strategy.
ISO 15189:2022 reinforces this perspective by embedding timeliness as a key quality element throughout laboratory processes, while ISO 22367:2020 defines a systematic approach for identifying and controlling risks within medical laboratories. In line with these standards, this article (hopefully!) reframes TAT management as a clinical risk process, requiring formal risk assessment, structured controls, continuous monitoring, and ongoing review. We now recognise that the
responsibility of the laboratory extends beyond the analytical phase. From the
moment a sample is collected to the point the result reaches the clinical team, laboratories have a duty to ensure timely processing and communication. This article outlines a structured, risk- based framework to define, manage and monitor TAT, focusing not merely on meeting predefined targets but on safeguarding patients by ensuring test results are delivered within clinically acceptable timeframes.
Scope of risk-based TAT management Turnaround time is often measured solely from the point of sample receipt within the laboratory to the release of the result. However, a true clinical risk-based approach must at least consider the full journey of the sample: from patient collection through to result delivery and clinical interpretation. Laboratories have a responsibility to manage risks across all phases of the testing process, recognising that pre-analytical and post-analytical delays can be as clinically significant as within-laboratory processing delays. A risk-based TAT framework must
Information technology systems should provide live dashboards that display current performance against TAT targets, generate alerts when samples approach or breach defined thresholds, and enable proactive responses such as reprioritisation or reallocation of resources.
WWW.PATHOLOGYINPRACTICE.COM AUGUST 2025
differentiate between: n Pre-analytical phase: Delays during sample collection, labelling, transport, and initial reception can critically affect patient care. Laboratories should work collaboratively with clinical and logistical stakeholders to address pre- analytical risks, even when outside their direct operational control.
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