The Kurashiki Central Hospital, established by the President of the KURABO Industrial, Magosaburo Ohara, in 1923. Even after 80 years, it has kept its concept of "Patient Oriented", "Bright Hospital" and "Most Ideal Hospital in Asia" and the idealistic and humanistic attitude that are the base of the hospital management. Their accreditation by the Japan Council for Quality Health Care was restated in 2003 and reassessed as a "high quality hospital".

<Kurashiki Central Hospital>
Address: 1-1-1, Miwa, Kurashiki-shi, Okayama
710-8602
TEL: 086-422-0210
Website: http://www.kchnet.or.jp/
No. of Dept.: 27
No. of Beds: 1,116
No. of Staff: 1,929

Vice Chief Technologist Kanemitsu:
Automation and Efficiency
In 2002, we received over 9,700,000 test orders but a little less in 2003, probably due to the fact that doctors took DPC (Diagnosis Procedure Combination) in consideration when making test orders. We prioritize speed and accuracy when testing a large number of samples. In August 2003, LAS was installed in the chemical and serum divisions to automate some works for efficiency. On the other hand, outsourcing is not used for some manual tests requesting promptness though efficiency decreases. The reason is that even if it may cause some problems with efficiency, it is more beneficial to both the hospital and the patient because swift test results can allow treatment to start sooner and shorten the term of hospitalization.We plan to effectively utilize the extra human power produced by the automation and systematization for the next development.

Collaboration with Doctors
We do our best to meet the needs and requests of the doctors. When changing analyzers, reagents or methods, the doctors check and approve the review data before consultation with the Laboratory Committee. We receive requests to cooperate on clinical trials and/or studies, and answer questions on data that do not reflect patient's clinical condition by performing supplementary examinations. Through these processes, our relationship with the doctors is strengthened and which helps our laboratory develop.

Blood Collection Room for Outpatients
500-600 patients visit the room daily. The blood collection room is designed in pink-based colors which produces a bright and comfortable atmosphere. The room is equipped with 8 tables and 2 vessel preparation systems.

Primary Tube Preparation for Wards
A primary tube preparation instrument placed near samples are received is used for preparation for the wards. Due to the ordering system, the primary tubes to be used the following day is bar-coded and handed out.

Sample Reception
Samples are delivered by SIMACOM or manually by hand to sample reception. Centrifuge is performed at all times and inserted to LAS which allows swift reporting of results.

A&T's LAS (CLINILOG Ver.2) was installed in August 2003.
Since any delay in reporting time, even for a minute, would be allowed after installation, detailed and thorough discussions and examinations were held many times.
Because we held such meetings and had plenty of time for preparation, the system has been stable without any major problems.

Starting & De-capping
Two starting units are prepared for large amounts of sample: one is for samples and the other is for daughter racks. Each has a de-capping unit.

Online Aliquot
2 units are set parallel to each other to obtain maximum throughput.

Offline Aliquot
Considering the destination of the tested samples, the unit is set in a layout where samples end up near the inserting point.

Clinical Chemistry · Immunology Serum
Two H7600-210 and two newly constructed ARCHITECT i2000 are connected. Both test items included in pre-examination testing, which requires prompt reporting of results, which is realized by the function that automatically distributes the loads on each analyzer, increasing total efficiency. Moreover, since emergency samples can pass through normal samples, the system works in a way where the TAT is less apt to be long even when the line is full.

H7600-210	ARCHITECT i2000

Blood Examination (Offline)
In addition to the conventional HST system, the implementation of the smaller scale sample transportation system with Retic items of XE, enhanced the back up function and shortend the TAT in the hematology department.

LIS (CLINILAN) has been working in the sections of sample testing, bacteriology, general and blood banking since August 2003. Since HIS and LIS can be controlled on the same PC, it has helped decrease the number of PCs. Regarding information systems considered to be implemented, we are examining the installation of a system for outside office hours and medicine control related to blood transfusion.

LIS (Note: Displays on the left side are LAS terminals)

For Patients
The explanatory leaflet about how to read the result data is provided. The content is an easy-to-read general information of typical test items described with illustrations. It is very well received that there are requests for a sequential issue.
For in-hospital
*Guide to Clinical Testing - Note type general guidance in testing done at our hospital is distributed. Since printed materials are not suitable in keeping up with new information, a webified LI information system was constructed in cooperation with the information system department. In the future, we plan to provide all up-to-date information on the intra network system.
*Labmail - Information media issued on a regular basis by our laboratory. We select timely issues that we find may be helpful and interesting for the readers.
*Laboratory News (official document) - Information on details of test contents, assay methods, instruments and changes made in reagents are provided.

Vice Chief Technologist Kanemitsu:
61 out of 110 technologists are also involved in other jobs with other departments and also actively attend the committee meetings in the hospital.

Department	No.	Type	Remarks
Total Health Care Center	6	Dedicated	Sample testing, EKG, Ultrasound
Blood Care Center	5(1)	Dedicated	Blood test, Blood transfusion, Radiation
In-vitro Ballast Care Center	4	Dedicated	Ballast, Echo, Balance function, Prostate biopsy assistant
Dialysis Center	2	Dedicated	Clinical engineering technologists
Cardiac Disease Center	10		Clinical engineering technologists 24 hour operations Cardiac catheter Pump-oxygenator
2nd physiology	5		Electroencephalography, Venter Ultrasound
Blood Collection	12(5)
Wards	5		POCT, Blood collection
CRC	1	Dedicated
In vitro Fertilization	2	Dedicated
Infection Control	2
ICT	3
Diabetes Classes	4		2 wk course (classes held everyday) Lab techs attend once / 2wks
Total	61(6)

Vice Chief Technologist Kanemitsu:
It is said that present one year is equivalent to ten years of old days. The founder Mr. Magosaburo Ohara spoken at the 10th anniversary that "I praise your effort for these past 10 years. But at a time where changes are drastic, keeping present standing is equivalent to retreat. I would like the hospital to improve continuously at all times". The message is still vivid even after 70 years. We would like to keep our minds innovated and continue to be the laboratory that satisfies all patients.

Director Kageoka: With the aim of constructing LAS and LIS which would handle the overcrowding work, through well-thought-out evaluation of simulations by our technologist in charge and A&T, and the overcoming of the demands for improvement, the new systems were installed and have been operating smoothly. Although operations have improved, our next step is to enhance testing information service and security management and improve our system. As the future role of laboratories is to provide service that is beyond that of the conventional, it is necessary to actively be involved in such advancement where technologists assigned to sample testing as well as those assigned to physiological testing work closer with patients. That is to say, it is important that we provide humane service to other departments of within the hospital and patients. With such vision in mind, we will strive to become a laboratory, flexible with a challenging mind.

Director: Kageoka, MD

Opinion Box 27 boxes are placed to gather patients' opinions to better our hospital. The contents of the letters and details of measures taken or changes made are published on the bulletin board, PR magazine "K News" for patients, and on our homepage.

Ohara Memorial Hall	Waiting Room -Pediatrics-	Green House
Tropical Fish	Garden of Medical Information	Central Parlor

Special thanks to Director Kageoka M.D., Vice Chief of Technologist Kanemitsu, and the laboratory staff of Kurashiki Central Hospital.

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