LAB MANAGEMENT :: AUTOMATION
Lab automation: Learnings and insights T
By Nikola Baumann, PhD, DABCC; Paul J. Jannetto, PhD, FACC, MT(ASCP); Christopher T. Yoch, MA
he effort to lower costs, increase efficiency, and improve patient care continues to drive clinical laboratory auto- mation. At Mayo Clinic, automation is embraced across
our campuses, from the lab to the lawn and in other day-to-day routines including food service deliveries and supply chain. In the clinical lab, our laser focus on optimizing automation began more than 10 years ago and has continued as we leverage our own experience and technology developments. We envision that more and more areas within the Department of Laboratory Medicine and Pathology will benefit from automation as more automated analytics processes in mass spectrometry become reality, replacing costly, manual processes and supporting specialized expertise. This article offers an overview of how two groups of clinical laboratories at our Mayo Clinic campus in Rochester, Minnesota, leverage automation to meet the increasing demand for timely, high-quality results in an environment of rapidly evolving tech- nology. One group encompasses the Central Processing area, which receives and processes 12,000–15,000 patient specimens a day, and the Central Clinical Laboratory, with a volume of more than 6 million tests a year. The second group includes the Clinical Mass Spectrometry Laboratory, the Clinical and Forensic Toxicology Laboratory and the Metals Laboratory, with a combined volume of about 3.5 million tests a year. Both groups of labs serve local Mayo Clinic patients and Mayo Clinic Laboratory clients worldwide, with an estimated 15% of the patient testing volume coming from outside the United States.
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Automation: Where we are today Automation was first implemented in our Central Processing area and Central Clinical Lab in 2009 and underwent a major update in 2019 to encompass greater functionality into our total lab automation (TLA) solution. Automation has been critical in enabling us to serve physicians and patients at Mayo Clinic by processing a large volume of specimens, including blood, urine and other body fluids. Two-thirds of patient blood specimens ar- riving in Central Processing are analyzed in the Central Clinical Lab, with a test menu that includes chemistry, immunochemistry, coagulation and hematology. Figure 1 provides an overview of our total laboratory automation. The automation line covers pre-analytics and chemistry and immunoassay analyzers, as well as hematology and post-analytic refrigerated storage units. With post-analytic refrigeration and storage, we can eliminate the steps involved in manually archiving and retrieving specimens when additional testing is needed. Our 2019 update was prompted by the availability of new technol-
ogy, ever-increasing test volumes, staffing challenges and, to a lesser degree, a growing test menu. Key to this update was the consolidation of two automation lines into one, further streamlining workflow and improving efficiency. This included the integration of Roche cobas connection modules, cobas 8000 modular analyzers, Sysmex XN-9100, and cobas p701 post-analytic storage/retrieval.
Our second group of labs—including Clinical Mass Spectrom- etry, Clinical and Forensic Toxicology, and Metals—has a broad
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