Experimental fusion of different versions of the total laboratory automation system and improvement of laboratory turnaround time

Abstract

Background: Use of total laboratory automation (TLA) system has expanded to microbiology and hemostasis and upgraded to second and third generations. We herein report the first successful upgrades and fusion of different versions of the TLA system, thus improving laboratory turnaround time (TAT).

Methods: A 21-day schedule was planned from the time of pre-meeting to installation and clinical sample application. We analyzed the monthly TAT in each menu, distribution of the "out of range for acceptable TAT" samples, and "prolonged time out of acceptable TAT," before and after the upgrade and fusion.

Results: We installed and customized hardware, middleware, and software. The one-way CliniLog 2.0 version track, 50.0-m long, was changed to a 23.2-m long one-way 2.0 version and an 18.7-m long two-way 4.0 version. The monthly TAT in the outpatient samples, before and after upgrading the TLA system, were uniformly satisfactory in the chemistry and viral marker menus. However, in the tumor marker menu, the target TAT (98.0% of samples ≤60 minutes) was not satisfied during the familiarization period. There was no significant difference in the proportion of "out of acceptable TAT" samples, before and after the TLA system upgrades (7.4‰ and 8.5‰). However, the mean "prolonged time out of acceptable TAT" in the chemistry samples was significantly shortened to 17.4 (±24.0) minutes after the fusion, from 34.5 (±43.4) minutes.

Conclusions: Despite experimental challenges, a fusion of the TLA system shortened the "prolonged time out of acceptable TAT," indicating a distribution change in overall TAT.

Keywords: laboratory quality; out of turnaround time sample; total automation system; total laboratory automation; turnaround time.

Figure 1

Map of the total laboratory automation (TLA) layout (A) First‐generation TLA system, in 2007: the position of the module included along the automation line, at the National Cancer Center. From the left: Start Stocker/Sample input and centrifuge, aliquoter, and connected test modules. (B) Second‐generation TLA system after fusion, in 2016. From the left: sample input and uploading, centrifuge, MPAM for de‐capping and aliquoting, and connected test modules

Figure 2

The Violin Plot shows the distribution shape of the out of turnaround time (TAT) samples. In this figure, that the pattern of “prolonged time out of TAT” is more compressed can be recognized. In the density plot, the vertical line indicates the 95% confidence interval of “prolonged time out of TAT,” and the width indicates the frequency. The box indicates the interquartile range, with central horizontal line revealing the 50th percentile. The diamond point in the middle of the box in each group represents the mean value of “prolonged time out of TAT.” The mean “prolonged time out of acceptable TAT” in the chemistry samples was significantly shortened to 17.4 (±24.0) min after the fusion, from 34.5 (±43.4) min