Impact on microbiology laboratory turnaround times following process improvements and total laboratory automation

Abstract

Introduction: The impact of workflow changes and total laboratory automation (TLA) on microbiology culture processing time was evaluated in an academic-affiliated regional hospital. Materials and Methods: A retrospective analysis of microbiological data in a research database was performed to compare turnaround time (TAT) for organism identification (ID) before and after implementation of TLA (2013 versus 2016, respectively). TAT was compared using chi-squared test for categorical variables and log-transformed t-test for continuous variables. Results: A total of 9,351 pre-defined common and clinically important positive mono-bacterial culture results were included in the analysis. Shorter TAT (hours) in 2016 compared to 2013 (p<0.0001) for positive result pathogen ID were observed in specimen types including blood (40.7 vs. 47.1), urine (30 vs 44), wound (39.6 vs. 60.2), respiratory (47.7 vs. 67), and all specimen types, combined (43.3 vs. 56.8). Although shorter TAT were not observed from all specimen categories for negative result pathogen ID, TAT for all specimen types, combined, was shorter (p<0.001) in 2016 compared to 2013 (94 vs. 101). Conclusions: Total laboratory automation and workflow changes-including process standardization-facilitate shorter organism ID TAT across specimen sources.

Automation of plate inoculation and reading reduces process time in the clinical microbiology laboratory, compared to a manual workflow

“…However, successful implementation of laboratory automation requires thorough assessment and appropriate refinement of laboratory workflow practices that might impact system efficiency. 10, 12, 13, 29, 30 This study provides a comprehensive evaluation of the time and steps required with a modular Kiestra-enabled automation workflow in comparison with manual processes. Utilization of the Kiestra automation system (InoqulA and ReadA) led to 88% fewer media plate touches, 85% less HOT, and 69% less TTT.…”

“…10,11 To address these and other common problems encountered in the clinical laboratory, automation can be employed to streamline and standardize laboratory workflows. Several studies have shown improved laboratory workflow efficiency, 3-5, 10, 12-16 result reproducibility, 4,5,13,[15][16][17][18][19] and decreased incidence of errors 10,13,[18][19][20][21] following the implementation of automation-related processes.…”

“…Several studies have shown the benefits of implementing Kiestra automation systems in clinical microbiology laboratories, including shortening workflow time and optimizing result quality. 13,14,18,19,22,[24][25][26] This report describes a step-wise utilization of automated inoculation, incubation, and imaging modules, in a simulated clinical laboratory environment, in order to streamline workflow processes. Here, we recorded each workflow step (plate setup, inoculation, and reading) and timing for plates that were processed manually, compared to the same number and types of plates that were processed via Kiestra automated modules: InoqulA (BD product number: 446973) for inoculation, ReadA (BD product number: 446948) for incubation and imaging, and Synapsys (BD product number: 444158) for digital image reading.…”

“…Several studies have shown the benefits of implementing Kiestra automation systems in clinical microbiology laboratories, including shortening workflow time and optimizing result quality. 13, 14, 18, 19, 22, 24-26…”