The effect of auto-verification on turnaround time for clinical chemistry and immunoassay tests.

Abstract

Background: Auto-verification is increasingly recognised as a key tool for improving quality and efficiency in clinical laboratories. This study aimed to investigate the impact of an auto-verification system implemented for clinical chemistry and immunoassay tests on turnaround time (TAT) in a tertiary-care medical biochemistry laboratory.

Methods: This study was conducted in the Medical Biochemistry Laboratory of Çanakkale Onsekiz Mart University Hospital, a tertiary healthcare institution. Clinical chemistry and immunoassay tests were automated and verified using the navify® Lab Operations middleware (Roche Diagnostics, Germany), integrated with the MIA-MED Laboratory Information System (MIA Technology, Türkiye). Algorithms were developed in accordance with CLSI AUTO10-A and AUTO 15 guidelines, incorporating rules for quality control, serum indices, analyser flags, delta checks, critical values, consistency checks, and analytical measurement intervals, as well as recommendations from the national health authorities. Validation of the algorithms was carried out using both simulated and patient data. The proportion of results exceeding predefined TAT targets was compared before and after auto-verification implementation using the chi-square test. p< 0.05 was considered statistically significant.

Results: Overall, 71% of test results and 21% of tube-based results were verified automatically. Median TAT was reduced by 6 minutes for emergency tests and 12 minutes for routine tests. The proportion of results exceeding the TAT threshold decreased significantly from 6.4% before auto-verification to 5.8% after auto-verification implementation (p< 0.001).

Conclusions: Auto-verification, with clearly defined and validated rules, enhances both the reliability and timeliness of laboratory results, thereby supporting quality improvement initiatives in clinical laboratories.