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| * Name of facility and titles are from the time of visit. |
Contents
I. Preface
The Fraternity Memorial Hospital was established as a foundation hospital
in 1924 with donation from the American Red Cross after the Great Kanto
Earthquake on September 1, 1923. Named in remembrance of the humanity of
the American people and their deep concern of the devastated victims, the
hospital began its operation in June, 1929. Although it was taken over
by the occupational army for 10 years after Japan was defeated in WWll,
it resumed providing medical care as a social welfare corporation in April,
1956.
 <The Fraternity Memorial Hospital>
Address: 2-1-11 Yokoami, Sumida ward
Tokyo 130-8587
TEL: 03-3625-6381
URL: http://www.doai.jp/
No. of Depts.: 16
No. of Beds: 427
No. of Staffs: 530
 Hospital specialties
ESWL (Extracorporeal Shock Wave Lithotriptern) was undertaken in their
urology department from the start, and endoscopic surgery is actively operated
in their orthopedic surgery department performing over 130 arthroscopic
surgeries a year mainly for sumo wrestlers and other athletes. In addition,
it established a nursing and convalescent ward providing 30 beds and built
a special nursing home, The Fraternity Memorial Home, containing 100 beds
in the same property to better serve the community and anticipate the needs
of the aging community.
II. Overview of clinical laboratory
Hospital Staff (As of Jan. 2007)
| Physicians (Lab. Director) |
2 |
| Medical Technologists |
28 |
| Contract Medical Technologists |
3 |
| Clerks |
2 |
| Photographic Engineer |
1 |
No. of Tests (2005)
| Urinalysis |
574,290 |
Serology, Blood Trans. |
75,219 |
| Hemato. |
450,777 |
Pathology |
12,635 |
| Biochem. |
1,149,204 |
Physiology |
52,273 |
| Microbio. |
29,298 |
Non business hr testing * |
14,632 |
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Total |
2,358,328 |
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| * For Jan. - March. April to Dec. are added to each dept. in Urinalysis - Physiology. |
| The Fraternity Memorial Hospital has been operating with our Laboratory
Information System, CLINILAN since 1994, and Laboratory Automation System
Open LA21 Module since May, 2006. Chief Technologist Mr. Okita told us
their reason for implementing the systems and the effects. |
III. Path to installation of LIS, LAS
Installation and update history
| Oct. 1994 |
: |
Installation of Laboratory Information System (LIS) CLINILAN Ver.7.5 |
| Dec. 2004 |
: |
Updated to LIS CLINILAN Ver.8 |
| Feb. 2005 |
: |
Order Entry System begins operation |
| May. 2006 |
: |
Installation of Laboratory Automation System (LAS) Open LA21 Module System (CLINILOG Ver.3) |
During the 10 years between the installation of CLINILAN Ver.7.5 in 1994
and the Order Entry System in 2005, we used FAX to report results. But
because we only had three fax machines, reports were delayed during rush
hours. In addition, since many additional orders were requested, we had
to communicate each time by telephone which was problematic.
By implementing the Order Entry System and linking it to CLINILAN Ver.8, we were able to decrease the amount of report paper used by terminating preparation of reports, improve quality control tasks, and have access to client data in real-time. We were able to solve problems we had all at once.
 Trigger for LAS installation
Although many issues were solved by the installation of the Order Entry
System, problems with operations of analyzers remained. Because analyzers
were operated separately on their own, we had to assign one clinical technologist
for each of the larger analyzers. The responsibility of each technologist
was limited to operating a specific analyzer which restricted their growth,
needless to say it was very inefficient. Most of the analyzers needed to
be upgraded so we considered the installation of the Open LA21 Module System
which connected all to a single line.
IV. Effects by the installation of LAS
Shortened reporting time and reduced cost
The central blood collection room is located on the second floor surrounded
by the outpatients and samples are sent to the laboratory on the forth
floor by a dedicated elevator immediately after blood is collected. Currently,
results are reported within 40 minutes after blood collection which is
much faster than before. Also, because the analyzers are connected to Open
LA21 Module System, consumables (tips, cups, etc.) are collected which
contributed to the reduction in cost.
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| Central blood collection room |
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Elevator dedicated to sample transfer |
Reconstructing staff assignment
We were able to reevaluate staff assignment and improve efficiency in operation
because several technologists are assigned to the single-line Open LA21
Module System reducing the burden on each technologist. Starting this April,
the staff in charge of biochemistry is being assigned to blood transfusion
department since blood collecting will be done only by a technologist without
a nurse. The clinical engineering technician who was trained and recently
assigned to a different department, had studied and acquired the certification
while keeping the job.
It has almost been a year since we installed LAS but I believe there is still room for improvement in staff assignment. The transferring of technicians from laboratory testing to physiological testing will be reevaluated so that the right people will be placed at the right jobs.
V. New approach and changes
Beginning of emergency testing during evening hours by LAS
Because our hospital is a designated hospital for emergency care including
hospitalization and surgery, we provide emergency testing during evening
hours (24 hours on weekends and holidays) with one staff assigned in the
evenings and two during day time on weekends and holidays.
Starting October, 2006, we started emergency testing with Open LA21 Module System even during evening hours. Operating 24 hours on the same system has enabled us to provide test results with the same quality regardless of the time.
Changes brought by appointment based patient examination
We began providing patient examination based on appointments starting November,
2006. In the past, tests ordered from wards and outpatients concentrated
in the morning. Now appointments are spread out throughout the day and
so are the test orders.
VI. Further improvement measures
I believed that LAS implementation could also play a big role in hospital
operations. So a proposal was made to the hospital regarding operations.
Evaluation of expanding corporate medical checkup business
More time is available now with the reduced daily tasks by the implementation
of LAS. So using that time available, business expansion would be the key
to hospital operations. As something that could be reasonably implemented,
I proposed expanding corporate medical checkup business.
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| Open LA21 Module System |
Opening up the clinical laboratory
While expanding the corporate medical checkup business, we plan to provide
new services such as offering information on tests and setting up a laboratory
tour for the examinees. Although physiological testing would not be shown,
we could show laboratory testing which would give patients an idea how
tests are conducted and results are obtained. Our goal is to open up the
laboratory and have more interaction with the clinical side by being able
to provide consultation when requested or collaborate on researches with
summarized and analyzed test data which would give our technologists more
opportunities.
VII. Goals in the future
Currently, our daily operations are performed with stabilized systems, LIS, Order Entry System, and LAS. Our top priority now is training of personnel corresponding to the changes in generation of clinical technologists. In opening up the laboratory, there is much to do: exchanging ideas with physicians, collaborating on research, conducing individual research, and submitting research papers. In surviving the difficult times in the medical environment, technicians will be demanded to think what improvements would contribute to cost reduction and efficiency in daily operation. As a clinical laboratory, we will continue to propose business expansion ideas, plan projects that would help patients better understand about testing, and contribute to hospital operation as well as higher satisfaction from patients.
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| Chief Technologist Okita |
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Laboratory Staff |
We thank Chief Technologist Okita and all staff at The Fraternity Memorial
Hospital for their cooperation and support.
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