Minghong Tong, Ying Li, Chenxia Deng, Xiaohui Wu, Zhiming Li, Chen Hang, Huiming Sheng and Hui Ding
Background: To improve workflow efficiency, we periodically analyzed the key performance indicators (KPIs) for our total laboratory automation (TLA) system, including the preanalytic processing system, centrifuge, biochemistry analyzer, immunoassay analyzer, and storage refrigerator. Providing the useful information for the potential TLA decision-makers.
Methods: Comparisons of KPIs before and after implementation of total lab automation were collected from July 2016 to August 2019 from the biochemistry and immunoassay group in the clinical laboratory of Shanghai Tong Ren Hospital. The pros and cons of the laboratory automation system were analyzed, and potential improvements were proposed.
Results: There was a 88.91% and 76.97% increase in immunology and chemistry tests in July 2019 compared to July 2016 (before and after implementation of TLA). Biochemical and immunoassay turnaround time (TAT) was reduced by an average of 2 and 4 hours respectively. With normal daily use of TLA and adoption of optimized processes, turnaround time (TAT) was reduced in the first few months of TLA operation. There was a significant difference in the total amount of tubes handled by the Input/Output Module (IOM) before and after process optimization. Better operational synchronization of the two centrifuges was the most important factor in this improved performance. Prior to optimization, the total number of tubes unloaded and loaded on the IOM during each time period did not exceed 700. The highest number of tubes was 653 at 10 a.m. After optimization, centrifuge 1 and centrifuge 2 centrifuged 919 and 908 specimens respectively. The two centrifuges peaked at 9 a.m., centrifuging 248 and 234 specimens respectively. Biochemical TAT and immunoassay TAT were shortened by 22 and 37.6 minutes on average respectively after optimization. There are still some defects in TLA, such as the slower detection speed of overall Immunoassay compared with Biochemical, so the maximum efficiency of TLA still has bottlenecks. Moreover, we even need earlier pre-analytical step for total efficiency enhancement integratedly.
Conclusion: Undoubtedly TLA significantly increased the efficiency of the clinical laboratory, however, some subtle points should be considered beforehand.