Achieving Best in Class Performance with Your Laboratory Automation System. Presented by: Denny Lamb, FACHE

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1 Achieving Best in Class Performance with Your Laboratory Automation System Presented by: Denny Lamb, FACHE 2010 Executive War College April 27 28, 2010 Disclosure Employee of Roche Diagnostics since 2005

2 What does best in class look like - other industries What leads to best in class performance How to achieve best in class results with your automation system Q & A Agenda Audience Poll Automation environment Less than a year 2 4 years > 5 years Auto-verification Don t use yet < 50% of chemistry auto-verified 50 75% auto-verified > 75% auto-verified

3 Best In Class Other Industries 2009 Malcolm Baldrige Healthcare Award Recipients All product names and trademarks are the property of their respective owners Characteristics Reinvented the company where needed Created a reputation for dependability, ingenuity, creativity Willingness to take calculated risks Paid attention to the details Exhibited a willingness to change Developed processes and workflow to meet customer expectations Engaged their workforce

4 Laboratory Automation To achieve best in class is a journey, not a destination Decision making is months long Automation systems used 7 10 years Automation system impacts the spectrum from vein to brain Laboratory Automation Estimate hospital labs have some form of automation in the US* Automation isn t just for large sites Automation systems implemented for different reasons Large commercial labs have not pursued to the same degree as hospital labs * What Can Automation Do For You by Gary Tufel Clinical Lab Products February 2008

5 Why did we invest in lab automation? Improve lab operational efficiencies Improve quality Reduce errors Reduce turn-around-time Create an operation that can deal better with staffing and workload fluctuations Decrease dependence on human labor Lower cost structure Create a safer work environment Why have we not met our goals? Automated bad processes Working as we have in the past Didn t address the entire workflow Turf warfare - staff not engaged Have not addressed best practices for our laboratory Have not developed daily/hourly metrics as indicators of success real time process measures

6 Your Automation System Analytics Preanalytics Post Analytics Automation System Change Management LIS Staff Your Lab Automation System Preanalytics Order Entry Processes Unique accession numbers Extend to outlying sites Handheld Collection Devices

7 Does this look familiar? Manually in-labbing specimens Labeling tubes after arriving in lab Handheld Collection Devices Quality starts with positive patient identification Many errors begin here Reduce phlebotomies Capture last minute orders Capture collection time and ID Eliminate in-labbing Specimen ready to go on to automation system

8 Your Lab Automation System Preanalytics Order Entry Processes Unique accession numbers Extend to outlying sites Handheld Collection Devices Eliminate Exceptions Reluctance to eliminate or reduce Rainbow draws Moving to one tube and a single process Separate Processes For STATs and Routine BLUR THE LINE Your Lab Automation System Order Entry Processes Unique accession numbers Extend to outlying sites Handheld Collection Devices Preanalytics Eliminate Exceptions Reluctance to eliminate or reduce Rainbow draws One tube, one process Separate Processes For STATs and Routine BLUR THE LINE Processing Staff Not enough training and exposure Integrate them into the automated lab Further Automation Needs Large facilities for task-targeted-automation

9 High-speed Sorting Unit Aliquotting Unit

10 Aliquotting Unit Layout Your Lab Automation System Analytics Reduce Front Loading of Specimens Quality Control Systems Real-time QC metrics More robust alerting Archive Refrigerators Close to Automation System Develop the Cockpit Station Monitors on swiveling arms

11 S E I I The Cockpit A E I The Cockpit S E 13" X 34" 10" x 34" S B Your Lab Automation System Analytics Reduce the Front Loading of Specimens Quality Control Systems Real-time QC metrics More robust alerting Archive Refrigerators Close to Automation System Develop the Cockpit Station Monitors on swiveling arms TAT Monitors

12 Turn-around-time Monitors Your Lab Automation System Post Analytics Add-on Testing Does specimen exist?

13 Specimen Availability Your Lab Automation System Post Analytics Add-on Testing Does specimen exist? Autoverification Middleware rules and logic Storage and Retrieval Close to preanalytics automated system

14 Automated Storage Unit Your Lab Automation System Change Management LIS Needs Not Fully Implemented How is your automation system staffed and managed? Goals and Metrics to Operate By Replace gut feel with facts Develop KPIs and monitor real time STAT TAT Time Interval TATs % results autoverified

15 Your Lab Automation System Change Management Lean Processes Not Developed Single tube, reduced touches Automation Project Plan Never Fully Developed Or Implemented Why Change A Process? Value added for the customer? What value is brought to the laboratory? Does it improve productivity? Is an efficiency gain made? Your Lab Automation System Additional Needs Futures Dashboard Real Time Monitors automation system performance Qualty Control Parameters Real time Average of normals / patient moving averages Use to monitor system performance in new ways

16 Dashboard Needs Your Lab Automation System Additional Needs Anatomic Pathology Automation of barcode labeling Automating slide preparation functions Automating staining functions

17 Summary Achieving Best in Class Address all areas of the automation system to achieve best in class Preanlaytics, analytics, post analytics LIS operations and needs Order entry processes Additional automation products The Cockpit and TAT monitors Auto-verification acceleration Summary Achieving Best in Class Understand processes and then apply Lean analysis Don t automate bad processes Invest in a change management Develop a philosophy Engage the staff Eliminate turf warfare

18 Summary Achieving Best in Class Continue to asses the future state needs for improvements Dashboards Develop new ways of using QC Begin exploring other areas of the lab to automate Achieving Best in Class is based on Execution! Process Improvement Execution But Leads to Cost Reduction Leads to competitive advantage and long-term financial benefits