With an average technologist age of 53, the lab had an increasing number of employees facing retirement. Worse yet, many of those that remained were either unhappy or contemplating leaving because of the stressful work environment.
And the timing couldn’t have been worse. The lab’s increasing test volume was driving a need for more qualified technologists than ever before.
Facing this dilemma, OUMC lab administration sought to determine whether automated laboratory equipment could reduce its labor needs, while maximizing lab technologists’ time and technical skills.
An Automated Approach
“We knew that laboratory automation had proven its worth in numerous clinical laboratories worldwide—even in labs with much lower test volumes than ours,” says Dr. Kenneth Blick, Director of Clinical Chemistry. “In these cases, automation systems proved to be highly cost-effective, very reliable and a strong contributor to decreased labor and greater operational efficiency.”
“At OUMC, where labor represented approximately 62 percent of our overhead expenses, we believed that investing in a total automation solution would justify itself in an acceptable timeframe,” he adds.
Thus, OUMC decided it made more sense to update laboratory instrumentation and software than to seek out patchwork replacement solutions for its legacy instruments.
After conducting due diligence with a wide range of automation manufacturers, OUMC selected Beckman Coulter for its industry-leading total lab automation solution.
When the lab implemented automation in March 2004, it eliminated its previous batch processes and further optimized its investment by adding electronic test request and ordering, via the DL2000 middleware.
According to Dr. Blick, the expert decision-making software provided many capabilities that exceeded the lab’s current LIS functionality, such as auto-validation of normal test results and automatic retrieval of stored samples for add-on testing. It also substantially improved the speed and accuracy of lab results and reduced stress on technologists, enabling them to do higher-quality work on tasks that can’t be automated.
Reduced Staffing
Right off the bat, automation of the lab’s chemistry operation eliminated the need for 10 per diem employees (the equivalent of five FTEs), at an estimated $50,000-$55,000 annual compensation each (including benefits). This dropped the staffing levels in the core lab from 65 to 60 FTEs.
“This was just one part of the positive financial impact of automation, which also included dramatically reduced material costs, the strategic ability to increase volume without adding staff and reduced labor and materials necessary for sample collection and transportation,” explains Dr. Blick.
Automation also enabled the lab to close its two STAT labs—saving roughly $1.5 million per year—and transfer those technologists to the core lab. This move enabled the lab to bring in 22 tests that were previously sent out to a reference lab. All this was done without needing to hire additional staff.
Faster Turnaround Time (TAT) for Results
After automation, physicians noticed the faster TAT almost immediately. For example, they were getting trustworthy, reliable immunoassay results back in 40-50 minutes, instead of three to four hours—and electrolytes back in 30-40 minutes, instead of two hours.
Faster testing TAT often leads to a reduction in patient length-of-stay, especially in critical care areas like the Emergency Department.
Drastic Reduction in STAT Testing
“Prior to automation, our STAT tests were performed manually—because they demanded immediate attention,” says Dr. Blick. “Today, the automated turnaround time for results is so fast, there’s no reason for STAT orders. Because physicians now trust our lab’s consistently fast turnaround times, the number of STAT tests coming into the lab has dropped from 53 percent to only 5 percent of the tests ordered.”
Greater Volume With Fewer Staff Members
Despite the fact that a significant number of FTEs had been eliminated, OUMC’s lab witnessed a 35 percent increase in overall testing volume—from 3.5 million to 5 million tests per year. Before automation, this increase in volume would have theoretically required a 35 percent increase in technologists on hand—approximately 18 additional FTEs.
Auto-Validation of Normal Results
Today, the DL2000 middleware automatically verifies user-defined “normal” results without technologist involvement and sends the results to the patients’ charts via the LIS. This feature has eliminated tech time, further enabling the lab to take on additional reference work.
Plus, auto-validation frees technologists to focus on the technical tasks that require their specialized training, skill set and judgment.
Improved Management of Critical Results
The middleware also alerts OUMC technologists to user-defined critical results so that no critical results go overlooked and helps ensure that technologists follow the proper, user-defined protocols, including appropriate reporting of the result.
Automation of Add-On/Reflex Testing
Previously, add-on tests were phoned into the core lab, which triggered manual location of the previous sample or collection of a new sample. Especially troublesome was the time factor—since finding the exact specimen often took 45-60 minutes each.
“After automation, this process improved greatly,” says Dr. Blick. “Today, the existing sample is automatically located, placed on the automation line by robotics and tested without any human involvement.”
Increased Staff and Patient Safety
When performing manual aliquotting, laboratory technologists are often exposed to blood-borne pathogens and infectious samples. Plus, they’re at risk for repetitive motion injuries, such as carpal tunnel syndrome, caused by manually capping and de-capping tubes.
Automation significantly decreased these risks by eliminating the manual processes. And, because of the stockyard and DL2000, the lab also optimizes each patient sample, often eliminating the need to collect additional patient specimens.
Elimination of Aliquotting
Previously, 40 percent of OUMC’s samples required aliquotting—a labor-intensive manual procedure that increased the risk of exposure to infectious diseases and required additional (and costly) materials and medical waste disposal.
Automation greatly reduced the lab’s need to aliquot samples, which led to increased staff safety, a dramatic reduction in specimen labeling errors and fewer mistakes caused by manual hand-offs.
Automated Evaluation of Specimen Quality and Integrity
Because the automation system checks samples for bilirubin, hemolysis, lipemia, clots and other indices, the lab no longer requires manual evaluation by a technologist prior to testing.
The robotics and middleware take over mundane tasks that don’t require advanced skills. This frees technologists to focus on tasks that only they can do and makes it possible for technologists to prioritize and manage their workloads more effectively.
According to Dr. Blick, “Automation has proven to be a crucial supplement to our clinical lab environment, helping to offset the industry’s ongoing labor shortage and providing a faster, more efficient and more accurate testing process.” |
