Total Laboratory Automation - The Planning Process

Abstract

The South Bend Medical Foundation, Inc., recently installed the Boehringer Mannheim / Hitachi Clinical Laboratory Automation System. The planning process and investigation of Total Laboratory Automation (TLA) started in January 1995 with installation and operations commencing in December 1996. During this two year process, information was learned that could benefit others in the clinical laboratory field as they plan for TLA. Information gained by the author from discussions with automation vendors, experts and colleagues, from attendance at various seminars and from having actually gone through the process forms the basis of this article concerning the planning process. The article is intended to be an overview of the planning process used by one laboratory and not a detailed discussion related to all issues that may arise when planning for TLA. As the field of laboratory medicine faces centralization, networking and downsizing, laboratorians continue to debate the merits of the various strategies to meet successfully these challenges. Any action plan selected and implemented must be in agreement with the organization's long term strategic plan. The plan must support customer “added value”, improve organizational performance, enhance the strengths of the organization and assist the organization in its long term survival. One strategy being explored by many is the concept of Total Laboratory Automation (TLA). TLA can be defined as the automation of the pre-analytical, analytical and post-analytical functions associated with laboratory operations. The automation of these functions is achieved through use of computer systems, conveyor systems and self operating devices. Pre-analytical self operating components can include: •Primary tube sorter•Centrifuge•Tube de-capper•Aliquotter•Aliquot tube re-capper•Barcode labeler•Aliquot tube sorter With a TLA system, specimens are automatically transported between pre-analytical components and analyzers by a conveyor system. Analyzers will either sample a specimen directly from the conveyor system or the specimen will automatically be loaded on to the analyzer. Specimens for storage can be transported to automated refrigerated units for later retrieval. A laboratory exploring TLA will determine which components are the most effective for its operation. Numerous conferences on TLA have been attended by many laboratorians throughout the country over the last two years. The conferences have addressed the differences between a turn key and modular design systems, the merits of pre-analytical equipment versus a total automation system, and the potential costs and benefits associated with the equipment. One aspect of TLA that has not received much coverage is the planning. Many have asked the question—“Where do I start?” As we all know, the success of any project is related to the planning that takes place prior to any acquisition or implementation. This article will focus on the planning process utilized by the South Bend Medical Foundation, Inc. (SBMF) located in South Bend, Indiana for its total laboratory automation project. SBMF began installing the first Boehringer Mannheim / Hitachi Clinical Laboratory Automation System (CLAS) in North America on October 22, 1996. But, long before installation, the planning process started. The planning process began in January 1995 and continued to evolve as the project unfolded. While there are key components to any planning process, details may be different from one organization to another. Readers should bear in mind that this was one laboratory's planning approach and is intended to be an overview of the planning process and not a detailed discussion related to all the issues that may come up when planning for TLA.