Henry Ford Hospital relies on products from Iris Sample Processing.

Henry Ford Hospital is an appropriate name for a 900-bed facility in Detroit. When it comes to its labs, Motor City is no different from anywhere else—speed is king. With samples coming in from multiple satellites around the metropolitan area, the hospital’s central stat lab processes 3 million tests annually, in addition to the 4 million routine chemistry tests its employees are called upon to perform. Due in large part to the equipment it uses, and some creative thinking by the people working there, the high-volume lab maintains a 1-hour turnaround time for stat tests.

Before the StatSpin arrived, John Zajechowski had a problem with turnaround time in the high-volume lab.

Saving Time

With the ever-increasing need for faster turnaround times, the lab turned to Iris Sample Processing to cut the time that samples spent in the centrifuge. John Zajechowski, chemistry supervisor of the lab, remembers that before the StatSpin arrived, “because turnaround time was an issue, people would run the centrifuge for 5 minutes, then turn it off, figuring it was long enough.”

Running the samples for half the required time resulted in floaters in the plasma and stray results that didn’t make sense. On Iris’ unit, the tubes could spin for just 3 minutes before going into the analyzer, appeasing even the most impatient lab tech.

Zajechowski was so pleased with how the StatSpin Express 2 was performing in his lab that when word came that Iris was planning to unveil the next incarnation, he hounded the company for information. “For probably about 3 or 4 years, every time I’d go to their booth at AACC I’d ask them when they were going to have that available,” he says. The lab was asked to be involved with evaluating the unit before it was released, a direct result of the years of excited inquiries at the AACC shows.

After the StatSpin Express 3 was released to the public, the trial lab kept the new unit alongside its half dozen incarnations of the previous model, but hasn’t invested in any more because a year before getting their hands on it, the lab bought a collection of other centrifuges.

“When these are at the end of their life cycle, we’ll certainly look into replacing them with the StatSpin 3s, or maybe the new one Iris is coming out with,” Zajechowski says. His lab has already been approached about being a testing site in June for the next centrifuge from Iris Sample Processing.

Where High and Low Meet

“We’re always under pressure to provide results faster and faster,” Zajechowski says.

As easy as it is to rely on technology and advancements in equipment, sometimes a low-tech solution can have an impact on cutting down processing time. At Henry Ford, once blood is drawn and labeled, the sample is put into the pneumatic tube and sent to the lab. The lab has been able to increase efficiency by bringing the source and destination closer together, cutting the commute from in-basket to analyzer from 70 steps to 10—a trip that’s easier for a busy tech to justify for a single sample.

The lab also implemented an autofiling system, which consists of a computer that sits between the analyzer and the lab computer, checking the results against a set of rules the technologists developed. If the results are unremarkable and meet all the established criteria—which are about 60% of the results—the information goes straight into the EMR. Critical values or nonsensical results send up a red flag for someone to take a look and call the physician directly with the results.

According to Zajechowski, the addition of the computer checkpoint has increased quality as well as efficiency. Before implementing the middleware, a lab tech had to check all of the results coming out of the analyzers. “After a while, if you’re doing 200 samples an hour, you’re just going to sit there and press ‘Accept’—you get mesmerized,” Zajechowski says.

Crunch Time

The lab can get flooded when the perfect storm hits. “Turnaround time in our stat lab is the biggest thing that we have to be concerned about,” Zajechowski says. “Around midnight all of the critical care units start getting their blood draws. At the same time, you have some of the floors drawing their routine blood so the next morning it will be ready for the doctors when they get in. Of course, in a major metropolitan area, that time of night is right around when the ER starts heating up.”

Zajechowski says the midnight shift accounts for about half of the volume the lab sees, but “the StatSpin has been really instrumental in being able to meet our turnaround time goals.”

The Future of the Lab

Zajechowski says that in the years ahead, the lab will have to run faster and more efficiently. Testing volume is expected to increase approximately 3% to 5% per year, but with an aging workforce and fewer people entering the medical technology field, the employees will have to perform more tests without extra manpower.

“We are in the process of doing a Lean production system to remove the waste from what we do,” Zajechowski says, adding that the goal is to become more efficient by eliminating anything that doesn’t add value.

Small things can add up to time-consuming activities when multiplied by 3 or 4 million. The act of removing a cap may not seem like a major activity, but someone with cap-piercing equipment will soon forget what it was like before the upgrade.

“We’re constantly looking at our processes to see how we can make them run smoother,” Zajechowski says.

Zac Dillon is associate editor for  CLP.