Improving efficiency at Norfolk & Norwich
Xchange newsletter - Spring 2007
Extending with integration AND automation
Earlier in 2007, the pathology department at Norfolk and Norwich University Hospital NHS Trust went live with a new, far reaching analytical solution housed in an extended laboratory. With the goal of dealing with their bulk workload more efficiently, the hospital turned to Abbott automation and integration to improve throughput and turnaround times.
Record test levels
Dianne Gibson, service manager for laboratory medicine, explains, "Like many laboratories, our workload is increasing year on year while staffing levels remain static. In fact, the laboratories are processing twice the number of samples as they were just four years ago. Earlier this year we received a record 4,000 patient requests in one day. Clearly, our analytical power needed to increase to cope."
Dianne Gibson
The NNUH serves a population of 650,000 directly and acts as a specialist reference centre for 1 million. The majority of the GP work arrives at the hospital from surgeries some distance away, tending to arrive towards the end of the afternoon. Unfortunately, this is when staffing levels are at their lowest. Dr Garry John, clinical director of laboratory medicine and consultant clinical biochemist explains, "Having analysed the volume and timing of our workload, we understood that some kind of automation would be key to a successful system upgrade."
Dr Garry John
More space
Garry describes the original laboratory as "too small, badly designed and with no windows." So, when histopathology moved out to new premises, the team took advantage of the additional space for biochemistry and haematology to expand into. "This laboratory renovation coincided with our need to replace clinical chemistry, immunoassay and haematology analysers," said Garry.
Dianne commented, "When we went out to tender, we hadn’t made the decision to source everything from the same supplier, but it soon became apparent that a single company solution would offer us the best and most affordable option. We recognised that this might require compromise in some areas."
Tender considerations
Both analysers and staff were struggling with the workload. "We were looking to automation to provide us with a working platform that would deal efficiently and reliably with the bulk of our samples," explained Garry. "This would free up time for staff to focus on the more specialist work that requires their analytical and interpretive skills. We felt this would also boost morale."
"During the tender process two broad approaches emerged, either complete automation or the use of integrated instruments. There were plenty of arguments for each. We visited a lot of sites and talked to users, both about the instruments and also the support they had received."
Reaching a solution
The solution the NNUH team chose is in fact a combination of the two (see box). "The majority of our analysers will be connected using the ACCELERATOR APS, smoothing workload and ensuring a constant feed to analysers. We will also have a standalone ARCHITECT clinical chemistry/immunoassay combined analyser for maximum flexibility as well as a CELL-DYN Ruby to provide results within minutes in a ‘one-stop clinic’," said Garry.
"We concluded that Abbott offered the best package in terms of quality, throughput and cost," added Dianne.
| The NNUH solution | |
|---|---|
| Biochemistry | Haematology |
| ACCELERATOR APS, with 2x i2000, 4x c8000, 2x centrifuges, decapper, resealer and storage unit ARCHITECT ci8200 |
3x CELL-DYN Sapphire, CELL-DYN Slide Maker Stainer Clinic-based CELL-DYN Ruby |
First impressions
The clinical chemistry systems went live in January 2007 with the haematology analysers following in March. Garry says, "Abbott has been very supportive during the installation process and their onsite staff have done a great job. They are very knowledgeable and helpful. The initial evaluation of the new analysers has shown good analytical outcomes. In addition, the CELL-DYN analysers have been very reliable and we are more than happy with their performance – they are far better than the instruments they replaced."With the high volume of work being loaded onto our new ACCELERATOR APS, we encountered a few teething problems initially, however, back-up has been good, with issues being rectified along the way."
Conclusion
Dianne concludes, "To improve our processes further we have to continue to think differently. Once our solution is complete and all the equipment is in, we’ll do another workflow analysis to see how it is performing - and adapt the configuration if necessary."
"We also expect that once turnaround times improve, we will receive far fewer STAT requests," adds Garry, "We’re very pleased with the progress that has been made in such a short amount of time."
