A-186 Enabling Laboratories to Do More With Less: Assessment of Workflow Efficiencies Through Instrument Consolidation in an Immunology Lab
Authors: Murphy J , Miller C , Yu E 
Published: September 2023

Abstract

Background
As today’s laboratories adjust to the ever-changing landscape of growing demands while continuing to provide quality diagnostic testing, the need to evaluate and improve workflow, productivity and efficiency has never been more important. One way to ensure current processes and technology are fully optimized is to perform a Workflow Analysis Study. Geisinger Medical Center (GMC) recognized an opportunity to consolidate their immunology laboratory for allergy and autoimmune testing with annual volume of approximately 138 000. A consolidation solution can result in many improvements for the laboratory, such as: improved turnaround times, decreased manual labor, reduced reagent waste, increased employee morale, enhanced space utilization. Maximizing operational efficiencies is and will always be a good business model. We aimed to assess pre- and post- workflow changes to determine impact to laboratory resources.

Methods
To measure the impact of the instrument consolidation and integration of Phadia250TM systems, operational data was collected through direct workflow observations, time and motion studies, and targeted interviews of testing personnel at GMC’s Immunology Laboratory. The initial/baseline study was conducted in May 2022 and the follow-up/post study occurred in October 2022. The baseline study encompassed seven separate platforms that GMC utilized for autoimmune and allergy testing. The following systems were included: two DYNEX DSX®, two Werfen BIO-FLASH®, two Siemens IMMULITE® 2000, one ZEUS IFA™.

Results
The workflow assessment resulted in GMC consolidating down to three platforms for autoimmune and allergy testing: two Phadia250, one ZEUS IFA™. The major benefit of the change was the reduction in technology from three types of technology to one type of technology, resulting in standardization of practices. The decrease in number of testing systems simplified overall test management (reduced LIS interface, process steps, instrument maintenance, reagent management, contract management) and reduced system footprints. A total of 361 square feet of laboratory space was saved equating to a 57% improvement over the baseline metric. After consolidating most of the testing to the two Phadia250 systems, the total daily manual time went from 4.2 h to just over 2.5 h. The combined workflow assessment resulted in saving a total of one full time employee (FTE).

Conclusion
To keep up with growing testing demands, laboratories must continue to produce high-quality results in an efficient manner. Test assay quality and utilization should also be evaluated when determining test consolidation options. Instrument consolidation is a viable strategy to save on technologist time, space and costs.This can result in not only economic savings to the laboratory, but also allows medical technologist to be funneled to other more needed areas of the laboratory, while saved space can be used for test expansion. In the climate of major medical technologist shortage nationwide, efficient workflows and productivity are important considerations to ensure the continued success of any laboratory.