Processing control and cost in bacteriology.

Controlled processing was applied to lower respiratory, wound, and cervicovaginal exudates, and urine. The extent of processing was determined by assessment of quality in direct smears and/or by limits placed on complete identification and antimicrobial susceptibility testing of isolates in mixed cultures. Some specimens were not cultured; others were cultured, but certain isolates were identified by colonial morphologic features only. The time in minutes for performing 22 processing operations was determined. The average number of operations performed with processing control was established along with the total cost per minute of labor expended. A 19% reduction was observed in the time expended with controlled processing relative to projected time expended without processing controls. Urine specimens yielded the greatest saving. Processing control speeds recollection of poor-quality specimens, provides reporting of results of examination of all Gram-stained direct smears, minimizes reporting of information potentially misleading to physicians, and may reduce other health-care costs through improved patient care.