{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T03:59:42Z","timestamp":1778299182670,"version":"3.51.4"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>In this study, we developed and validated a logistic regression-clustering joint model to: (1) quantify multistage workflow bottlenecks (collection\/transport\/reception) in urine culture pre-TAT prolongation (&amp;gt;115\u2005min); and (2) assess the efficacy of targeted interventions derived from model-derived insights.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using complete workflow data obtained from 1,343 urine culture specimens (January 2024\u2013March 2024) collected at a tertiary hospital, we integrated binary logistic regression analysis with K-means clustering to quantify delay patterns. The analyzed variables included collection time, ward type, personnel roles, and patient demographics. Post-intervention data (May 2024\u2013July 2024, *<jats:italic>n<\/jats:italic>*\u2009=\u20091,456) was also analyzed to assess the impact.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analysis of the critical risk factors revealed that specimens collected between 04:00\u201305:59\/10:00\u201311:59 had 142.92-fold higher delay odds (95% CI: 58.81\u2013347.37). Those collected on SICU\/ICU wards showed 9.98-fold higher risk (95% CI: 5.05\u201319.72) than general wards. Regarding intervention efficacy, pre-TAT overtime rates decreased by 58.6% (13.48% \u2192 7.55%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.01). Contamination rate decreased by 59.8% (5.67% \u2192 2.28%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.01). The median pre-TAT decreased by 15.9% (44 \u2192 37\u2005min, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The joint model effectively identified workflow bottlenecks. Targeted interventions (dynamic transport scheduling, standardized training, and IoT alert systems) significantly optimized pre-TAT and specimen quality, providing a framework for improving clinical laboratory processes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fdgth.2025.1603314","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T05:27:31Z","timestamp":1751261251000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Applying a logistic regression-clustering joint model to analyze the causes of prolonged pre-analytic turnaround time for urine culture testing in hospital wards"],"prefix":"10.3389","volume":"7","author":[{"given":"Shuangshuang","family":"Lv","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huan","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/j.1749-6632.2000.tb05283.x","article-title":"The role of diagnostic laboratories in disease control","volume":"916","author":"Saliki","year":"2000","journal-title":"Ann N Y Acad Sci"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1016\/S0140-6736(18)30458-6","article-title":"Access to pathology and laboratory medicine services: a crucial gap","volume":"391","author":"Wilson","year":"2018","journal-title":"Lancet (London, England)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"17457","DOI":"10.1149\/10701.17457ecst","article-title":"Effect of pre-analytical errors on turnaround time of central clinical laboratory: a study protocol","volume":"107","author":"Pankawase","year":"2022","journal-title":"ECS Trans"},{"key":"B4","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1089\/bio.2014.0072","article-title":"Evaluation of the short-term stability of specimens for clinical laboratory testing","volume":"13","author":"Ikeda","year":"2015","journal-title":"Biopreserv Biobank"},{"key":"B5","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1128\/CMR.00030-15","article-title":"Effectiveness of preanalytic practices on contamination and diagnostic accuracy of urine cultures: a laboratory medicine best practices systematic review and meta-analysis","volume":"29","author":"LaRocco","year":"2016","journal-title":"Clin Microbiol Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.mimet.2017.12.012","article-title":"Preservation of Neisseria gonorrhoeae: should swabs be refrigerated or not?: neisseria gonorrhoeae preservation","volume":"145","author":"Serra-Pladevall","year":"2018","journal-title":"J Microbiol Methods"},{"key":"B7","doi-asserted-by":"publisher","first-page":"104325","DOI":"10.1016\/j.ijnurstu.2022.104325","article-title":"Prevalence and predictors of urine culture contamination in primary care: a cross-sectional study","volume":"134","author":"Hansen","year":"2022","journal-title":"Int J Nurs Stud"},{"key":"B8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1038\/s41746-023-00995-5","article-title":"Digital remote monitoring for screening and early detection of urinary tract infections","volume":"7","author":"Capstick","year":"2024","journal-title":"npj Digit. 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