Laboratory Turnaround Time: What Happens Between Sample Collection and Laboratory Testing? 

A specimen can leave the collection site on time and still reach the analyzer late. Between collection and testing sits a pre-analytic chain of identification, order matching, accessioning, clarification, routing, tracking, and system handoffs. When one of those steps fails, laboratory turnaround time can stretch before analytical testing has even started. 

The importance of turnaround time in laboratory operations is not limited to analyzer speed. Time can be lost while a mislabeled tube is investigated; an incomplete order is corrected, or missing information is clarified. 

CLSI PRE01 places ordering, specimen identification, labeling, transport, and handling within the preexamination process. Against that backdrop, MDForLives surveyed laboratory managers, supervisors, and directors across the USA, UK, and Canada to understand where accessioning friction builds. The detailed findings are available in the MDForLives Laboratory Accessioning Insight Report. 

The Insight Report covers detailed data. This blog asks a more practical question: where can a specimen lose time between collection and testing? 

Identity uncertainty can delay TAT before accessioning begins 

The first threat to laboratory turnaround time may appear before the specimen reaches the laboratory. In the MDForLives survey, 71.4% identified mislabeled, unlabeled, or mismatched specimen tubes or containers as the most frequent cause of pre-analytic rejection or processing delay. 

A labeling problem turns a routine specimen into an exception. Staff may need to verify identifiers, contact the collection site, decide whether the sample can be accepted, or arrange for recollection. Leaders also described barcodes positioned in ways that prevented scanning and samples arriving with handwritten identifiers. 

For TAT for lab tests, collection quality influences whether a specimen enters the laboratory as routine work or as a problem that must first be resolved. Protecting turnaround time therefore starts with making the specimen identifiable and scannable at first touch. 

A mostly digital laboratory can still inherit a manual queue 

A correctly labeled specimen still needs an order the laboratory can use. Electronic ordering is common, but paper requisitions remain part of the workflow for many respondents. 

Paper or incomplete orders may still need to be read, matched to the specimen, entered, verified, and corrected. The survey found that 42.9% of respondents spent 1 to 3 minutes manually transcribing or verifying information for each paper requisition. 

Those minutes may seem minor individually, but they accumulate across busy receiving workflows. Partial digitization does not eliminate manual work. It concentrates on the orders outside the normal digital pathway. 

Improving turnaround time in laboratory operations therefore means looking beyond how many orders arrive electronically and asking how much staff time is still spent resolving exceptions. 

Missing information turns processing time into waiting time 

Registering a specimen may take only a few minutes. Waiting for missing information can take much longer. In the survey, 42.9% reported clarification taking 15 to 60 minutes, while another 42.9% reported waits of 1 to 4 hours when an accessioning error or missing order detail had to be resolved. 

The specimen may already be inside the laboratory, but it cannot progress until someone confirms the missing information. During that time, it still must be held, tracked, revisited, and followed up. 

The opportunity is not simply to make accession faster. It is to shorten the time between identifying an exception and resolving it. Complete electronic orders, clear ownership, rapid communication channels, and defined exception workflows can prevent a small information gap from becoming an hour-long pause. 

While the specimen moves: poor visibility creates work around the work 

Not every delay begins because the specimen has stopped moving. Sometimes the people waiting for it simply cannot see where it is. 

The MDForLives research found that specimen-status calls from doctors, nurses, or clinic staff create recurring interruptions for accession teams. That creates two workflows around one sample: the physical work of receiving, accessioning, routing, and testing it, and the informational work of confirming where it is and whether something is missing. 

When specimen status is not visible outside the laboratory, clinical teams have little option but to ask. Real-time tracking can reduce that duplication across receipt, accessioning, routing, send-out, and testing. 

As laboratories seek to improve visibility, AI in Clinical Laboratories may also support the identification of workflow patterns and information gaps that contribute to unnecessary delays.

Visibility can therefore influence turnaround almost as much as location. A specimen that is moving physically but is invisible digitally can still generate uncertainty and additional work. 

Automation only saves time when the handoffs work 

Many laboratories already use electronic ordering, barcode systems, and LIS platforms. The remaining friction often appears between those tools. 

Only 14.3% of respondents described LIS integration with ordering systems as seamless. Laboratory leaders also described specimens becoming difficult to locate in busy receiving areas and poor integration with third-party vendors for send-out testing. 

This matters when considering the causes of delays in outsourced or send-out laboratory testing. Once a specimen crosses organizational boundaries, transport, external interfaces, tracking, and communication can create new points where information and specimen status separate. 

The implication is broader than installing more technology. A barcode helps only if it scans, an electronic order only if the receiving system can use it, and an LIS interface only if it reduces manual matching and re-entry. 

Effective lab automation can reduce repetitive manual work and improve workflow consistency, but its impact depends on how well the underlying systems and handoffs are connected

For laboratory turnaround time, the goal is not maximum digitization. It is continuity from order to specimen to testing. 

Turnaround time starts before the analyzer 

When laboratory teams discuss turnaround time, attention often moves to analytical platforms, staffing, or testing throughput. But part of the delay may already have accumulated before the analyzer receives the specimen. 

A labeling problem creates investigation. An incomplete order creates manual work. Missing information creates a hold. Limited tracking creates status calls. An interface gap creates re-entry. None is the laboratory test itself, yet each can affect when testing begins. 

These pre-analytic dependencies matter not only for speed but also for diagnostic accuracy in laboratories, since identification, order matching, specimen handling, and information integrity can all influence the reliability of the testing pathway.

That is the broader importance of turnaround time in laboratory practice: TAT reflects how reliably the full pathway moves, not simply how quickly an instrument produces a result. 

For laboratory leaders, the useful question is not only, “How can testing run faster?” It is also, “Where does the specimen stop moving smoothly before testing begins?” 

Better specimen identification, more complete digital orders, faster clarification, visible tracking, and stronger system integration all point toward the same goal: reducing the moments when staff must stop, interpret, re-enter, chase, or locate information manually.