The Impact of Urinalysis Turnaround Times on Patient Disposition in the Emergency Department.

Abstract

Introduction: Diagnostic efficiency in the emergency department (ED) is crucial for workflow. Among these, urinalysis (UA) is a key test for abdominopelvic complaints. Prolonged UA turnaround times can extend patient length of stay and reduce patient satisfaction, highlighting the need for improvement. In this study qw sought to measure the correlation between UA turnaround times and time to disposition.

Methods: We conducted a retrospective analysis of discharged ED patients with abdominopelvic complaints who had a UA ordered between January-August 2022. Electronic health records data included UA order-to-result time, urine human chorionic gonadotropin (hCG), time to disposition, and complete blood count (CBC) turnaround time as a venipuncture comparator. Spearman correlation coefficients assessed associations between lab processing times and time to disposition.

Results: Among 6,708 discharged patients included in the study, 3,795 presented with abdominopelvic complaints. In this subgroup, 3,688 UAs, 1,285 urine hCG tests, and 2,966 CBCs were obtained. Median times from UA order-to-specimen receipt and result were 65 (IQR 29-138) and 92 (53-168) minutes, respectively. A modest positive correlation was observed between UA order-to-result time and time to disposition (ρ = 0.46), relative to CBC order-to-result time (ρ = 0.29). The relationship was slightly weaker for urine hCG (ρ = 0.35). Laboratory turnaround times showed minimal correlation with ED time to disposition (UA ρ = 0.04; urine hCG ρ = 0.03; CBC ρ = 0.09).

Conclusion: Urinalysis acquisition and processing times are modestly correlated with time to disposition in patients with abdominopelvic complaints. Reducing collection time for UA and urine hCG tests may improve throughput for this patient cohort.