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Pathology processes and emergency department length of stay: the impact of change

Andrew Georgiou and Johanna I Westbrook
Med J Aust 2009; 191 (6): . || doi: 10.5694/j.1326-5377.2009.tb02833.x
Published online: 21 September 2009

To the Editor: Francis and colleagues revealed a significant 29-minute decrease in the median emergency department (ED) length of stay and reductions in mean turnaround times for full blood count requests following the redesign of pathology processes.1 Laboratory performance and clinician satisfaction are intrinsically bound up with the timeliness of test results, not least because of their effects on patient diagnosis and treatment. The association between test turnaround times and ED length of stay is difficult to decipher. The reasons for this, as pointed out by Francis et al, include the many potential variables that contribute to patient length of stay in EDs. Turnaround times can also vary dramatically according to laboratory operating procedures and work processes. Nevertheless, there is a strong imperative to monitor these indicators as contributors to designing effective interventions to improve the quality and outcomes of patient care.


  • Health Informatics Research and Evaluation Unit, University of Sydney, Sydney, NSW.


Correspondence: a.georgiou@usyd.edu.au

  • 1. Francis AJ, Ray MJ, Marshall MC. Pathology processes and emergency department length of stay: the impact of change. Med J Aust 2009; 190: 665-669. <MJA full text>
  • 2. Westbrook J, Georgiou A, Lam M. Does computerised provider order entry reduce test turnaround times? A before and after study at four hospitals. Proceedings of the XXII International Congress of the European Federation for Medical Informatics; 2009 Aug 30 – Sep 2; Sarajevo, Bosnia and Herzegovina. Amsterdam: IOS Press, 2009. In press.
  • 3. Westbrook JI, Georgiou A, Dimos A, Germanos T. Computerised pathology test order-entry reduces laboratory turnaround times and influences tests ordered by hospital clinicians: a controlled before and after study. J Clin Pathol 2006; 59: 533-536.
  • 4. Westbrook JI, Georgiou A, Rob MI. Test turnaround times and mortality rates 12 and 24 months after the introduction of a computerised provider order entry system. Methods Inf Med 2009; 48: 211-215.
  • 5. Storrow AB, Zhou C, Gaddis G, et al. Decreasing lab turnaround time improves emergency department throughput and decreases emergency medical services diversion: a simulation model. Acad Emerg Med 2008; 15: 1130-1135.

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