{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:30:50Z","timestamp":1740180650747,"version":"3.37.3"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T00:00:00Z","timestamp":1641600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>With appropriate turnaround time (TAT), cerebrospinal fluid (CSF) Gram stains can provide rapid, clinically actionable information in patients with meningitis. Monitoring CSF Gram stain TAT at our institution revealed workflow gaps that were causing result reporting delays. We then implemented a new quality management program to improve TAT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We reviewed the TAT of all CSF specimens submitted for bacterial culture received between August 1, 2016, and July 31, 2020, and began prospectively monitoring CSF Gram stain TAT in January 2019. We then implemented the following changes in April 2019: (i) monthly reviews of TAT with staff, (ii) hand-off sheets for shift transitions, and (iii) pre- and post-shift walk throughs including centrifuge checks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 6913 samples were included in the analysis. CSF samples with TAT &amp;gt; 60\u2009min decreased from 27.3% to 9.89% (P\u2009&amp;lt;\u20090.0001), and median TAT decreased by 9\u2009min (P\u2009&amp;lt;\u20090.0001) with significantly reduced variability. These changes were sustained throughout the follow-up period across all shifts and shift transitions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A new monthly quality metric allowed us to track CSF Gram stain TAT, identify barriers to TAT goals, and implement workflow changes that significantly improved TAT without the need for costly interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfab165","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T20:18:08Z","timestamp":1636489088000},"page":"782-787","source":"Crossref","is-referenced-by-count":0,"title":["Quality Management to Improve CSF Gram Stain Turnaround Time"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6745-9452","authenticated-orcid":false,"given":"Christopher A","family":"Kerantzas","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob P","family":"Merwede","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Yale-New Haven Hospital, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan","family":"Fadlallah","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas J S","family":"Durant","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R","family":"Peaper","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,1,8]]},"reference":[{"issue":"9","key":"2022050518545214700_jfab165-B1","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1086\/425368","article-title":"Practice guidelines for the management of bacterial meningitis","volume":"39","author":"Tunkel","year":"2004","journal-title":"Clin Infect Dis"},{"key":"2022050518545214700_jfab165-B2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciy381","article-title":"A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the Infectious Diseases Society of America and the American Society for Microbiology","volume":"67","author":"Miller","year":"2018","journal-title":"Clin Infect 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