Time-And-motion tool for the assessment of working time in tuberculosis laboratories: A multicentre study

V. Mathys, E. Roycroft, P. Raftery, R. Groenheit, D. B. Folkvardsen, D. Homorodean, E. Vasiliauskiene, L. Vasiliauskaite, C. Kodmon, M. J. Van Der Werf, Francis Drobniewski, Vladyslav Nikolayevskyy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


S E T T ING: Implementation of novel diagnostic assays in tuberculosis (TB) laboratory diagnosis requires effective management of time and resources. OBJECTIVE : To further develop and assess at multiple centres a time-And-motion (T&M) tool as an objective means for recording the actual time spent on running laboratory assays. DESIGN: Multicentre prospective study conducted in six European Union (EU) reference TB laboratories. RESULT S : A total of 1060 specimens were tested using four laboratory assays. The number of specimens per batch varied from one to 60; a total of 64 recordings were performed. Theoretical hands-on times per specimen (TTPS) in h:min:s for Xpertw MTB/RIF, mycobacterial interspersed repetitive unit-variable number of tandem repeats genotyping, Ziehl-Neelsen staining and manual fluorescence microscopy were respectively 00:33:02 6 00:12:32, 00:13:346 00:03:11, 00:09:546 00:00:53 and 00:06:23 6 00:01:36. Variations between laboratories were predominantly linked to the time spent on reporting and administrative procedures. Processing specimens in batches could help save time in highly automated assays (e.g., line-probe) (TTPS 00:14:00 vs. 00:09:45 for batches comprising 7 and 31 specimens, respectively). CONCLUS IONS : The T&M tool can be considered a universal and objective methodology contributing to workload assessment in TB diagnostic laboratories. Comparison of workload between laboratories could help laboratory managers justify their resource and personnel needs for the implementation of novel, timesaving, cost-effective technologies, as well as identify areas for improvement.

Original languageEnglish
Pages (from-to)444-451
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number4
Publication statusPublished - 1 Apr 2018

Bibliographical note

Funding Information:
The authors thank members of the participating laboratories for their kind and helpful collaboration in data recording and collection, and the Project Manager, Y Holicka, for her invaluable support. Our study received funding from the European Centre for Disease Control (ECDC; Solna, Sweden) under grants 2009/004 and 2014/001. The Belgium National Reference Centre, Antwerp, is partially supported by the Belgian Ministry of Social Affairs, Brussels, Belgium, through a Health Insurance System fund. Conflicts of interest: none declared.

Publisher Copyright:
© 2018 The Union.

Copyright 2019 Elsevier B.V., All rights reserved.


  • Hands-on time
  • Laboratory diagnosis
  • Workload


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