Optimising Diagnostic Turnaround Time without Compromising Analytical Reliability: A Quality Management Framework for Clinical Biochemistry Laboratories

Abstract

Clinical biochemistry laboratories are under persistent pressure to release diagnostically useful results rapidly while maintaining analytical validity, traceability and patient safety. In many laboratories, however, turnaround time (TAT) improvement and analytical reliability are handled as separate quality projects: one operational, the other technical. This separation is intellectually weak and managerially dangerous. A fast result that is analytically unreliable is not clinically useful, while an accurate result released too late may lose diagnostic value. This narrative review and quality-improvement framework argues that TAT and analytical reliability should be governed as linked outputs of the total testing process. Drawing on ISO 15189:2022, WHO laboratory quality management guidance, CLSI risk-based quality control principles, and IFCC quality indicator work, the manuscript proposes an integrated model for measuring, analysing, and improving diagnostic TAT without compromising analytical assurance. The framework distinguishes order-to-report, specimen-reception-to-release, analytical, and critical-result TAT; links each interval to pre-examination, examination, and post-examination risk controls; and proposes a dashboard that combines TAT distributions, quality-control performance, specimen rejection, analyser downtime, autoverification performance, and corrective-action tracking. The paper concludes that sustainable TAT improvement requires workflow redesign, competence management, information-system integrity, risk-based internal quality control, external quality assessment and disciplined corrective and preventive action. The contribution is a practical governance model rather than a claim of new empirical causality