The pioneers of laboratory automation such as the University Hospital laboratory in Malmö, Sweden, have tended to adopt the total lab automation approach (TLA), with tracking connecting the analysers and extensive laboratory re-engineering. But whatever the size of the laboratory, the advice is the same the decision to automate should be made only after a detailed and objective analysis of existing work practices. And the most important requirement is to automate the pre-analytic processes.
Manual processing is where medical errors most often occur a risk that automation significantly eliminates. There is also staff safety to consider, particularly at times of high pressure when the workload peaks. Laboratory staff have the second highest rate of documented occupational transmission of blood borne and other pathogens. Being able to manage biohazard risk effectively is an important challenge for todays hospital management.
So far, the concept of total lab automation has been limited to larger laboratories. It requires high initial capital outlay and the laboratory is committed financially for five to seven years. For some laboratories, whatever their size, this is a commitment they are unable to make. Mid-size to small laboratories, often restricted by space as well as cost considerations, have not been able to capitalise fully on the benefits of automation. They have had to select partial automation solutions or stand-alone, front-end automation systems with significant limitations for example, with centrifugation, aliquotting or automated capping often excluded. But front-end systems without connectivity are able to offer similar gains, so long as they integrate major pre-analytic and post-analytic functions.
With the new automation system from Beckman Coulter, AutoMate 800, the key benefits of larger automation systems are now available to laboratories of varying sizes and workloads. It delivers their primary objective to cut turnaround time and integrates the vital pre-analytical steps of centrifugation, decapping, aliquotting and sorting for analysis, and the post-analytic step of storage mapping. This is achieved without the investment costs or floor space requirements of the TLA solution. Being more compact, it adapts to changing workloads. The hospital sees the benefit in long-term cost savings fewer errors; faster, consistent delivery of results; improved staff safety and a better service for patients.
The AutoMate 800 loads all samples chemistry, immunoassay, haematology or coagulation at one entry point; and tracks them throughout the process. They pass the bar code reader for positive patient identification; and those for centrifugation are allocated without manual intervention. A normal spin of 3,000g for five minutes produces platelet-poor plasma, allowing identical processing for coagulation, immunoassay and chemistry samples. The tubes are then sorted immediately, or aliquotted prior to sorting, depending on the test request. New tubes are continuously loaded while completed samples can be moved for archive mapping. Requests for additional testing are handled easily by AutoMates post-analytic functions, including storage management.
A dedicated stat input area prioritises urgent samples and flags an alert after they are processed. The software automatically directs samples according to the tests being run by a specific analyser, diverting those tubes being processed at work stations with closed tube sampling technology to avoid the decapping module. This helps to ensure fast and constant turn-around-times. The system is programmed so that intelligent aliquotting, a feature which already reduces the number of patient samples that need to be taken, can further speed up turnaround time by providing extra samples for other departments or external, specialist testing.
Automation clearly improves efficiency, handles larger workloads and delivers greater reliability of results. It also underpins the service the modern laboratory delivers, enabling it to play a more direct role in patient care. The lab has time to focus on the information and analysis it provides clinicians, highlighting disease management options and adding value to the overall diagnostic service it provides.