Maintaining quick turnaround times during COVID-19
Turnaround time refers to the time measured between collection of a patient sample to the delivery of results, including delivery, receipt, processing of the specimen. It is one of the most noticeable signs of laboratory service and is often used as a key performance indicator of a laboratory. We spoke to RCPA Vice President, Dr Lawrie Bott who explains the importance of turnaround times during COVID-19.
“Turnaround times have been absolutely critical in this pandemic. When a patient receives a negative result, and as long as they don’t have symptoms, they can stop their isolation with the certainty that they are not positive. If there is a positive result, it gets notified immediately to public health, to the referring doctor and to the patient. The advantage of a quick turnaround time is that when a positive result is returned, the public health team can spring into action and commence contact tracing immediately. That person is quickly isolated and can be taken to hospital quickly if they deteriorate.
“Turnaround times in Australia are variably less than 48 hours and are often less than 24 hrs. Every now and again there might be a test which takes a bit longer if retesting is required in the laboratory or if there are delays with couriers, but the core numbers of results are getting back to patients within a very short time frame. We have therefore quickly been able to identify where the cases are in Australia, we are able to trace, we are able to act,” said Dr Bott.
Australia was quick to introduce COVID-19 testing clinics and dedicated pathology collection centres, including fever clinics, respiratory clinics, hospital clinics and drive through testing points. Self-collection was also rolled out, allowing patients to collect a sample themselves under the supervision of a medical professional, or at home with detailed instructions. Not only has this helped protect both patients and health workers from unnecessary risk of infection, it also allowed patients to access testing quickly.
“In the COVID-19 situation, it has been highly beneficial to improve the turnaround time by allowing people to go straight to a collection point. This cuts out the time of going to a GP, getting a referral and then going to a collection centre. Along with the introduction of teleconsultation, these dedicated collection points also kept people who were potentially positive out of the GP surgery, therefore limiting the spread of disease.”
Following the collection of a specimen with a combined deep nasal and oropharynx swab by a doctor, nurse or pathology collector, the sample is put into a tube with liquid in it, placed in a specimen bag and transported to the laboratory. All samples are delivered by courier to the Specimen Reception Area of the laboratory. All COVID-19 samples are prioritised and entered into the Laboratory Information System (LIS).
“We have couriers frequently collecting samples from these collection points, sometimes every couple of hours. During the surges in Sydney and Melbourne, we were seeing 600-800 samples every couple of hours. In that setting, the laboratories would have increased the courier runs to get the samples to the laboratory as soon as possible. Once the sample has been processed, many laboratories have introduced SMS to return the results directly to the patient, again cutting down the time that it would usually take.
“What’s more, whilst public and private laboratories usually undertake work largely in their own areas, on this occasion they have worked together and have talked to each other. Clearly, we needed all hands on deck for managing the testing for the virus and that’s exactly what happened.
There have been meetings between public and private laboratories, there have been allocations of areas or workloads and through that we have been able to increase the level of testing across Australia. It is something that has been very encouraging,” said Dr Bott.