Patients presenting to the emergency department (ED) with chest pain must be evaluated quickly. Rapid serum troponin measurement is an important part of ED practice that can provide decisive information for patient management. Reducing delays in troponin testing has been reported to result in shorter length of stay in the ED and more rapid initiation of anti-ischemic treatment. EDs and chest pain centers should, therefore, have effective procedures for ensuring optimal turnaround time (TAT) for troponin testing and a process for ongoing monitoring to ensure that performance meets expectations.
QT15 has multiple time intervals to help pinpoint process time challenges. Laboratories use this monitor to help meet CAP Laboratory Accreditation Program Checklist statement GEN.20316 QM Indicators of Quality. The American College of Cardiology and the American Heart Association recommend troponin as the preferred diagnostic biomarker in their Acute Coronary Syndromes guideline.
Objectives
This study will assist participating laboratories to determine and monitor:
- The median TATs for processes from order time through result availability, with up to five times intervals within the total testing process
- The percent compliance for troponin results with their institution's established deadline
Data Collection
Six days per month, collect data from nine patients presenting to the ED with chest pain and tested for troponin level. Data includes time of troponin test order, specimen collection, laboratory receipt, and result availability. Participants are not required to provide data from each TAT component. Participants will select TAT metrics that they wish to monitor, with the option to monitor all metrics.
Participants will also complete a questionnaire about clinical and laboratory practices related to troponin testing.
Performance Indicators
Median TATs for the following time intervals:
- Test order to specimen collection
- Specimen collection to laboratory receipt
- Laboratory receipt to result availability
- Specimen collection to result availability
- Test order to result availability
Compliance (%) with institutional threshold for the following time intervals:
- Specimen collection to result availability
- Test order to result availability
Shipping Schedule
- Shipment A: December 4, 2023
- Shipment B: March 11, 2024
- Shipment C: June 10, 2024
- Shipment D: September 9, 2024
Additional Information
Participants in this program receive:
- User Guide
- Templates and instructions for data collection
- Quarterly reports that include fingerprint clusters, customer-defined groups, and all institution comparisons
- Peer directory
Quality Management Tools activities meet the American Board of Pathology MOC Part IV Practice Performance Assessment requirements.
For Comprehensive Collection of Tools, see Quality Management Tools.