Reducing Diagnostic Delays in Resource-Limited Healthcare Systems: Management Strategies for Laboratory Workflow Optimization

Reducing diagnostic delays is essential for timely clinical decision-making in resource-limited health systems, where laboratory turnaround time (TAT) is often prolonged by workflow congestion, pre-analytical defects, weak post-analytical communication, and operational reliability challenges. This study evaluated the impact of a management-led laboratory workflow optimization programme on diagnostic timeliness and related quality indicators using routine paper-based records. A quasi-experimental before–after design was applied, with interrupted time series (ITS) analysis using weekly aggregated outcomes where available. Data were abstracted from specimen reception (accession) registers, bench and verification/dispatch registers, and critical value call logs. The primary outcome was receipt-to-release TAT, summarized by median, interquartile range (IQR), and the 90th percentile (p90). Secondary outcomes included target TAT attainment, specimen rejection rate and reasons, critical result release-to-notification time, analyzer downtime, and stockout burden. A total of 9,930 test records were identified (baseline: 4,820; post-intervention: 5,110), and 9,081 records were included in analysis after exclusions for cancellations, duplicates, and missing timestamps. Median receipt-to-release TAT decreased from 230 minutes (IQR 140–420) at baseline to 150 minutes (IQR 95–260) post-intervention, and p90 TAT decreased from 780 to 420 minutes (p < 0.001). Target attainment improved from 38.4% to 67.2% (p < 0.001). Specimen rejection rate decreased from 6.4% to 3.1% (p