The impact of electronic order communications on laboratory turnaround times in acute hospital care


This project aims to describe the impact of electronic orders on laboratory turnaround times for processing blood tests at the Queen Elizabeth Hospital in Birmingham.  Electronic orders are the ability to request tests using electronic systems rather than hand-written requests. 


Pathology services (such as blood tests) are a fundamental part of health care. An estimated 70-80% of all healthcare decisions affecting diagnosis or treatment involve a pathology investigation. Laboratory tests are particularly important in acute care. The results of tests may decide if someone needs to be admitted to hospital for treatment, or whether treatment can be provided at home. With the increased demand on acute care services it is important that laboratory results are available quickly. This means that doctors can decide how to treat a patient as quickly as possible.   

Requests for laboratory tests are often hand-written on forms.  This can lead to errors or delays, as handwriting can be hard to read.  Filling in the forms also takes time. 

Computerized Provider Order Entry (CPOE) systems are designed to replace a hospital’s paper-based ordering system for laboratory tests. They enable healthcare professionals to request tests electronically.  These systems should mean that lab results are available quickly so improving patient care. They should also decrease errors. 

Laboratory turnaround time is the wait between when a test is ordered to the time when the result is available. Laboratory turnaround times are one of the most important markers of laboratory services. They are often used to show how well healthcare settings are working. 


A large number of departments at University Hospitals Birmingham NHS Foundation Trust have adopted CPOE technology. It is unclear what impact this new service has had.  

The project will use laboratory turnaround times to find out how well clinical workflow are working. This will identify any weak points. The key focus will be to examine if the effect of electronic orders is greater in acute care populations. 

It is hoped this identify areas where changes can be made which would improve the service. This might include finding out what slows down decision making in hospitals.  

Patient involvement

The move from paper systems to electronic systems to order blood tests has been discussed with a group of patients in acute care. Many of these patients were awaiting the results of blood tests prior to discharge. They agreed that any improvements in the lab turnaround time would be very welcome.  

Progress will be discussed with a group of these patients and members of the public who have agreed to remain involved in the project. This will ensure that any findings and changes to service delivery are clearly explained and would be acceptable to patients. 


This project was supported unanimously by the PIONEER Data Trust Committee.

Principal investigators

Suzy Gallier, University Hospitals Birmingham.

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