Abstract
Today's automation rush is similar—in some respects—to the California gold rush of the mid 1800s when James W. Marshall discovered gold at Sutters Mill. As the word quickly spread that there was gold to be found in the California foothills, thousands rushed out west to participate in the so-called bonanza. Likewise, clinical laboratories have heard about the treasures they will reap if they invest in automated lab systems. Some laboratories have rushed to purchase new systems, but just like the gold diggers, they have quickly found that following fortunes of gold can leave them with disappointing results. Rather than seek “get-rich solutions,” today's clinical laboratories need to take a more objective approach. It's true that new systems that provide automated operations allow laboratories to remain more competitive in this cost-cutting environment. But with so many choices, it's easy to pick the wrong solution.
So how can laboratories find their way through such a maze of decisions? To be successful, laboratories need to identify their future goals. But before laboratories jump to make a decision, they should analyze their current operations and determine what they need to do to get from point A to point B.
To approach this decision-making process, laboratories should follow a “stepwise” approach that will guide them down the proper path to achieve significant efficiencies. Laboratories should not rush to purchase lab automation systems before they identify process improvements and data management enhancements. Investment in lab automation systems, if appropriate, should be the final step. When laboratories follow a systematic approach, they will save money and avoid wasted time.
Just the beginning
Improving a lab requires that you adopt a Rome-wasn't-built-in-a-day philosophy. To start, managers need to be committed to re-engineering their labs, and at the same time recognize their own limitations. An independent consulting company can evaluate the strengths and weaknesses of your business and provide valuable insight into opportunities to become more efficient. Without such an independent evaluation, it's difficult to properly critique a lab and uncover any shortcomings.
Surprisingly, consulting companies don't always come with expensive price tags. At the process improvement stage, costs of consultants can run from $15,000 to $225,000. But annual cost savings from process improvements alone can range between $100,000 and $1 million. Even a modest investment can mean a big payoff for a laboratory. After you have determined if there are any process improvements needed to be done, it's time to consider your data management capabilities. Investment in software programs or laboratory information system upgrades can result in substantial savings. Here again, you should decide if you have the expertise to conduct such an analysis yourself or if you need the help of a consultant. Once you have tackled process improvements and data management issues, the time has arrived to consider lab automation. During this step, the advice of a consultant is extremely valuable to avoid making expensive mistakes.
Multi-step automation approach
There are four major steps to lab automation, beginning with evaluating front-end equipment, implementing consolidated workcells, integrating front-end equipment with workcells and finally adding back-end equipment.
1. First, you need to evaluate the lab's front-end equipment, including automated centrifugation, sample loaders, decapping, aliquoting and sorting units. Through front-end automation, labs can gain substantial labor savings that improve efficiencies.
2. Second, labs should consider investing in consolidated workcells, which are groups of instruments that are connected together, but are not mechanically connected to front-end equipment. Through a workcell system, numerous efficiencies are realized, including reductions in sample splitting, sample manipulation, head count training and service. Consolidated workcells require minimal capital investment compared with the capital outlay for a complete lab automation system.
3. Third, if it's warranted, labs can integrate their front-end equipment with their workcells through a conveyor system. For instance, a track system can be installed to transport samples from one station to the next. By doing this, immunoassay, chemistry and hematology instruments can be connected together to streamline operations. Connecting workcells and front-end equipment requires a major investment so only high-volume labs should move forward.
4. Fourth, after steps one through three have been implemented, labs may also consider adding back-end equipment, such as automated storage and retrieval units. Given the substantial capital required to properly add back-end equipment, only large labs should consider this step.
Once you have followed some or all of these steps, your lab will realize noticeable reductions in labor costs, faster turnaround times, improved quality and safer working conditions. Typically, process improvements will provide the most savings—about 40 percent of total cost reductions. Data management upgrades account for about 30 percent, and total lab automation decisions could garner up to 30 percent of savings. Even if it's only possible to implement steps one and two of the stepwise approach, your lab will achieve substantial savings and efficiencies. Depending on the level of investment, the payoff period for process improvements may range between two and four months. But the investment will have long-term rewards: your laboratory will be more efficient and better prepared to remain competitive for years to come.