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Any approach to improving the quality of laboratory operations by data management has to be concerned with its effect on patient test management. For the laboratory to be effective, instruments have to communicate with computers that improve the speed and efficiency of the work in a real-time distributed-processing environment. Chemistry services are highly information-intensive in terms of quantity, variety and rate of generation.
We used a systematic process with defined and measurable outcome expectations to restructure automated chemistry. Our goal was to improve dissemination of medical information. We had spectacular success, allowing effective reassignment of staff to support our service base. This study uses laboratory and hospital trends for staffing, work volume, workload statistics, and carefully designed time studies to analyze the crossovers in replacing chemistry analyzers and modifying a computer interface to realize automatic results verification with callup of results outliers for review.
In 1987 work in automated chemistry was mainly done on two of five analyzers supported by six technologists on three shifts. We considered replacement of these five with two instruments and constructed a model comparing the measured characteristics of the existing system with its replacement with a projected savings of $1.2 million over seven years. Measurements were made on an intermediate, and on the final installed system, and on the contribution of technical and nonlabor expenditures to the expected savings. The expected savings are adjusted to $1.5 million over seven years based on a 30% increase in testing. 22% of the time eliminated is in test generation and 30% is accounted for by interface changes with an effect on information transfer, editing, and rechecking the results generated.
Technology replacement, workflow management, laboratory productivity, cost impact analysis
Section Chief, Chemistry, Bridgeport Hospital, Bridgeport, CT