Brian Kuluris, regional application specialist for Roche Diagnostics, prepares to demonstrate how the company's Cobas P 501 post-analytical unit processes test tubes following a ribbon-cutting ceremony Tuesday at St. Charles Medical Center. The unit can store 13,500 test tubes.

The St. Charles Health System on Tuesday held a ribbon-cutting ceremony — not for a new facility, but for a new set of machines in the laboratory in its Bend hospital.

The lab’s new equipment, which cost the not-for-profit company $1.5 million, will increase staff efficiency, decrease exposure to pathogens, drop processing times and cut down further on human error, said Chuck Huggins, its technical supervisor. The quicker turnaround times also aid doctors and patients at other facilities for which the lab does analyses, Huggins said.

Besides St. Charles, other hospitals around the country, especially bigger ones, have added technology that automates some parts of laboratory work in recent years, Huggins said.

“Is automation the solution to the workforce shortage? I believe that automation is not the solution but, rather, one important component of a strategy that includes everything from streamlining processes to employee satisfaction programs,” wrote M. Sue Zaleski, clinical pathology laboratory manager of the core laboratory at the University of Iowa Hospitals and Clinics in Iowa City, Iowa, in the July 2011 issue of the journal Medical Laboratory Observer. Zaleski is also the incoming chair of the American Society of Clinical Pathology’s council of laboratory professionals.

More locally, a Roche system with automating abilities has been in the laboratory at Salem Hospital since 2007, said Julie Howard, spokeswoman for Salem Health, which operates the hospital.

“It has offered us higher-quality results, less opportunity for human error, so that translates to better patient safety,” Howard said. “We can do more with fewer people.”

According to a St. Charles news release, when the transition is complete, the health system will be the first in the United States to configure the equipment in the way it plans to. The physical coupling of preprocessing devices for samples in test tubes and a new storage unit for the tubes, recently approved by the U.S. Food and Drug Administration, is the major distinguishing feature, Huggins said.

For Huggins and his colleagues, the degree of automation means a whole lot of adjustment.

“This is a huge change in the way we’re doing things here,” Huggins said.

St. Charles started looking for the right technology to replace the aging analyzers in its lab about three years ago. Additionally, the average age of lab scientists was rising, and the number of lab professional candidates was decreasing, because there are fewer and fewer training programs for such employees, Huggins said. St. Charles officials decided to invest in extra equipment to bring further automation to the lab, he said.

The health system invited four companies to make presentations of their offerings, including Switzerland-based Roche. On Tuesday, several executives from the American branch of Roche, headquartered in Indianapolis, were on hand for the ribbon-cutting ceremony.

The new automation is allowing some staffers to switch to other areas in the lab that cannot be automated, such as microbiology, Huggins said.

A speedier process

Although streamlined, the new system deals with the same basic material as the old: blood.

A pair of machines in the first segment of equipment in the lab separates blood into two separate components with centrifuges. Blood, Huggins said, is “a slurry of plasma and cells.” The lab scientists are interested in the liquid plasma, not the solid cells, Huggins said.

In the previous arrangement, lab technicians or assistants uncapped and capped test tubes during the process of preparing samples for storage and analysis. They carried racks of tubes into a walk-in refrigerator in the lab. And there were more analyzers, with dedicated functions, requiring staff to switch samples from one machine to another.

The new system speeds up the process, while reducing the risk of carpal tunnel syndrome for technicians, with a component that takes the caps off test tubes.

“When you talk about 2,000 tubes a day, … even if you’re only spending 15 or 20 seconds apiece, it’s a lot of time,” Huggins said.

A mechanical arm sticks pipettes in the open tubes, takes miniscule portions of the samples to analyze and drops the portions in small cups. The test tubes holding the remainder of the samples get capped again and forwarded down the line, to be passed to tall storage refrigerators nearby.

With everything moving quickly, Huggins said, “this takes all the sitting steps out of the process.”

The automatic delivery of samples from the preprocessing machines to the storage area has yet to be brought online. Workers are still delivering the capped samples to the refrigerators by hand. Huggins said he expects software to allow the connection to become automatic later this week or next week, eliminating the need for those extra human steps. Everything else has been in place in the lab for about two months, he said.

A device beside the new refrigerators scans the height of the tubes to make sure they’re capped before they enter the refrigerator. Metallic arms pick up and drop off groups of tubes, and employees can observe most of the operations through windows on the machines.

Less time with tubes

Several machines in the third group perform tests for various chemicals in plasma, such as troponin, which can lead to heart failure, and glucose and calcium. Scientists are still an important factor in this portion of the lab work, because they look out for abnormalities, which could signal problems for patients. But the new set of equipment allows for shorter analysis times, which can prove crucial in emergencies.

“Ninety-five percent of (turnaround time) was on target before, but we’re getting more and more consistency now, so we have improved it,” Huggins said.

Drawing smaller sizes of the original samples for analysis with the new equipment means having enough to run tests again should there be problems the first time around, he said.

Plus, the new system keeps workers better guarded from samples, with less human contact and more robotic work.

“It’s all about reducing the number of times the person has to touch the tube,” Huggins said.