Comparative analysis of turnaround times before and after the implementation of a new total laboratory automation system

INTRODUCTION: This study aimed to evaluate the impact of Total Laboratory Automation (TLA) with the implementation of the Beckman Coulter DxA Fit 5000 on laboratory workload and performance.
METHODS: A comparative analysis was conducted at the Biochemistry Laboratory of Zonguldak Bülent Ecevit Hospital, covering the pre-automation period (May 1–June 30, 2024) and the post-automation period (May 1–June 30, 2025). Key performance indicators included mean turnaround time (TAT), median TAT, 90th percentile TAT, the proportion of outliers at 60 and 120 minutes, and achievement of emergency department (ED) benchmarks (≤45 minutes). Test volumes were monitored to ensure stability as a covariate.
RESULTS: Following the introduction of TLA, mean TAT decreased by up to 20%, median TAT by 18%, and 90th percentile TAT by 25% across inpatient and outpatient tests. Outlier rates at 60 minutes declined from 12% to 10% in inpatients and from 83% to 55% in outpatients. For STAT testing, the proportion of samples meeting the 45-minute ED benchmark increased from 65% to 88%.Total test volumes remained largely stable between periods, indicating that observed TAT improvements were attributable to automation rather than changes in sample volume. Glucose exhibited the shortest mean TAT, whereas gamma-glutamyl transferase had the longest. In outpatient testing, C-reactive protein demonstrated the highest compliance with the 60-minute TAT benchmark, while human chorionic gonadotropin showed the lowest; however, all outpatient tests were completed within 120 minutes.
DISCUSSION AND CONCLUSION: The implementation of TLA significantly improved numerical TAT metrics, reduced outlier frequencies, and increased achievement of ED benchmarks, while maintaining stable test volumes, highlighting enhanced efficiency, predictability, and workflow stability in a high-volume university hospital laboratory setting.

Keywords: DxA Fit 5000, total laboratory automation, tunaround time