Lab Med Online LMO Laboratory Medicine Online 2093-6338 The Korean Society for Laboratory Medicine 10.3343/lmo.2016.6.4.228 Original Article Changing Guidelines for Clinical Microbiology Laboratories and Their Influences on Workflows Related to Consultations Ahn Sunyoung M.D. Kim Hyunsoo M.D. Sung Ji Yeon M.D. Kim Myung Sook M.T. Yong Dongeun M.D. Lee Kyungwon M.D. Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea. Corresponding author: Dongeun Yong. Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemu-gu, Seoul 03722, Korea. Tel: +82-2-2228-2446, Fax: +82-2-313-0908, deyong@yuhs.ac 10 2016 01 10 2016 6 4 228 232 05 11 2015 03 01 2016 08 01 2016 © 2016, Laboratory Medicine Online 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

Since the concept of 'minimal identification of poor quality specimens or microbes with low pathogen potential' has been introduced into the standard operating procedure (SOP) to enhance work efficiency, consultations are requested for further species identification and antimicrobial susceptibility testing. The aim of this study was to evaluate the impact of consultations requests to the clinical microbiology laboratory on its work efficiency.

 Methods

From January 2013 to April 2015, consultation requests to the laboratory in a tertiary-care hospital were collected from electronic medical records. The characteristics of consultations and changes to workflow due to the laboratory SOP amendment were analyzed. Turnaround time of the consultation and specimen culture were evaluated as an indicator of workflow efficiency.

 Results

A total of 971 consultations were evaluated during the study period. The most common purposes for consultations were microbe species identification and antimicrobial susceptibility tests. Among the minimal identification reports, the proportions of consultations were below 5%. The number of consultations had increased substantially. However, the turnaround time of consultation and specimen culture showed declining trends.

 Conclusions

With the introduction of the consultation system, the workload for species identification and antimicrobial susceptibility testing of colonizing microbes could be minimized. This research provides an example of work efficiency management for laboratory procedures based on an SOP amendment.

 Microbiology Laboratory Minimal identification Consultation Turnaround time

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Consultation Topics Number %
Bacterial identification 36 3.7
Antimicrobial sensitivity test 325 33.5
Both bacterial identification and antimicrobial sensitivity test 553 57.0
Others 57 5.9
Antimicrobial synergy test 18
Additional antimicrobial sensitivity test 17
Request for not established test 8
Information about cultured microbes 7
Request for additional culture 3
Interpretation of laboratory data 2
Information about proper antibiotics 2
Total 971 100
Classification of consultation requests to the clinical microbiology laboratory that could not be answered
Reason for not being settled Number %
Specimen storage period expired 42 44.7
No growth of microbes in subculture 20 21.3
No need to perform the requested examination 11 11.7
Not established examination in the laboratory 11 11.7
Patient discharged or expired 9 9.6
Contamination of the specimen 1 1.0
Total 94 100