an insight into middlemore hospital’s experience …an insight into middlemore hospital’s...
TRANSCRIPT
An insight into Middlemore Hospital’s experience with the Roche
C8100 Track System
1. The C8100 Front End
2. C8100 Track
3. C8000 - Line 1 and Line 2
4. Haematology XN Line
5. Coagulation Stago
6. P701 Fridge
CENTRIFUGEX2
INPUT BUFFER
DESTOPPER
OUTPUT BUFFER
ADD ON BUFFER
RESTOPPER
SAMPLE CHECK MODULE
BARCODE LABELLER
ALIQUOT MODULE
Connects all the analytical instruments from chemistry and haematology to the c8100.
Transport Junction Lines (TLJ) - The transport junction lines are responsible for carrying the single tube holders along this belt system.
Reformatter - Transfers racks of samples off the C8100 onto an analytical instrument.
ISE – C702 – C502 –E602 – E602
Two duplicate lines.
Connected to the c8100 track via a corresponding reformatter.
ISE MODULE CHEMISTRY
C702 +C502
IMMUNOASSAY E602 X2
Full blood Counts!
XN1,XN2, XN3SLIDE MAKERS
REFORMATTER
Completed primary samples are sent here for a seven day storage.
Test adds are also retrieved from here using a remote test add system.
1. Doctor requests an electronic order.
2. Order is created with a lab number.
3. Prints lab form with tube labels.
4. Blood collected and labelled.
5. Form barcode scanned – tests loaded.
6. Samples go on c8100 Input Buffer.
ACU –Centrifuge
SCM – Check volume and take picture
DSP – Remove the cap
TLJ –Transport line junction
BRF – Bi directional reformatter
C8000
E602 – Sample for TNT
ISE – Sample for Potassium
C702 – Sample for the serum
indices
Results go to IT3000.
Non-critical results means it will auto
validate.
Critical results will be checked by a validator.
RSF – New cap on.
AOB – Stored for 2 hours at
room temperature.
Fridge –Storage for disposal or waiting for next task.
1. Our TAT’s had taken a slight decline.
2. Belt breakage’s
3. Presenting or re-presenting samples back onto the
system post breakdown – would cause more breakdowns.
4. Labels on primary tubes not adhering adequately, which
would lead to sample spillages.
5. Separating sample types when loading into the IPB tray –
eg. Heparin Gels and EDTA tubes had to be put in a
different IPB tray – which decreases efficiency.
6. Urgent aliquots not being frozen.
84
86
88
90
92
94
96
98
100
Old Lab - May 2016 New Lab - Nov 2016 New Lab - Sep 2018
Month
Percentage of TNT tests completed within 60
minutes vs Month
Perc
enta
ge
84
86
88
90
92
94
96
98
100
Old Lab - May 2016 New Lab - Nov 2016 New Lab - Sep 2018
Month
Percentage of Potassium Tests Completed with
60 Minutes vs Month
Perc
enta
ge
SODIUMSODIUM
POTASSIUM
CHLORIDE
IT3000
(Middleware)
CHLORIDE
POTASSIUM
CLINICAL PORTAL FOR THE
CLINICIAN
Before
Normal
10 minutes
After
STAT
3 minutes
18
Minute
Assay
9
Minute
Assay
No separate aliquots
No carry over issue
Release result as G10000
MANUAL CENTRIFUGATION MANUAL FRONT LOADING
Secondary workflow configuration which isolates the
c8100 front end to continue performing its pre-
analytical tasks.
As long as nothing is broken on the c8100 front end we
can implement this configuration.
Spun, picture taken, volume checked.
Aliquots still made and sent to the output buffer
Samples are tracked.
Loading the completed samples directly into the fridge comes with a few minor issues.
Test adds will not always go directly to the analytical instrument.
Higher probability the fridge may crash. This means stopping, starting and troubleshooting.
A sample maybe loaded into the fridge which requires an aliquot, which have to be retrieved manually and actioned.
Add On Buffer overload.
• In this tray we can load any sample and it will go directly to the fridge.
• Any outstanding tests will be completed on the way.
• Any aliquots will be made if missed.
• Load with caps on or off.
• No AOB overload causing a back log of samples.
Aliquot’s to be urgently
frozen - the software
will play a tune to alert
staff.
All hardware issues are
logged, continually
monitored and
communicated. Increases
understanding of
hardware knowledge and
reduces breakdown time.
Fully customised our
fridge retrieval workflow
to ensure all our test
adds smoothly come out
of the fridge including
aliquots.
Investigated which
labels adhere the
best to prevent
breakdowns.
Created rules in IT3000
to deliver samples to the
Output Buffer which
have critical results to
be double checked.
The End.