Evaluation on the performance of clinical laboratory automation system

Objective By analysis of the key performance indexes of the clinical laboratory automation system, to clarify the advantage and optimize the comprehensive performance of the laboratory automation system. Methods Key performance indexes were Collected from January 2017 to April 2017 in biochemistry and immunoassay group of Clinical Laboratory of Shanghai Tong Ren Hospital.(1)The data were collected and compared by the before-and-after method, the starting time of the automation system and initial sample test were analyzed.(2) Key performance indexes were analyzed for the time of specimen registration, inspection, and reporting. (3) The specimen turnaround time (TAT) was analyzed based on two months operation of the laboratory automation system. In view of disadvantage of infectious assays, setting up priority sample absorption, then TAT performance was re-evaluated. (4) By the assessment of total serum dosage required in the automation system, the number of blood vacuum tubes were reduced reasonably. The pros and cons of laboratory automation system were analyzed and the potential improvement were proposed. Results (1)According to the sample peak shift forward, the system start time could move forward 30 minutes earlier.(2)With the adopting of railway logistics, the specimens were sent to the lab and the registration time was at 7∶25 am, and the time required for specimen delivery was greatly reduced which made specimen test, report and audit time all moved forward accordingly. (3)Data has shown that specimen TAT declined dramatically based on the performance of the first two month operation of the automation system, biochemical items were shortened 2 h, and the immunoassay shortened 4 h, respectively. Moreover the trend keeps better gradually. With setting up priority absorption infectious tests, the TAT was improved greatly, TAT reduced the average by 40 min. (4)500 μl (including the sample in dead space of vacuum tube) were needed for all the 65 biochemical items included in the system, and 1 495 μl serum were used for the 28 immunoassay. As a result, a total of 2 000 μl serum will be enough for sample analysis by the system, which provided the feasibility to reduce 3 vacuum tubes averagely . Considering the current automation system does not include all the analysis items in our lab directory, a few tests remain to be performed on offline instruments respectively. The methodology for some infectious agents are different from previous method, therefore some test results may need a period of time for comprehensive clinical appreciation. Furthermore, due to the parallel connection of multiple instruments included in the system, more rigorous and frequent quality control becomes a necessity, which may rely on more strict quality control procedure to guarantee the quality. Conclusions The application of the automation system significantly enhanced the efficiency of clinical laboratory all round. In addition, by the quantitative indicators, it is possible to monitor the system operation performance real time, which may feedback and facilitate the improvement constantly, and result in auto confirmation the majority results, eventually. (Chin J Lab Med, 2017, 40: 810-815) Key words: Automation, laboratory; Clinical laboratory information systems; Data interpretation, statistical; Evaluation studies