How ARUP Consultants Helped a Client Adjust to Unexpected Order Volumes and Prepare for Future Growth

For more than 25 years, ARUP Healthcare Advisory Services has partnered with clinical laboratories to help them demonstrate their long-term value to their health systems. With an expansive portfolio of customizable offerings, our team of healthcare consultants is focused on clients’ success in terms of sustainable revenue growth, high-quality patient care, and cost-saving operational efficiencies. Our consultants are seasoned lab leaders and data analysts who empower laboratories with adaptive solutions that enable healthcare leaders to deliver on the promise of value-based care.

Here, we take an in-depth look at how ARUP Healthcare Advisory Services helped one client absorb an unexpected and unprecedented amount of new lab outreach business. Look for more client success stories in future issues of Magnify as we highlight the real-world impact of our expert consultants.

Solving a Logistical Challenge

A large academic-based health system operating out of the Midwest won a significant amount of new laboratory outreach business after a commercial lab acquired a nearby regional reference laboratory.

Seeking an alternative to the large commercial lab, many hospitals in the region transitioned their reference testing to the health system laboratory, an ARUP client. This influx of testing greatly benefited the health system laboratory’s growing outreach program, but it presented logistical challenges. The laboratory experienced higher dwell times, order errors, and large daily pending logs, all while struggling with employee turnover in key positions.

The health system sought the expertise of ARUP Healthcare Advisory Services to manage the challenges from the increased outreach volumes and to plan a course for future growth.


Lab equipment

ARUP Healthcare Advisory Services consultants recommended layout adjustments to a client’s specimen processing area, helping to eliminate bottlenecks and streamline workflows.

After conducting a thorough review of the health system’s laboratory and outreach operations through stakeholder interviews and observations, ARUP Healthcare Advisory Services noted several improvement opportunities.

Layout Adjustments to Specimen Processing Area

ARUP’s healthcare consultants observed several bottlenecks in the health system’s specimen processing layout. To reduce inefficiencies, ARUP recommended reorganizing the courier pickup and drop-off locations, pneumatic tube stations, and specimen processing stations. The consultants provided three alternative plans for the client to choose from, offering the health system flexibility in making the improvements.

Career Ladder Positions

Given the influx of new testing and a continued labor shortage, the health system experienced high employee turnover and difficulty filling new positions. ARUP recommended the addition of career ladders for many positions within the lab to increase retention and allow experienced employees to take on additional responsibilities. The healthcare consultants also suggested the creation of a new specialist position in specimen processing to help streamline workflows. The addition of this role would enable processors to escalate outlier cases, allotting them more time to focus on routine orders. Together, these changes would help with recruiting efforts, reduce errors, and minimize staffing stress.

Revised Issue Resolution Management

Many of the 22,000-plus samples on the client’s pending log were unnecessary duplications. Processors routinely canceled these orders without a review process. Although this approach was appropriate for managing inpatient testing, it resulted in significant delays, unnecessary cancelations, and customer dissatisfaction when applied to outreach specimens. ARUP recommended a structured review and resolution process for all samples and orders, including suspected duplicates.


Stacked petri dishes

After implementing ARUP healthcare consultant recommendations, the health system achieved a reduction in daily pending logs from more than 22,000 samples to about 3,000 samples.

The health system implemented many of ARUP’s operational recommendations at its main laboratory location, including the reconfiguration of the specimen processing area, the addition of new career ladder positions, and the introduction of a structured review process for pending specimens and order cancelation.

With a new specimen processing layout, new specialized roles, and a revised order review approach, the client cut daily pending logs from more than 22,000 samples to approximately 3,000 samples. The health system also reduced the number of unnecessary cancelations to near zero.

Given their main laboratory’s successful implementation of these changes, other laboratory locations within the health system are now making similar modifications. The client continues to pursue new outreach business opportunities with the confidence that its laboratory is well positioned to handle growth.


  • Daily pending log reduced by more than 19,000 samples
  • Shorter dwell times with streamlined processing space
  • Unnecessary cancelations reduced to near zero
  • Lower turnover and improved employee satisfaction with career ladder positions

Client Demographics

  • 24/7 operations
  • 35+ expert pathologists
  • 650+ laboratory professionals
  • 30+ laboratory locations
  • ~20M tests/year