Joe Gardner, med tech III, Chemistry Laboratory, Memorial Medical Center, Springfield, Illinois (USA)

 

Memorial Medical Center is an acute-care hospital located in Springfield, Illinois (USA), licensed for 507 beds. The Chemistry Laboratory at this facility bills approximately 2.8 million chemistry tests per year—and like many busy laboratories its size, it relies on advanced instruments and software from Beckman Coulter to help streamline testing and shoulder the load.

The Quest for QC Process Improvement
Over the years, the Chemistry Laboratory has invested in a number of sophisticated diagnostic solutions from Beckman Coulter—with the goal to help the lab streamline processes, reduce the potential for errors, increase consistency and speed results. Among them: a Power Processor core automation system, two UniCel DxC 800 systems, two UniCel DxI 800 systems, an IMMAGE immunochemistry system and the DL2000 data manager, which consolidates and manages patient test information from multiple lab instruments onto a single workstation.

In March 2009, the lab increased efficiency when it upgraded its DL2000 data manager to the REMISOL Advance clinical information system with the optional Extended Quality Control (EQC) software application. The result? Additional benefits in the area of quality control process improvement.

Although the REMISOL Advance software already provides basic QC features to help ensure the accuracy of lab results, the optional EQC software application enhances quality control even further—enabling the lab to be even more confident in its results and to find instrument and control irregularities faster.

Automatic Shut-Off of Autoverification
For Memorial Medical Center, one of the primary selling features of EQC was its ability to choose an action when commercial controls drift. For example, EQC can cease autoverification when QC exceeds acceptable limits. Or it can cease loading new specimens for the failed test, which is particularly helpful for labs using broadcast download. These features help address inspection requirements and can have a positive effect on overall lab efficiency.

"It's important to have the most efficient mechanism possible to cease autoverification when there is a QC issue or when the patient mean shifts outside the norm," explained Joe Gardner, med tech III in the Chemistry Laboratory. "Although we have a highly trained staff that's alert to monitor these situations, we knew we could strengthen our processes with an automatic mechanism to make sure that autoverification is shut off in cases when a QC issue arises."

"Before, our staff members had always been ready to shut off the autoverification manually and to make the decision to cease loading that instrument," he said. "But we were always on the lookout for ways to improve our process."

EQC proved to be the solution to further improve their efficiencies.

"With this software now in place, we have an additional measure to document and validate our compliance," said Gardner. "It's very easy to demonstrate that when a QC issue arises, the software shuts off autoverification immediately. We have a mechanism that automatically dictates the automatic shut-off. This gives us an additional level of assurance and greater peace of mind."

Additional Benefits
With EQC, the lab can continually monitor its system stability by comparing commercial quality control data and patient statistical data. Plus, lab technologists have the ability to display or share results by printing reports, statistical data and a variety of in-depth, graphical charts.

"With the EQC charts, we now have the ability to overlay two—or all three—QC levels on a given analyte at once, which is quite nice," said Gardner. "We've got everything right there on one page, rather than on multiple charts. This makes it much easier to read and compare the data."

Exponentially Weighted Moving Average (EWMA)
Gardner discovered additional benefits with another new feature: EWMA.

Previously, when the lab had a QC failure that was attributed to something other than QC product, technologists had to check the patient results run on that particular instrument back to the time of the previous acceptable QC. With EWMA, however, they can now look at the moving average of patients and determine whether there really was an impact on patient results. In addition, they can pull up the series of patient results that went into the calculation for the moving average and the times of those measurements, so they can better determine exactly where the problem originated.

"This has been another significant advantage," said Gardner. "When this kind of situation occurs, we are able to better pinpoint exactly when the problem originated—and we only need to recheck a portion of the results rather than all of them. Checking fewer samples translates into time savings and greater lab efficiency overall."

"We had the DL 2000 software since 1999 and had been extremely happy with it all along," said Gardner. "It really improved our lab's management of patient data. Today, with REMISOL Advance and EQC, our improvements have only continued."

Beckman Coulter, the stylized logo, DxI, IMMAGE and UniCel are registered trademarks of Beckman Coulter, Inc. REMISOL Advance is a trademark of Normand-Info SAS.