As part of a laboratory’s quality improvement plan, key performance indicators (KPIs) provide useful data so that performance can be continuously monitored and improved. Outreach laboratory programs provide essential services to those clients who often have a choice as to where their laboratory testing is performed. It is important for outreach-specific KPI metrics to be included in the overall department plan.

These metrics can be described by three distinct categories: financial, internal-facing, and client-facing.

Financial key performance indicators

• Courier expense: Clients expect the laboratory to pick up their specimens and transport them to the laboratory. Laboratories should clearly define the level of service they are providing to clients and record that cost within the organization. Courier costs vary depending on the level of service, so the total courier expense should be defined by route, per client, per stop.
• Supplies: Clients expect that certain “allowable” supplies will be provided by the testing laboratory. The supply cost should be calculated into the cost per test for outreach laboratory specimen testing.
• Pre-analytic: Handling external laboratory specimen orders often involves registration and data entry functions to get a specimen “testing ready.” A laboratory should incorporate these costs in the client business review, track the expense, and work with the client to get an acceptable requisition, initially, to avoid any unnecessary rework expense.
• Information technology: Technology solutions are essential to connect the client with the laboratory. Connectivity and maintenance costs should be allocated, tracked, and budgeted, per client. 
• Billing: The cost to bill and collect a claim has an associated expense and should be included in the business review of a client relationship.

Internal-facing key performance indicators

Many laboratories dedicate time to address overall department KPI data as part of their regular leadership meetings. Outreach metrics should be part of this departmental quality scorecard so that performance trends are monitored and clients experience consistent service.

• Courier: The laboratory staff depend on a courier’s consistent schedule for efficient patient care. Knowing the courier’s “on-time” performance percentage can help in adjusting routes and identifying driver variability or issues related to the courier-client interaction. This data should be communicated to the courier leadership team, and staff should have a process to report courier issues, such as compromised or missing specimens, or driver professionalism.
• Pre-analytic: Specimens should come to the laboratory as expected, but no system or process is perfect. Any errors or defects should be recorded, tracked, and communicated back to the client.
• Customer service: Client access to the laboratory is pivotal to a positive working relationship. Specific call data can be useful to manage this relationship. These may include total number of calls per month, calls by client, types of calls, abandoned call rate, and length of call per agent.

Client-facing key performance indicators

When meeting with clients, a standard agenda item should be to address client-facing KPIs. By sharing KPI data, the outreach team can discuss the issues and improvements that have come up since the last regular meeting. Clients appreciate a laboratory being responsive and proactive when caring for their patients. The client may also need to implement some process changes on their end as part of the KPI review.

• Courier performance: Review the on-time performance and variances recorded.
• Stat orders: Review the number of stat occurrences and the response time of the courier to accommodate this request. Discussion may lead to adjusting the courier schedule to incorporate additional routine stops that will provide non-urgent specimen pickups and a potential cost savings to the laboratory.
• Results: Review the timeliness of reports, accuracy, preliminary results vs. final reports, and method of delivery. Also review the delivery of results during off-hours, weekends, and holidays, and communication of canceled tests and critical value reporting.  
• Special handling issues: Clients are responsible for providing a properly labeled and collected specimen that is accompanied by a laboratory order so that the test, once performed, can be properly billed. Issues that prevent this from happening should be shared with the client so that they can address the issues internally. By tracking data related to order entry errors, canceled tests, never-received specimens, or erroneous paperwork, the client can educate and train staff to minimize these issues.

A well-known phrase that laboratories use is, “If an issue is not documented, it didn’t happen.” KPIs create a scorecard that allows a laboratory to continuously improve its service. Outreach service categories should be part of that total scorecard to maximize a laboratory’s performance and provide the highest quality patient care.