Evaluating turnaround time to improve clients’ satisfaction in the tuberculosis reference laboratory in Douala

Abstract

Introduction Delivery delays of laboratory results can result in death and/or economic loss to both the patient and the health system. Data is limited regarding turnaround time for tuberculosis testing in Cameroon. We evaluated intra- turnaround time in tuberculosis diagnosis, identified root causes, and brainstormed solutions to improve patient satisfaction. Materials and methods In this cross-sectional descriptive study, turnaround time for the pre-analytic phase was set at 3 hours, the analytic phase at 11 hours, and the post-analytic phase at 10 hours. The overall turnaround time was 24 hours. We used the Fishbone method of problem analysis involving the personnel of the Tuberculosis Reference Laboratory-Douala, to identify root causes. We brainstormed using the “Whys” causes of turnaround time failure during the process of tuberculosis diagnosis by GeneXpert MTB/RIF Results We analyzed samples from 526 clients. The median turnaround time was 45 (Range: 2-120) hours. A total of 216(41.1%) clients had a turnaround time failure. The turnaround time failures in the pre-analytic, analytic, and post-analytics phases were 64(29.6%), 128(59.3%), and 12(11.1%) respectively. Overall, 19 root causes of turnaround time failure were identified and grouped into six categories, namely: equipment, administration, technical-staff, environment, material, and method. Equipment maintenance (defective or non-calibrated modules) was the critical cause of turnaround time failures accounting for 86 (39.8%) of the overall turnaround time failure. Conclusion turnaround time in tuberculosis diagnosis is longer than expected, retarding patient care management. Focusing on equipment maintenance enhances the intra-laboratory testing process, thus improving overall patient satisfaction. The need for further studies to incorporate the extra-laboratory turnaround time in assessing the overall turnaround time is imperative.