Evaluation of the impact of a total automation system in a large core laboratory on turnaround time.
BACKGROUND
Growing financial and workload pressures on laboratories coupled with user demands for faster turnaround time (TAT) has steered the implementation of total laboratory automation (TLA). The current study evaluates the impact of a complex TLA on core laboratory efficiency through the analysis of the In-lab to Report TAT (IR-TAT) for five representative tests based on the different requested priorities.


METHODS
Mean, median and outlier percentages (OP) for IR-TAT were determined following TLA implementation and where possible, compared to the pre-TLA era.


RESULTS
The shortest mean IR-TAT via the priority lanes of the TLA was 22min for Complete Blood Count (CBC), followed by 34min, 39min and 40min for Prothrombin time (PT), urea and potassium testing respectively. The mean IR-TAT for STAT CBC loaded directly on to the analyzers was 5min shorter than that processed via the TLA. The mean IR-TATs for both STAT potassium and urea via offline centrifugation were comparable to that processed by the TLA. The longest mean IR-TAT via regular lanes of the TLA was 62min for Thyroid-Stimulating Hormone (TSH) while the shortest was 17min for CBC. All parameters for IR-TAT for CBC and PT tests decreased significantly post- TLA across all requested priorities in particular the outlier percentage (OP) at 30 and 60min.


CONCLUSIONS
TLA helps to efficiently manage substantial volumes of samples across all requested priorities. Manual processing for small STAT volumes, at both the initial centrifugation stage and front loading directly on to analyzers, is however likely to yield the shortest IR-TAT.
Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Dalhousie University, Halifax, Canada. Electronic address: Amy.Lou@nshealth.ca.
Amy H
AH
Lou
Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Dalhousie University, Halifax, Canada.
Manal O
MO
Elnenaei
Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Dalhousie University, Halifax, Canada.
Irene
I
Sadek
Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Dalhousie University, Halifax, Canada.
Shauna
S
Thompson
Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Dalhousie University, Halifax, Canada.
Bryan D
BD
Crocker
Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Dalhousie University, Halifax, Canada.
Bassam
B
Nassar
D057205:Automation, Laboratory; D006801:Humans; D013996:Time and Motion Studies
Priority of sample requests; Total automation system; Turnaround time