News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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New Use for Existing Lab Technology Wins UK Technology Award

Here’s another example of taking existing laboratory technology and applying it in a new way. A scientist at Queen’s University Belfast in the United Kingdom is using an existing technology to create what he describes as “intelligent molecules,” capable of identifying tags in human cells that could signal the presence of organisms common in an epidemic. They also could be use to track infections in a population and identify patients who would be vulnerable to certain infections.

This new application of existing technology earned A. Prasanna de Silva, Ph.D., Professor and Chair of Organic Chemistry at Queen’s University, the 2008 Royal Society of Chemistry’s Sensors Award, sponsored by GE Healthcare. The award is given biannually for chemical input into the design of novel sensors or novel applications of existing sensors.

The technology incorporates fluorescent “catch and tell” sensors that emit light signals when they catch chemicals in the blood. It is familiar technology to most laboratories, as it is incorporated into in blood diagnostic cassettes sold worldwide. Hospitals, ambulances, veterinarians, and others use this fluorescent sensor technology to monitor blood for levels of common salt components such as sodium, potassium, and calcium.

The worldwide market for this type of blood diagnostic cassettes totals $50 million. Roche Diagnostics Inc. uses the fluorescent sensor technology in the chemistry module of the OPTI point-of-care blood analyzer, a module that has produced worldwide sales of $39 million.

Using an extension of the same design, de Silva has developed molecules that act as ‘logic gates,’ which are similar to the mechanisms in computers. De Silva and colleagues at Queen’s University are using these molecular logic gates as identification tags for objects the size of biological cells.

The new application could be used in a variety of clinical and other settings, de Silva said. “One such use could be as an ID tag for cells in an epidemic, such as a bird-flu outbreak,” he explained. “From a population, our sensor molecules could help track infection and highlight vulnerable people. Another one is a ‘lab-on-a-molecule’ system which combines several lab tests with a rudimentary diagnosis without human intervention.”

This example demonstrates how advances in science, combined with the ongoing ability to continually shrink the size of diagnostic analyzers, will package long-established and familiar diagnostic technologies in new ways. It is a reminder that, outside today’s clinical laboratory, large numbers of research projects and biotech companies are rapidly developing new assays. It is one reason why laboratory medicine is almost overwhelmed by the daily and weekly stream of press releases and product launches for new biomarkers and new laboratory tests.

Related Information:
New ‘Catch-And-Tell’ Molecules Designed By Queen’s Chemist

New ‘Catch-and-tell’ Molecules Send Out Light Signals When They Catch Chemicals In Blood

Swedish Hospital Uses Lean to Advance Patient Care and Lab Services

With the theme of a “Lean Laboratory Supporting Lean Healthcare,” attendees at Lab Quality Confab this morning in Atlanta, Georgia, heard the remarkable story of Stockholm, Sweden-based St. Göran Hospital’s  Lean journey to improved clinical outcomes and better customer service for its patients. This 250-bed hospital serves 21,000 inpatients and 200,000 outpatients annually.

This story had added intrigue because it is healthcare delivered to the public in Sweden’s single-payer health system, provided by a privately-owned hospital! St. Göran Hospital is owned by Capio, a for-profit company that provides hospital, radiology, laboratory, and other healthcare services in eight European countries. Thus, it demonstrates how private sector Lean-based innovation and execution is advancing patient care in Sweden. In fact, St. Göran Hospital was sold to Capio by the Swedish health system at the beginning of this decade specifically to be a demonstration site to show other healthcare providers in Sweden how private sector initiative could produce innovation that improves the quality of care while lowering the cost of care.

In his presentation at Lab Quality Confab this morning, Tom M. Pettersson, Ph.D., Head of Development, for Capio Diagnostics/Unilabs at St. Görans Hospital, shared how Lean methods are being used to boost performance in each of the clinical departments, which then do inter-disciplinary Lean improvement projects as integrated teams. Step one, earlier this decade, was to make over the laboratory with an exhaustive application of Lean methods and principles. During this phase, process-ordered production was instituted throughout the laboratory, along with targeted automation solutions. At the same time, staffing was reorganized and laboratory staff satisfaction became a regularly measured attribute. The result was a significant contribution to clinical care through shortened turnaround times, improved quality, and significant reductions in errors.

But what captured the audience’s attention was Pettersson’s fascinating explanation of how, at the next phase, laboratory services played a role in improving work processes in the primary care and inpatient care continuums. Again, Lean methods and techniques were used to realign processes to respond to the voice of the customer while improving outcomes. Pettersson spoke at length about how this was accomplished in the Emergency Department (ED), in a project originally launched in 2005.

Lean techniques were used to address five targeted problems in the ED:

1.   We do too few things in parallel-this increases waiting time and reduces value.

2.   The best competences examine too few patients and that too late.

3.   Lack of coordination and routines.

4.   Working hours of doctors not synchronized with patient flows.

5.   There is much distractions and waste (Muda) in doctors’ work

These problems are common to emergency departments in hospitals in this country. What distinguishes the ED at St. Goran’s Hospital from most of their American hospital peers is how the use of Lean methods has improved the performance of its emergency department. Pettersson explained how the following six Lean approaches were utilized to change work flow through the ED, with impressive gains in patient throughput, outcomes, and reduced costs:

1.   Link activities-to recognize problems early.

2.   Activities in parallel-to gain time.

3.   Pull-next step in chain is prepared to receive the patient.

4.   Visualize-everyone sees what must be done.

5.   Takting (takt time) the flow-improve the working environment.

6.   Standardize-that we can see problems to solve (waste to eliminate).

What captured the audience’s attention was the range of solutions that were inspired by use of these Lean methods. For example, like most hospitals, C discharged the vast majority of its patients daily during the late morning and early afternoon-a batch mindset that has been changed. Now the hospital has a continuous flow of patients into and out of wards across the day and the evening. This has helped the emergency department move patients more effectively from presentation to treatment and either discharge or admit.

This is just one example of how Lean-inspired thinking lead to an unorthodox, but highly-effective solution to a problem common in most hospitals across the globe. That’s been the theme in presentations this morning, which included the laboratory profession’s first public look at the “smart room” developed at University of Pittsburgh (UPMC) . There will be more to come on events unfolding at this week’s Lab Quality Confab.


Robert Michel
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