Implementation of Total Laboratory Automation and its Outcome Analysis for Laboratory Productivity

Park, Hyosoon; Kim, Jong Won; Min, Won Ki; Chi, Hyun Sook; Kim, Jin Q; Kim, Dae Won

Abstract

BACKGROUND: To cope with demands of ever-increasing test volumes, laboratories have implemented the total laboratory automation (TLA) system. The main goals of TLA are superproductivity, shortened turnaround time and universal availability of laboratory data throughout the hospital and/or hospital network. The TLA system was installed at Samsung Medical Center (SMC) in 1994; at Asan Medical Center (AMC) in 1995. To evaluate the benefits of TLA system, the comparative study between the laboratories with varying degree of TLA installation and Seoul National University Hospital (SNUH) without TLA installation was conducted.
METHODS
Three laboratories of tertiary care university hospitals participated in this study; SMC (with the full TLA installation), AMC (with the TLA installation in outpatient laboratory) and SNUH (without TLA installation). To evaluate productivity of a TLA system, the productivity of a technologist and a laboratory person between laborotories with and without TLA systems, the comparison of productivity between TLA laboratories and non-TLA laboratories in AMC, and test numbers per hospital bed were obtained. To evaluate the qualitative aspects, the turnaround time (TAT) analysis was carried out. For overall performance index, the length of hospital stay was calculated and analyzed.
RESULTS
The test numbers per technologist in AMC, SMC, and SNUH were 177,082.2, 161,966.7 and 95,752.5, repectively in 1997. The test numbers per laboratory personnel including physicians in AMC, SMC, and SNUH were 108,287.7, 118,682.5, and 67,304.3, repectively in 1997. Those per hospital bed were 6841.8, 12194.1, and 6192.0, repectively. The turnaround times of routine hematologic tests in AMC (Outpatient) and SMC were 75 minutes and 102 minutes, and those of routine chemistry tests were 49 minutes and 106 minutes.
CONCLUSIONS
The laboratories with TLA installation showed much improved productivities in all categories analyzed; especially test numbers per hospital bed. The TLA system would be the vehicle of the laboratory to gain the superproductivity without sacrificing the quality of laboratory and to ensure the short turnaround time.