PT  - JOURNAL ARTICLE
AU  - John Boulton
AU  - Iain Roberts
AU  - Kelly Ward
TI  - 6 Transforming a national laboratory network to meet COVID-19 testing demand
AID  - 10.1136/bmjoq-2021-IHI.6
DP  - 2021 Nov 01
TA  - BMJ Open Quality
PG  - A5--A6
VI  - 10
IP  - Suppl 2
4099  - http://bmjopenquality.bmj.com/content/10/Suppl_2/A5.short
4100  - http://bmjopenquality.bmj.com/content/10/Suppl_2/A5.full
SO  - BMJ Open Qual2021 Nov 01; 10
AB  - 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 testsLack of standard processes for handling samples upon arrival in the laboratoriesObjectives 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 laboratoriesMapping sample flows Development of dashboards to understand flow, demand and activityMapping of in-laboratory processesModelling sample flowsMethods Using a Lean methodology, the following were implemented:Flow of all asymptomatic community samples to a dedicated high volume laboratoryStandard process for receipt of samples, including prioritisation Improved flow of samples around laboratoriesDaily meetings to discuss on-going issues and an opportunity to share good practiceLaboratory process redesignResults 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.Abstract 6 Figure 1 Abstract 6 Figure 2 Abstract 6 Figure 3 Abstract 6 Figure 4 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.