Realising change

You have developed the ideal automation strategy, selected new analysers, and perhaps also designed new working practices. Now, the implementation phase is critical for bringing your pathology modernisation plans to life. It is easy to underestimate the scale and importance of the work involved, potentially jeopardising a successful transition and threatening to impact on clinical care. Here some laboratories share their experiences.

Challenging times

Installing new instruments, validating them, removing old systems, dealing with building works at the same time, ensuring IT connectivity to the hospital LIMS, training staff and adapting to new working practices… and all the while maintaining a reliable clinical service – just some of the challenges which arise when modernising.

Dai Davies, general manager for pathology at East Kent Hospitals NHS Trust, recently chaired a project group when the Trust installed new automation. "Right from the onset we met fortnightly to plan the implementation and we were relentless in our attention to detail and our determination to accomplish tasks in a timely manner!"

Pulling together

Involving all lab staff and keeping everyone informed helped give ownership to a similar modernisation project at Royal Gwent Hospital. Gwyn Llewellyn, Lead BMS and project manager for the implementation explains, "Abbott analysers were being installed amidst ongoing refurbishment and all the while existing instrumentation was being used. At one point, the team were working in the corridor but staff did an excellent job maintaining service throughout. Everyone really pulled together."

On your team

At East Kent, the project group consisted of the pathology team, Abbott and other suppliers, the finance and supply department and the estates team. Paul Cowell, customer service director for Abbott, comments, "With many large scale pathology modernisation projects under our belt, we know from experience where challenges are likely to arise and how best to prevent or prepare for these."

Identifying risks and forming contingency plans enables issues to be dealt with quickly and with minimal disruption. Gwyn reports that, "Being an early adopter of such new large-scale automation, we did experience a few teething problems. However, Abbott responded very well to the issues that arose and tackled them swiftly. A strong partnership and rapport saw us through, together with extremely helpful engineers. We have ended with smiles on our faces."

Changes to workflow and practice

Having adopted a total laboratory automation approach, Gwyn explains, "We chose the ACCELERATOR APS so we could streamline our processes. Lean solutions are the most cost-effective and you can't get much leaner than the APS! Only four manual steps are required in total whereas our previous approach required 28-103 steps – depending on how many workstations the samples were being loaded onto and the degree of reflex testing needed. However, this automation meant a big change for staff in terms of working practice. Good preparation is essential."

All too often, IT problems occur during installations and often because IT is only considered once the instruments are already in place. "Getting the hospital's IT team involved early on meant that they took responsibility for making the IT work," says Dai. Gwent too, found the partnership of the IT teams from Abbott and the Health Authority, essential for success.

An early start

Of course, the change management process doesn't begin with the installations. Critically evaluating the lab's needs – to identify workflow challenges and predict future demand – is the starting point for all pathology modernisation programmes. And repeating this analysis at regular intervals once a solution is in place will highlight areas where improvements can continue to be made. Importantly, the Abbott team is very experienced in developing and refining the most appropriate solutions. At Royal Gwent Hospital, this type of workflow analysis has led to turnaround times for GP/outpatient tests being reduced from 1,154 to 254 minutes and a 46% decrease in the walking distances for staff within the lab.

Conclusion

Dai concludes, "A thorough approach to implementation has enabled us to pull off a very successful yet complicated project. We continued to deliver a service at all times – even while working in a building site – and the end users saw no difference in service during the process. And best of all, we had fun along the way."