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6 Transforming a national laboratory network to meet COVID-19 testing demand
  1. John Boulton,
  2. Iain Roberts,
  3. Kelly Ward
  1. Public Health Wales NHS Trust


Background Public Health Wales NHS Trust (PHW) is responsible for Microbiology laboratory services that support NHS Wales. The testing capacity within the laboratories was increased rapidly. There was a requirement to improve laboratory turnaround time for samples to enable results to be provided to individuals as quickly as possible.

As laboratory capacity increased, turnaround times did not improve. The following issues were identified:

  • Variation in turnaround times for different populations.

  • A lack of understanding of daily demand for tests

  • Lack of standard processes for handling samples upon arrival in the laboratories

Objectives The aim was that within 3 months, 80% of all samples would be turned around within 12 hours of receipt in the laboratory. A stretch goal of achieving 95% by the summer. The work consisted of:

  • Engagement with all laboratories

  • Mapping sample flows

  • Development of dashboards to understand flow, demand and activity

  • Mapping of in-laboratory processes

  • Modelling sample flows

Methods Using a Lean methodology, the following were implemented:

  • Flow of all asymptomatic community samples to a dedicated high volume laboratory

  • Standard process for receipt of samples, including prioritisation

  • Improved flow of samples around laboratories

  • Daily meetings to discuss on-going issues and an opportunity to share good practice

  • Laboratory process redesign

Results Improvement work commenced in January 2021. As a consequence, times improved across all laboratories (figures 1–4). Median turnaround time reduced from over 24 hours to 6 hours. This has been sustained. 80% of samples are now turned around within 12 hours.

Conclusions The need for rapid turnaround of Covid-19 samples is essential. As a consequence of a national improvement program 80% of all samples have a turnaround time of 12 hours of less.

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