|
|
|
|
|
Impact of Pre Analytical Automation on the Quality of Laboratory Services
Ralph Dadoun
St. Marys Hospital Center, Montreal, Quebec, Canada
Traditionally, the overall quality of laboratory operations has been viewed
as a combination of three variables: analytical quality, timeliness (turnaround
time T.A.T.) and efficiency of the overall operations. Due to improvement in
the analytical devices, today, test quality varies the least as efficiency and
T.A.T. retain the greatest variability. In the last quarter of 1998, St. Marys
Hospital, a 414, acute-care bed, McGill-affiliated teaching hospital, acquired
a pre analytical automation system for its core laboratory. As our sample
volume kept on increasing, our goal was to improve the efficiency and the
quality of our services while reducing the potential of human errors.
Our pre analytical automation system improved our T.A.T. (from reception of
the specimen into the laboratory to the validation of the result) by more than
50 percent, but more importantly, drastically reduced the variability (SD)
leading to better satisfaction to the treating physician. A recent survey by
the C.A.P. (Q-Probe) on physician satisfaction on laboratory services (stat and
routine T.A.T.) ranked us within the top 10% of all institutions surveyed (n =
366). Results of our T.A.T. follow:
|
TESTS |
PRIOR TO AUTOMATION |
WITH AUTOMATION |
|
Stat Chemistry |
35 min + 22 ( n = 296) |
18 min + 4 (n = 218) |
|
Stat Hematology |
18 min + 15 (n = 414) |
8 min + 4 (n = 145) |
|
Coagulation (Pt-Ptt) |
22 min + 9 (n = 906) |
17 min + 7 (n = 471) |
By reducing the number of manipulations by more than 60%, automation
drastically reduced the potential of human errors. More importantly,
automation, coupled with the L.I.S., allowed us to catch errors, which were
not previously picked up.
As for efficiency, benchmarking with two different workload measurement
systems, our overall productivity improved by 30 percent. |