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Slide#1
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I would like to show the size of our hospital first to help you understand
my presentation .
Showa University Hospital is one of the largest private university hospitals
in Japan which has 1,000 beds and about 3,000 outpatients a day.
And the number of staff is 7 pathologists ( 2 surgical and 5 clinical pathologists),
and 86 Technologists in our laboratory.
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Slide#2
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I reported the introduction of LAS showed in this slide in Labautomation
'99,San Diego last year.
And three years have passed since this LAS introduction .
This time I am going to report our experience of improvement related to
four Coulter Gen*S.
And I report the fruits of the LAS introduction from the experience of
our three-year operation. |
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Slide#3
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Although we got a certain result in terms of operation from this LAS introduction
,we had some hardware malfunctions.
Especially in the hematology line we had problems like
- mechanical trouble of IDS Gen*S connection unit
- Instability of Gen*S caused by the use of the special sampling point
,and by that its measurement result is even lower than the measurement
result of the normal sampling point .
-The delay of development of Coulter Slide-maker which were planned to
be used
At last we decided to replace IDS Gen*S connection unit and introduce Omron
Slide-maker. |
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Slide#4
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This is the first hematology line which we constructed.
We planned to connect a Coulter Slide-maker to four Gen*S.
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Slide#5
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This is just the photograph of the former Hematology line showed in the
last illustration.
Four Gen*S are connected to the transportation line. |
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Slide#6
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This slide explains the structure of the old type IDS Connection Unit.
The robotic arm of IDS Connection Unit grabs samples from A&T General
Connection Unit,and loads the extra sampling point at the lower part of
the Gen*S with samples.
After the measurement the robotic arm returns the samples to the rack of
A&T General Connection Unit. |
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Slide#7
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This is the slide of the IDS robotic arm.
In this IDS Connection Unit the robotic arm grabbed samples from A&T
General Connection Unit,and loaded the extra sampling point of the Gen*S
with samples. |
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Slide#8
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In this improvement ,as you can see in this illustration ,we connected
four Gen*S in series,and newly added Omron Slide-maker & Stainer at
the end of the line. |
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Slide#9
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This is the new Gen*S Connection Unit.
I think you can see the oblong box attached in the front of Gen*S ,although
I am afraid it is hard for you to recognize it . Because its color is the
same as that of the body of Gen*S. |
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Slide#10
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Different from the IDS Connection Unit ,in the new Connection Unit the
robotic arm removes samples from the 5-sample rack for transportation system
to the Coulter special rack at the place 1.
And the rack is sent to the usual rack set position of Gen*S(2).
After the measurement the rack is returned to the Connection Unit at 3,and
the samples are returned to the former rack for the transportation system
at 1.
Now that samples are sucked out of the usual sampling point of Gen*S, we
have come to be able to get more stable results. |
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Slide#11
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This is the action of the robotic arm in the new Connection Unit of A&T.
Different from the IDS Connection Unit ,in this new Connection Unit the
robotic arm removes samples from the 5-sample rack for transportation system
to the Coulter special rack.
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Slide#12
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With the removal of samples the small robotic arm is used in the same way.
But compared with the former type,stability has improved substantially
and the number of errors has decreased dramatically.
To say nothing of making samples without orders pass and making racks which
don't need to be analyzed pass ,this type has the function which makes
racks which were measured in the blood cell counting mode go around inside
the line of the Connection Unit and measures the same sample in the platelet
counting mode.
In addition ,the function that judges the measurement result and automatically
retest by the same action has been realized ,too.
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Slide#13
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Here I show you the comparative data between IDS Connection Unit and A&T
Connection Unit,GENSU-02.
As you can see,the number of repairs per month(Total of 4 Connection Units)
has been improved substantially.
Before the change,the number of repairs was 3 times per month in the IDS
Connection Units.
Compared with that,it decreased to 1.2 times in the new A&T Connection
Units.
And reliability and so on is also better in the A&T Connection Unit. |
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Slide#14
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This is Automatic Slide-maker by Omron.
This machine makes blood smears automatically.
As I mentioned,we planned to connect Coulter Slide-maker at first.
But due to delay of development of Coulter Slide-maker we connected this
Slide-maker&Stainer at the end of the line.
This machine can select whether to smear is needed or not,four kinds of
acceleration patterns,and select centrifugal smearing time from 0.1 to
9.9 seconds.
And this has a lot of selective items as showed in the slide.
Well,I show you the video! |
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Slide#15
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Of course,we can understand the hard luck of Coulter which started the
development of Gen*S before the spread of LAS very much,and we don't think
it’s fair to blame them only from one side.
However,through the experience of this improvement we were able to learn
that in analyzers which take no account of connection to transportation
system the unreasonable connection caused trouble,and analyzers which take
no account of connection to transportation system needed the unreasonable
and expensive connection method.
We managed to improve them,but I cannot help saying that it is totally
absurd.
I hope analyzers conform to NCCLS Standard.
Not closed system in which only one company's rack can be used, but open
standard is needed.
The outside sampling method can solve many problems,and it is possible
for us to add functions( like new retesting logic and so on). |
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Slide#16
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At the end of my presentation ,I would like to point out the concrete results
by a couple of slide.
Showa University Hospital is private university hospital different from
the national university.
So with the introduction of LAS there isn't financial support from the
nation at all.
Therefore we had to consider the introduction effect carefully. When we
evaluate the result from the three-year operation record ,LAS has improved
profitability of our laboratory a lot .
As you can see in this chart ,the price of LAS purchase is about $1.5 million
except for connected analyzers ,and this price can be said to be newly
invested amount except for the investment in analyzers which were introduced
before this LAS introduction .
As a matter of course,the largest portion of cost reduction is labor cost.
The number of reduced technologists is seven ,so suppose the labor cost
per person is $57,000 annually,we can recoup this investment in about four
years. |
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Slide#17
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As I show in this chart ,our laboratory tests nearly 20 thousands samples
a day.
We have been able to test about fifteen thousand among them by only 33
staffers by using the transportation system. We consider the labor-saving
effect by LAS is very high .
Incidentally,the redundant staff by LAS introduction were transferred to
other sections,and part of them retired.
We didn't fire them,so we have no problem between workers and employers. |
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Slide#18
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Furthermore,we got results which are shown in the screen other than reduction
of labor cost.
*We made the sample input process more efficient.
*We were able to make more efficient the front-end processing including
aliquot of daughter samples for analyzers which aren't connected to LAS.
*We abolished the emergency laboratory.This led to abolition of equipment
for emergency and its expensive reagents.
If we include cost reduction from these ,the time when we can recoup the
investment is shorter than I said before.
And with the introduction of this system we were able to make turnaround-time
for pretesting which has priority in operation substantially short to the
level of 30 minutes,and reduce the amount of blood collection .
Thinking of our three-year operation,we can say that investment in LAS
is very cost-effective and can improve the service quality of the laboratory.
Total Laboratory Automation including LIS(Laboratory Information System)
is worth investment. |
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Slide#19
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As Dr.Sasaki reported a little while ago,"Introduction of LAS which
focuses on profitability" has been realized in Japan.
As I mentioned,Showa University is the private university.
So we introduced LAS which focuses on profitability three years ago and
this introduction was successful.Investment in LAS pays well.
However,unless analyzer manufacturers and transportation equipment manufacturers
standardize their methods towards easy,sure,reasonable connection,users
are obliged to invest wasted money,and investment profitability will be
doubtful.
In Japan the course is gradually changing towards a world where profitability
is important,but even now there remains a tendency that laboratories are
proud of unreasonable connection of new analyzers.
So even now we see some introductions which think little of investment
profitability.
I hope from the bottom of my heart that all manufacturers conform to NCCLS
Standard.
And I believe the day will come when the open environment comes true and
we can connect analyzers to LAS at low cost.
Thank you very much! |
