Skyrocketing Daily Specimen Volume
Sacred Heart Health System is comprised of more than 500 physicians, a primary care network, 120-bed nursing home, a home health agency, and two hospitals; one in Pensacola and the other in Destin.  The 500-bed Sacred Heart has a strong presence in the Florida panhandle. Accommodating an upsurge in patient volume yet wishing to continue to improve and expand patient care, the Sacred Heart lab administration re-evaluated their workflow processes.  Their goal was to increase their test volume utilizing existing workspace and staff while decreasing testing turnaround time.

"As we expanded our outreach, patient volume skyrocketed," says Craig Wright, Core Laboratory Supervisor, Sacred Heart Health System.  "But since our lab had not grown in physical size and our staff remained constant, we required an automation system that would simplify our manual processes from drop-off to completion in order to decrease turn around time."

Sacred Heart determined they needed a mid-size solution, including pre-analytical process and chemistry instruments on the automation line.  They invested over 16 months budgeting for and researching available automation products on the market.

"After selecting Beckman Coulter as our automation vendor, we needed to choose a communication vendor to match," says Wright.  "Since we already had a successful relationship with Misys as our LIS vendor, the choice was easy."  Sacred Heart became one of the first hospitals in the southern United States to implement a laboratory automation solution. 

Misys Laboratory  Order and Container Management
Integrated with the Misys Laboratory solution, the container management module enables laboratory personnel to define Specimen Points of Tracking (SPOTs)—locations where containers are routed for processing and testing.  By linking SPOTs in a hierarchy that represents the setup and workflow of the enterprise or hospital, the system can automatically route containers through the laboratory—expediting the entire process, reducing errors, and increasing staff productivity.

Process Evaluation and Staff Training – Keys to Successful Implementation
Before installing the automation solution, Sacred Heart implemented a complete procedural re-engineering initiative in order to achieve optimal results from the new solution.  The physical location of the laboratory equipment was also reconfigured; for example, moving hematology to the front end of the automation line allows an entire rack to be picked up at once.  The tube system was moved to within a few steps of the automation line, reducing staff time and energy.

To prepare its employees to use the new software, medical technologists were trained on the new pre-analytical steps.  The focus on training allayed staff concerns, built their confidence and eased the transition to the new system.  Additionally, during the implementation process, regular conference calls took place between Beckman, Misys, and the project management team.

"Misys worked with us daily," Wright states.  "As a team, we achieved our operational goals. Communication is paramount in a successful installation.  To ensure this, a Misys IT support representative stayed with us during the week we went Live."

Improved TAT and Boosted Employee Morale
Significant results were realized soon after the Misys Laboratory Container Management Module and LAS were installed.  A major benefit included Sacred Heart's dramatic change in turnaround time.  Previously, its guidelines were 4-8 hours for routine specimens.  Each tube had to be taken out of the rack while its information was manually retrieved from the computer system.  With the new system, 100 specimens at a time can be placed directly on the automation line and immediately time-stamped.  This step, which previously took one hour to complete, now takes only five minutes.

With the tubes now being loaded immediately, they can run at a consistent pace with pre-analytical and analytical processes completed within 30-40 minutes, compared to the prior 4-8 hour average. Test time is now dependent on the chemistry of the test, not the pre-analytical steps.

"Before installing the new Misys solution, we were like a locomotive going down the mountain with its brakes not working," says Wright.  "We couldn't maintain a consistent staff because it was too much work and stress for people to handle." Wright says.  "Now they look forward to coming to work."

An additional benefit of the new system is comprehensive specimen tracking.  They can now track a specimen from its point of origin, look it up on the computer system, and instantly determine its exact current location.

"If someone calls and wants to add a new test to a specimen from yesterday, I can go to the system, pull that patient's information, and know exactly what row and what rack in what refrigerator the specimen is in, then immediately retrieve that specimen," says Wright. "Our previous method required the time-consuming manual search through 200+ individual specimens at a time."

Future Holds Enhanced Automation Line
The automation solution implemented has already proven to be a powerful tool that offers users the ability to increase productivity and efficiency without increasing laboratory facility size or staff.  Sacred Heart plans to continue expanding its automation solution in the near future, adding a second line with hematology and coagulation and a new 3000 test tube refrigeration system connected directly to the line.  When this is complete, the automation system will send the sample's refrigerator location to the LIS.  Then, when a new order is added to an existing specimen, the Misys Laboratory application will send the location to the LAS along with the order, the LAS will automatically retrieve the sample, run the add-on test, and return the sample to storage.

"Implementing the automation solution with Misys and Beckman Coulter was absolutely the right thing to do and the right approach for Sacred Heart Health," says Wright, "The changes were significant. We were suddenly doing many new things that caused uncertainty.  With the transition complete, we are pleased with the results and we are glad we made these necessary changes.  All we want now is more automation that will enable us to do even more with what we have."