Abstract
AIMS: To assess the current performance of the clinical biochemistry service provided to general practitioners, with particular attention to result turnround times, and to identify and improvements required. METHODS: Postal questionnaire survey of general practitioners in the London Borough of Tower Hamlets who used the clinical biochemistry laboratory of the Royal London Hospital. A flow analysis study of turnround times for general practitioner samples was also performed. RESULTS: Responses to the questionnaire showed that although 82% of general practitioners thought the current quality of service provided was better than fair, the actual turnround times achieved were longer than the acceptable times required. There was also a strong demand (> 66% of responders) for additional information-such as highlighting of abnormal results-to be provided with results. There was wide variability between practitioners in their use of the laboratory (from none to > 800 requests per year), with no apparent correlation to practice size. Of the repertoire of tests requested, a surprisingly high percentage (14.3%) were for thyroid function. Flow analysis of turnround times for thyroid function tests showed that problems lay not with the time taken for analysis (only 7.8% of the total turnround time) but with the pre- and postanalytical phases, that is, the sample collection and results delivery service. CONCLUSIONS: Increasing the proportion of health care delivered in the primary care sector will inevitably increase the requirement for pathology services. Improvements in the specimen collection and results delivery service to general practitioners are needed to meet their expectations. It remains to be determined whether increased investment in these aspects of laboratory service would result in improved patient care in the primary sector.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allen K. R., Harris C. M. Measure of satisfaction of general practitioners with the chemical pathology services in Leeds Western Health District. Ann Clin Biochem. 1992 May;29(Pt 3):331–336. doi: 10.1177/000456329202900314. [DOI] [PubMed] [Google Scholar]
- Hartley R. M., Charlton J. R., Harris C. M., Jarman B. Influence of patient characteristics on test ordering in general practice. Br Med J (Clin Res Ed) 1984 Sep 22;289(6447):735–738. doi: 10.1136/bmj.289.6447.735. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hilborne L. H., Oye R. K., McArdle J. E., Repinski J. A., Rodgerson D. O. Use of specimen turnaround time as a component of laboratory quality. A comparison of clinician expectations with laboratory performance. Am J Clin Pathol. 1989 Nov;92(5):613–618. doi: 10.1093/ajcp/92.5.613. [DOI] [PubMed] [Google Scholar]
- Hobbs R. Near patient testing in primary care. BMJ. 1996 Feb 3;312(7026):263–264. doi: 10.1136/bmj.312.7026.263. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Howanitz P. J., Steindel S. J. Intralaboratory performance and laboratorians' expectations for stat turnaround times. A College of American Pathologists Q-Probes study of four cerebrospinal fluid determinations. Arch Pathol Lab Med. 1991 Oct;115(10):977–983. [PubMed] [Google Scholar]
- Lamont J. General practice pathology. A field trial of the Seralyzer. Aust Fam Physician. 1988 Jul;17(7):547–548. [PubMed] [Google Scholar]
- Mills K. A., Reilly P. M. Laboratory and radiological investigations in general practice. I-Type requested and rate of use. Br Med J (Clin Res Ed) 1983 Oct 8;287(6398):1033–1036. doi: 10.1136/bmj.287.6398.1033. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rink E., Hilton S., Szczepura A., Fletcher J., Sibbald B., Davies C., Freeling P., Stilwell J. Impact of introducing near patient testing for standard investigations in general practice. BMJ. 1993 Sep 25;307(6907):775–778. doi: 10.1136/bmj.307.6907.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smellie W. S., Galloway P. J., Johnston J. I. Laboratory turnround time: closing the loop. J Clin Pathol. 1995 Apr;48(4):372–375. doi: 10.1136/jcp.48.4.372. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Valenstein P. Turnaround time. Can we satisfy clinicians' demands for faster service? Should we try? Am J Clin Pathol. 1989 Nov;92(5):705–706. doi: 10.1093/ajcp/92.5.705. [DOI] [PubMed] [Google Scholar]
- Wilkin D., Metcalfe D. H., Hallam L., Cooke M., Hodgkin P. K. Area variations in the process of care in urban general practice. Br Med J (Clin Res Ed) 1984 Jul 28;289(6439):229–232. doi: 10.1136/bmj.289.6439.229. [DOI] [PMC free article] [PubMed] [Google Scholar]