ABSTRACT
Objective:By exploring a construction and improvement system for total lab automation in emergency lab, this work aims to improve the success rates of project implementation and the effective utilization of medical resources.Methods:Firstly, clarify the short board of current solution and determine the configuration of the TLA solution which include the number of pre-analytic, post-analytic modules and analyzers by workflow and data analysis which based on the data from 16th to 22nd September 2019. Secondly, define the basic principles and design the optional solutions. Thirdly, determine the final solution based on the simulation results. Fourthly, evaluate the effectiveness of the solution by comparing the turnaroud time (TAT) before and after implementation.Result:We upgrade the system to improve the automation level of the track by add 1 online centrifuge module and upgrade the capacity of online storage module from 9 000 samples to 15 000 samples, and increase the throughput of the clinical chemistry analyzers form 2 500 tests/h to 5 400 tests/h and immunoassay analyzers from 668 tests/h to 1 320 tests/h with no more space. The 95th percentile TAT (from sample check in to validation) have 33% reduction on the premise of 9% increase on the workload of clinical chemistry and immunoassay, and it is highly consistent with the results obtained by data simulation whose 95th percentile TAT is 67 min.Conclusion:Good uasge of workflow and data analysis in the stage of solution design can help to ensure that the result can meet the expectations of the clinicians and effective utilization of medical resources.
ABSTRACT
Objective To evaluate hemolyticinfluence on 41 chemistry and immunology tests and define the hemolysis alert index, which can be used as evidence for sample rejection and test report verification.Methods Method evaluation.As a pair, both hemolyzed and non-hemolyzed serum samples were collected from the same patient at the same time.Hemolysis index and 41 tests were analyzed.The effect of hemolysis in different hemolysis level was evaluated by comparing results of the paired samples.The alertindex were defined by senior laboratory techniciansand clinical professionals based on discussion of widely accepted quality requirements.Results The number of sample with hemolysis index of 1,2,3 and 4was 24, 17, 7 and 4 respectively.Of the 41 analytes, 6 analytes increased in hemolyzed samples comparing to non-hemolyzed samples, namelyaspartate aminotransferase(AST), creatine kinase(CK), potassium(K),lactate dehydrogenase(LD),inorganic phosphorus(iP)and total bilirubin(TBil).Another 9 analytesdecreased in hemolyzed samples comparing to non-hemolyzed samples.These analytes are alkaline phosphatase(ALP), chloride(Cl), creatinine(Cr), immunoglobin M(IgM), sodium(Na), prealbumin (PA),rheumatoid factor(RF),triglyceride(TG),uric acid(UA).Hemolysis alert index was defined as 1 for AST,K,Na and LD;2 for Cr;3 for CK,iP,PA and TBil; and 4 for the other 32 tests.Conclusions Hemolysisalertindex were defined based on the investigation of hemolyticinfluence on 41 chemistry and immunology tests in ourlaboratory.However, hemolytic influence on clinical laboratory tests are closely related to the assay systems.So clinical laboratory should evaluate the hemolytic influence on its own analysis system,and define assay specific hemolysis alert index.