LABORATORY MANAGEMENT
Above: LCL’s molecular work area is the first in the UK to include process optimisation – an intelligent algorithm that streamlines the automated workflows in tracked molecular solutions. Left: The installation of the cobas 8800 and the additional automation it offered aligned with LCL’s priorities and strategic aims, allowing for the further development of its fully automated work area.
the installation of the equipment in December 2022.
Between the instalment process and launch, there were plenty of challenges to overcome. We weren’t expecting it to be smooth sailing – especially as we were delivering a best-in-class laboratory set-up – but we were fully prepared and had the welcome advantage of Roche’s services to provide support. For example, LCL and Roche collaborated on a process to manage the changes to their specimen collection media to a wide distribution of sexual health clinics and GP practices. This included delivering a series of seminars to prepare colleagues for the switchover to Roche cobas media. This was a vital piece of the puzzle as the sexual health teams are a major user of molecular services at LCL through sexual health screening and blood borne virus (BBV) monitoring.
Launching the molecular work area We went live with the molecular work area phase 1 in April 2023, which prioritised CTNG, TV, MG, HIV-1 RNA, HIV1/2 RNA, HCV RNA, HBV DNA and respiratory virus testing (SARS-CoV-2, Influenza B, RSV, Parainfluenza 1-4, hMPV, Adenovirus and Rhinovirus). These were prioritised based on clinical need.
Sexual health is also a large component. We have a local sexual health service (Axess) which delivers
services through numerous clinics in the area, including one on-site at the Royal Liverpool. These serve not just Liverpool city centre but also cover a large proportion of the Cheshire and Merseyside region, including Knowsley, Cheshire East, Warrington and Halton. Implementing the integrated molecular work area has delivered significant improvement in laboratory turnaround times (TAT). Chlamydia trachomatis/ Neisseria gonorrhoeae (CT/NG) TAT has decreased by two days and is expected to reduce further with refinements to working practices.
A key component of the strategy was to include tracked pre- and post- analytics in the plan. In this brand-new laboratory, we now have a solution called the cobas p 612 system, which is for pre-analytics. This works to uncap samples and put them in batches. It fully tracks everything, even identifying tube types and detecting liquid levels. It is fully automated and can be left alone to do its work for around three or four hours, which frees up valuable staff time to do other tasks. The system can be programmed to tailor efficiency and determine how the batches should run. From there, connected via cobas connection modules (CCM), the samples go to the cobas 8800 system. This was an opportune time for LCL to implement service reconfiguration. We were fortunate to have space that allowed the
Our vision is for a fully functional Integrated Core Laboratory – a single space in which all of our workload is high throughput – across haematology, chemistry, immunology, virology, and microbiology
28
reorganisation of work areas in different disciplines across levels 3 and 4 of CSSB while maintaining routine service delivery. Configuration of the work area was tailored to our expected needs; requirements for other laboratories might be quite different. Our viral serology KPIs have improved
greatly since these were moved to the fully automated serology work area. Two- day targets for serology are now easily achievable, with automated reflex testing and a rapid process for clinical add-ons – as appropriate – due to tracked sample storage and retrieval. Integration of the cobas 8800 analysers aims to deliver some of these benefits in the molecular work area. Significant resource was directed in process mapping for system programming to optimise this. As a result, we have a 24/7 fully automated solution for assays that can be run in process optimisation mode. Moving more assays into this workflow is the focus of phase two to deliver similar benefits for more patients in Cheshire and Merseyside.
Integration and its benefits These are early days for LCL’s Integrated Core Laboratory, and we’ve already seen some benefits – and some challenges – which we continue to work through with Roche’s aid. An integrated laboratory includes the nuts and bolts of a molecular laboratory, along with technological tools such as Roche’s navify analytics. By investing in this future-facing laboratory, we are investing in the future of our molecular set-up. Our vision is for a fully functional Integrated Core Laboratory – a single space in which all our workload is high throughput – across haematology, chemistry, immunology, virology, and microbiology.
SEPTEMBER 2024
WWW.PATHOLOGYINPRACTICE.COM
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56
