Let go of the tube!

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Let go of the tube

For most laboratorians, a patient specimen, no matter what type, represents the actual patient to us. We have a deep and personal relationship with each and every specimen. We know that the care and treatment of the patient is attached to that specimen. As lab techs, we have been known to bond with specimens – carry racks of tubes to our work areas and re-sort & alphabetize as we get to know them. We often carry them around in our lab coats to remind us of what we need to do with them.  This depth of attachment to the specimen also extends to every result from the instrument – as we lovingly review each and every result – to 1000’s of results per shift.

This personal handling of each and every specimen from receipt to final disposition of the result is a noble goal. Yet in today’s busy laboratories physician specimen handling is becoming impractical. Hands-on tube handling is much slower than we imagine especially when we try to marry the tube with the print-outs and worksheets or try to apply our own processing logic when reviewing batches of patient results without a standard set of rules.

How can we continue to give the care and attention we believe our specimens require while minimizing physical specimen handling? Lab techs can make the shift from physical management of specimens to a virtual environment model. Lab automation can be fully scaled to load specimen on analyzer, result assessment into positive and negative categories and post-processing for storage and archiving. Carefully planned IT solutions can easily replace manual paper. If lab techs can be persuaded to convert their paper-based processes to IT, they will gain an added benefit: standardization process across all lab techs at all locations. The logic behind the review of results can be programmatically represented into auto-verification and processing rules to fully apply standardization for result qualification.

The paper chase

Our proclivity to manage the physical sample in the clinical lab is often tied to the use of paper. In many labs without result verification technology, we compare the instrument printouts with the results in the LIS or match the hematology slide with the instrument print out for reference as we perform a manual differential. We organize our samples according to worksheets and sometimes even tape notes to our sample tubes as they move between work areas. The loss of information on paper is often vital data that does not get transferred into the electronic systems.

The challenge in some laboratories is a lack of acceptance by technologists to trust the transfer of data from the instrument to their IT systems (LIS, middleware, etc.) such as the ability of these systems to accept free text and unstructured notes. In addition, some laboratories are not planning their budgets around fully digitizing data retrieval and providing technologies that can assist and guide the technologist to take actions using systematic review criteria. The default process and loyalty are still to record data manually from paper into the system of record. As we know, manual data entry of any kind invites human error, prevents true process standardization and inhibits the laboratory’s ability to adapt to increases in volume without adding more people resources.

Ban the sticky note

If paper is the drag on laboratory efficiency, then sticky notes are the enemy of lab standardization and process control. Most labs almost without exception, post sticky notes on the PC workstations for result review – notes to remember who needs to be notified, customized critical ranges by location or patient specific instructions. The notes once posted remain and their relevance fade over time as lab policies change. In the current environment, the sticky note process cannot keep up with the speed of change. There are no economies of scale using paper and notes to keep the technologist abreast of clinical best practices and policies.

The challenges of change

Why don’t laboratories move from the manual review of results one by one to virtual data processing using rules processing? If the benefits of eliminating paper and implementing technology to manage samples and results is so great, why is the transition to a paperless environment not happening in the 50% of labs that don’t employ some form of technology?

First – technologists are often resistant to change. They hold an underlying fear that technologies that automate and change the traditional processes will eventually replace people. Techs feel in control of their environment if they can move samples around and review results using their own internal logic and knowledge. Secondly – techs use what is available to them with the current technologies such as manual worksheets and paper lists. The impetus to change usually is not a motivating factor when there is a perceived fear that automation will change the status quo.

Inspire you.

Find out where your gaps are in handling specimens and paper for result review. Take our self-assessment to start the process of identifying areas of improvement to challenge yourself to change.     

Replacing paper with technology

The move towards more automation breeds fear that the automation will take people’s jobs and replace their expertise.  But in reality, many technologists would like to be relieved of manual and monotonous tasks such as reviewing 90% of normal results. The use of predictive algorithms such as auto-verification, automated calculations, specimen tracking and archiving technologies actually helps labs make better decisions and frees up time for higher rewarding tasks in the lab. There is no more time to spend on paper-based processes anymore.

Labs that continue to push these paper-based processes, actually incur costs for their complacency. The data written on instrument print-outs, worksheets with unstructured notes and calculations performed off-line create, ‘blind-spot’s in the lab. These omissions of data into the electronic systems create risk of not complying to standardized processes, regulatory requirements and best practices.

Impact to you.

Don’t fall behind any further in the digital divide. Focus on key areas from your Result Review Self Assessment that can be automated to eliminate manual and paper-based systems.

Let’s get talking.

What challenges are you facing with manual result review?