Physicians rely on information obtained from bacteriology reports to make informed decisions regarding patient care. It is expected that the earlier physicians gain access to these reports, the better the outcomes are for their patients, improving patient care as well as the cost of care. In a retrospective study
in press in the Journal of Diagnostic Microbiology and Infectious Disease
, principal investigator, Gigi Lipori, MT/MBA, Chief Data Officer at the University of Florida, and her colleagues examine the relationship between the time a bacteriology report was made available and a patient’s length of stay (LOS) following the report.
All patients, aged 18 years and older, that were admitted to the University of Florida Health Shands Hospital between January 1, 2014, and February 29, 2016, who had bacteriology cultures reported were included in the study. Patients who were hospitalized for more than 1 week after their last report were excluded from the study. In addition, patients in the intensive care unit and those whose overall hospital stay was more than 1 week were analyzed separately from the other patients. This exclusion was due to the assumption that the reason for admission for these patients was likely more complex and it was unlikely that 1 bacteriology report would determine LOS.
A total of 26,429 patients were analyzed. Of this group, a total of 7,805 patients were excluded. The remaining 18,624 were divided into 2 groups: those whose LOS was below or equal to 1 week and those whose LOS was more than 1 week. For patients with total hospital stays of 1 week or less, the average time for last bacteriology report to discharge was 1.4 ± 1.2 days in comparison to 3.9 ± 1.6 days for patients admitted for more than 1 week. The authors found that for patients whose total hospital stay was less than 1 week, a strong, positive correlation existed between the time of the last bacteriology report and LOS until discharge. On the other hand, for patients who were admitted for more than 1 week, there was no correlation between bacteriology report time and LOS until discharge.
Of note is the fact that the study had several limitations, such as being a single-center study which can be prone to generalization. In addition, the authors caution readers that although they determined a correlation between bacteriology report time and subsequent LOS, this does not necessarily establish causation.
In addition, although the authors report a strong correlation between earlier bacteriology reporting time and decreased hospital stays, it is not clear whether hospitals and labs can feasibly release results earlier. For instance, the authors note that laboratories would be in violation of the College of American Pathologists (CAP) microbiology checklist, leading to a Phase II deficiency, if proper quality control measures are not taken in an effort to report results earlier.
Overall, however, this work demonstrates that for patients with hospital stays of 1 week or less, reporting results sooner may lead to earlier discharge, presumably by leading physicians to earlier decision-making which can improve a patient’s quality of care and reduce costs.
Samar Mahmoud graduated from Drew University in 2011 with a BA in Biochemistry and Molecular Biology. After two years of working in the industry as a Quality Control Technician for a blood bank, she went back to school and graduated from Montclair State University in 2016 with an MS in Pharmaceutical Biochemistry. She is currently pursuing her PhD in Molecular and Cellular Biology at the University of Massachusetts at Amherst.
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