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Objectives To implement collaborative process improvement measures to reduce emergency department (ED) troponin turnaround time (TAT) to less than 60 min using central laboratory. Design and methods This was an observational, retrospective data study. A multidisciplinary team from the ED and laboratory identified opportunities and developed a new workflow model. Process changes were implemented in ED patient triage, staffing, lab collection and processing. Data collected included TAT of door-to-order, order-to-collect, collect-to-received, received-to-result, door-to-result, ED length of stay, and hemolysis rate before (January–August, 2011) and after (September 2011–June 2013) process improvement. Results After process improvement and implementation of the new workflow model, decreased median TAT (in min) was seen in door-to-order (54 [IQR43] vs. 11 [IQR20]), order-to-collect (15 [IQR 23] vs. 10 [IQR12]), collect-to-received (6 [IQR8] vs. 5 [IQR5]), received-to-result (30 [IQR12] vs. 24 [IQR11]), and overall door-to-result (117 [IQR60] vs. 60 [IQR40]). A troponin TAT of < 60 min was realized beginning in May 2012 (59 [IQR39]). Hemolysis rates decreased (14.63 ± 0.74 vs. 3.36 ± 1.99, p < 0.0001), as did ED length of stay (5.87 ± 2.73 h vs. 5.15 ± 2.34 h, p < 0.0001). Conclusion Troponin TAT of < 60 min using a central laboratory was achieved with collaboration between the ED and the laboratory; additional findings include a decreased ED length of stay. [ABSTRACT FROM AUTHOR]