Milford Regional Medical Center, a 150-bed community
and regional teaching hospital in Milford, MA, became the first midsize
hospital in the state to adopt a completely integrated lab automation
system that spans the entire testing process – from pre-analytical
sample processing and analysis to reporting of results and eventually
specimen storage. As a result, the laboratory is now better equipped to
help the hospital lower health care costs, accommodate growing testing
capacity, increase physician satisfaction and, most importantly,
improve overall patient care.
The new system, which is from Beckman Coulter Inc.,
easily accommodates the lab’s test volume of about 1.4 million
chemistry tests a year. It also supports the hospital’s busy emergency
department, which serves a region of 20-plus towns and accommodates
more than 50,000 patients annually.
Like many laboratories, Milford began experiencing
increases in outpatient testing – a trend fueled by aggressive outreach
efforts and normal yearly growth. The growing test volume, as well as
other drivers for increased efficiency, prompted the hospital to begin
searching for new lab technology to fit its changing needs.
One of the lab’s most severe bottlenecks was evident
in the sample processing area. Previously, the lab accepted blood
samples from eight receiving stations and frequently had difficulty
keeping up with the ever-constant demand for centrifugation.
Last year, the lab addressed this challenge by
implementing a Power Processor automation system (Beckman Coulter) to
speed the front-end – or pre-analytical – phase of the testing process.
The system automated a number of time- and labor-intensive processes,
including bar-coded host query, tube sorting by department,
centrifugation, tube decapping, labeling of daughter tubes, and
aliquotting. It also automated the error-prone task of manually
entering the patient identification and sample test menu.
The automated front-end sorting streamlined the
process and increased productivity by 70 percent, helping the lab
control front-end labor costs. It also reduced turnaround time,
improved precision over manual pour-off methods, decreased mislabeling
errors, and enhanced lab safety by eliminating technologists’ need to
handle blood samples and lowering the risk of exposure to biohazards.
After the lab witnessed the pre-analytical benefits
of automation, it envisioned streamlining even more of its testing
processes by connecting the automation track directly to instruments.
In June of 2005, that vision became reality when the
lab connected its various chemistry and immunoassay analyzers to the
Power Processor. The integrated system, which uses a sophisticated
track system, transports samples directly to the analyzers, eliminating
the need for staff members to manually load and unload specimens.
After scanning each specimen barcode, the automation
system queries the laboratory information system for requested tests,
then automatically transports the tubes to their respective analyzers
for testing. Thus, after samples are logged in and placed on the
automation conveyor line, they never need to be touched by human hands
again.
After testing of specimens is complete, the results
are uploaded to a data management system, where the software
automatically verifies the results based on rules identified by the
lab. This auto-verification feature saves the lab an enormous amount of
time by eliminating the need for technologists to review normal
results. This speeds the delivery of test results to the patient’s
chart, helping clinicians make rapid and more informed treatment
decisions.
In addition, the system notifies the lab of critical
patient results, pending tests and add-on tests, making it a critical
piece of the entire health care IT network. Simultaneously, the
automation system prepares the sample tubes for storage, by recapping
the tubes and transporting them immediately to the 3,000-tube
refrigerated stockyard, which is mapped for easy sample recall.
By providing fast, reliable test results, the lab’s
automation system has led to improvements in virtually every area of
the hospital. The emergency department, for example, gains speedy
delivery of accurate patient test results, so physicians can make quick
health care decisions and improve patient outcomes.
The lab’s automated technology, for example, now
helps deliver critical cardiac Troponin I test results in about 30
minutes – which is down from its previous 60 minutes. Similarly,
general outpatient testing that was previously done in four hours can
now be done in as little as 90 minutes. As a result, physician
satisfaction is notably higher, as reported on survey results from
emergency physicians, as well as primary care physicians and
specialists in the medical center’s sister company, Tri-County Medical
Associates.
Furthermore, the network’s outpatient physicians now
have an advantage that few of its competitors enjoy. For example, if a
primary care physician orders a routine test such as a lipid panel on a
patient at 8 a.m., the hospital lab typically receives the sample by 10
a.m. and is able to deliver results to physician’s office by noon. More
critical test results can be delivered within 30 minutes if required.
The lab’s automation system is also having a
positive effect on patient safety. By delivering test results quickly
to the physicians, the automation system is minimizing treatment delays
and giving physicians the information they need to make more timely
decisions.
The new process has also improved technologist
productivity in the event of staff call-outs, because a technologist
can very easily handle the workload of two different benches.
Clearly, the laboratory’s automation solution helps the hospital
maintain high standards of quality and take service to new heights. But
the system also helps administrators address the widespread labor
shortage in the medical technology industry. Fewer med techs are
entering the field today, leading to a drastic situation akin to the
nursing shortage. Yet even in the midst of such shortages, the Milford
Regional Medical Center’s automation system helps offset the challenge.
First, it helps reduce dependency on manual labor.
Second, when medical technologists do apply for open positions, they
are usually so impressed with the way the lab operates, the hospital
can beat out a competitor just based on the quality of automation and
equipment in the lab.
Not only is the automation a recruiting advantage,
it helps the lab do more work with fewer people, which enables the lab
to survive temporary staffing vacancies without the workload being a
huge burden on current employees.
By taking advantage of advanced automation systems,
institutions like Milford Regional Medical Center’s are discovering how
they can gain functional benefits that will deliver efficiency,
economy, and value for years to come.
Salvatore Perla is the administrative director of Laboratory &
Registration Services at Milford Regional Medical Center in Milford, MA.
