Physicians need fast, accurate test results to help them make timely, appropriate treatment decisions for patients. Yet time pressures and the sheer quantity of information to manage often make it difficult for physicians to remember every test protocol and attribute.

Last month, at the 8th Annual NPSF Patient Safety Congress in San Francisco, Dr. Denise Uettwiller-Geiger presented an informative poster that explained how J. T. Mather Memorial Hospital addressed this challenge using Beckman Coulter automation middleware and new collaborative processes.

The poster, called “Enhancing Patient Safety by Integrating Lab Information with Middleware and Facilitating Laboratorian/Physician Collaboration,” showcased how the 248-bed community hospital used Beckman Coulter’s DL2000 middleware to help achieve the following:

• Substantially improve the speed and accuracy of lab results


• Alert technologists to important information about particular samples


• Reduce stress on technologists, enabling them to do higher quality work on tasks that can’t be automated

• Faster turnaround time (TAT) for results, which means more timely diagnosis and treatment. Total TAT for basic metabolic panels, for example, dropped from 73 min. in March 2002, to 56 min. in March 2005; and TAT for the seven-test drugs-of-abuse panel has dropped 116 min., a 79 percent improvement.


• Improved test accuracy. The auto-validation feature automatically verifies user-defined “normal” results and sends the results to patients’ charts via the LIS. This feature ensures errorless validation/reporting of normal results, and also relieves technologists of a large workload. That enables them to perform more focused, higher quality work on results that require manual validation.


• Improved management of critical results and other exceptional events. The middleware alerts technologists to user-defined critical results so no critical results are overlooked; and helps ensure that technologists follow the proper, user-defined protocol, including appropriate reporting of results.


• More global view of patient. By consolidating information from up to three analyzers, the middleware permits a more global view of each patient than if the lab were viewing, for example, chemistry, hematology and coagulation results separately.

Physician Collaboration and Communication

Dr. Geiger’s poster presentation also demonstrated how the hospital further enhanced patient safety by increasing the lab’s collaboration with physicians— enabling doctors to make rapid, well-informed decisions about disposition of patients. This is particularly important in the emergency room, where MDs must often make quick, crucial decisions about patients they don’t know.

The poster itemized the hospital’s various means of communicating with clinicians to help ensure that laboratory information optimally benefits patients, including information about new tests and new information about interpreting longstanding tests. The hospital now shares information via:

• A clinician/laboratorian “heart team” —A group of laboratorians, MDs and other relevant clinicians regularly discusses/implements best practices in cardiac care.
• Formal meetings — Laboratorians attend meetings involving cardiologists, including critical care meetings and medical department meetings.
• Informal exchanges — Laboratorians discuss pertinent issues during grand rounds, drop-in visits, phone conversations and other casual encounters with MDs.
• Informational tools – The lab provides “Smart Reports”— expanded lab reports that include a description of the biomarker if the marker is new to the lab, intended use of the test, expected reference range, clinical sensitivity/specificity, negative/positive predictive value, and follow-up tests.

The bottom line is simple: By utilizing state-of-the art automation and middleware, as well as encouraging regular collaboration between cardiologists and laboratorians in a variety of forums, J. T. Mather Memorial Hospital is improving patient outcomes and increasing patient safety.

In addition, appropriate utilization of resources has led to improved patient flow, which resulted in 854 saved patient days and 254 more patient admissions, generating additional hospital revenue.