Clinical Chemistry lab implements automation line to decrease test turnaround times

The UC Davis Health Clinical Chemistry laboratory simultaneously implemented several new analyzers and an automation line, retiring older platforms that have been in place since the opening of the Surgical and Emergency Services Pavilion.

The new automation line changes how all UC Davis Health chemistry specimens are received, processed and tested. The goal is to decrease test turnaround times while increasing test accuracy, precision and the efficiency of workflows.

“More than 70 percent of medical decisions are based on laboratory tests.  Having the latest, most accurate, and fastest automated system ensures that we provide the best information needed to care for patients,” said Dr. Lydia Pleotis Howell, professor and chair of the department of pathology and laboratory medicine. “This is what our community expects from the region’s only academic tertiary/quaternary medical center and UCDH’s clinical laboratory is proud to support this important role.”

The history behind this project is extensive, dating back to 2015 when the manufacturer of the system announced the new platform.

The Clinical Chemistry lab team said that over time, it became clear the existing system was not a solution for future needs. They then spent nearly two years working to identify a new system that would handle those needs.

The go-live is complex due to the sheer scale of testing performed by Clinical Chemistry.

Clinical Chemistry performs the most common tests ordered at the health system. On any given day, thousands of samples are processed and tested by the laboratory. The use of laboratory automation ensures many of these results are returned in less than an hour for the sickest patients. As seen in the COVID-19 pandemic, bringing up one test to detect SARS-CoV-2 was a significant effort. This new automation line required transitioning of over 90 tests and parameters from the legacy platforms as hundreds of samples with minimal disruption to patient care for the health system.

Pathology Specimen and Reporting Center (SARC), Clinical Chemistry lab staff, and Health System IT staff members were an integral part of this implementation. This project took five years to come to fruition and required laboratory, IT, and facilities to coordinate efforts to bring these new analyzers online.

All laboratory staff in these areas have been working far above their regularly scheduled shifts in order to have a smooth and successful transition. Additional staff have also been brought in to augment existing personnel, however, national laboratory shortages have limited the pool of potential hires.

“Our lab staff, specialists, managers, supervisors and directors have worked on this project since the planning phase in 2016. It is wonderful to see our new chemistry line in action and be able to provide high-quality lab results faster and more efficiently,” said Sabrina Okimura, department of pathology and laboratory medicine assistant director. “This would not be possible without the tremendous support of our IT, FD&C, and PO&M partners.”

In terms of the magnitude of difficulty this project entailed, director of pathology and laboratory medicine, Fabrizio Saraceni, said, “this was like changing an airplane engine midflight without crashing.”

“This chemistry line deployed over 90 tests/parameters at the same time, without stopping patient care in the middle of the pandemic,” added Dr. Nam Tran, department of pathology and laboratory medicine professor and senior director of clinical pathology. “Even this statement doesn’t fully capture the scale. I can’t overemphasize how complex this was.”

As the go-live winds down, the Clinical Chemistry team will begin to prepare for reconstruction of spaces occupied by the legacy automation line. This space will allow installation of a robotic refrigerator that will connect to the new automation line to provide hands-free storage of up to 27,000 patient samples, and laboratory real estate to expand other testing areas.