May 24, 2013 | Siemens is helping a Scottish hospital’s blood sciences laboratory meet the twin challenges of increasing demand and ever-tighter budgets. As the first hospital in northern Europe to adopt Aptio Automation, Ninewells hospital in Dundee is already reaping the rewards of being at the cutting edge.
Text: Ed Targett
Photos: Michelle McCarron
Nestled on the eastern coast of Scotland and bisected by rolling hills, the city of Dundee is home to Ninewells Hospital; the first in northern Europe to deploy Siemens Aptio Automation. The system is at the center of the hospital’s newly integrated blood sciences laboratory, which provides diagnostic services for the area’s 450,000 residents. The lab is run by NHS Tayside and conducts 5.9 million biochemistry tests, 850,000 hematology tests and 55,000 immunology tests each year, with demand growing at over five percent annually. The growing demand – resulting from an ageing patient population and protocol-driven increases in test volumes – has placed staff and equipment under increasing strain.
Starting to think smart
A review of laboratory services, headed by Joint Clinical Director of Diagnostics Dr. Bill Bartlett, left no doubt about the changes needed. And following a competitive tender, NHS Tayside put Siemens Aptio Automation at the heart of its reconfigured lab. “We're living in a changing environment in terms of delivery of healthcare,” said Dr. Bartlett. “Whether that is increasing workloads, new diagnostic technologies, or developments in IT. We really have to start to think smart, to use our resources more effectively. This is vital because if you compromise diagnostic testing in any way, you have a major impact elsewhere on the system.
By being able to provide a bigger repertoire of tests in a shorter period of time, we can actually increase the flow of patients through the acute receiving wards. Those are highly pressurized areas. If you are running out of beds there, the whole system bottlenecks.”
“Over 70 percent of the decisions made in healthcare around patients depend on the outputs of diagnostics. We need to find ways of increasing the effectiveness of that service – and we have a much smaller footprint to play with than we did 15 years ago.”
That shrinking footprint and NHS Tayside's growing demands for fiscal responsibility put increased pressure on lab services, typically considered as an expensive cost center: “We went into the review saying we wanted to look at how we could reduce waste and variation, so we could redirect ill-used resources into better-used resources,” Dr. Bartlett recalled. “There is an ethical imperative on us to reduce waste in a publicly-funded service. If we have the bulk workload delivered more efficiently by automated systems, it frees up time to focus on the quality aspects of the service at value-added levels.”
Designing the laboratory hand in hand
Stepping out of his office and donning a lab coat, Dr. Bartlett is an enthusiastic and erudite guide to the hospital’s newly designed laboratory.
He explains: “We get work in bursts here, as community surgeries work from 9 am to 6 pm with intermittent resulting delivery of large batches of work , and then we also get work from phlebotomy clinics and so on. In the past, we would have had people running around, but now it is a simple, calm process. Siemens looked at our processes, looked at what we were trying to achieve, then – working with our staff – they helped us design the laboratory. The aim was to get all this workload processed as efficiently as possible; minimizing wastage and ensuring that we got the information flows through correctly, as well.”
Speeding up the Patient’s Journey
The projected efficiency increase is not just a matter of abstract metrics for hospital staff. Picking up a test tube from a waiting rack, Dr. Bartlett glances quickly at its label: “Here, someone is going to have their thyroid function looked at, as well as their urea and electrolytes – which can give you a whole range of information.”
“Now, Terri here zaps the barcode, puts it into the Aptio rack, and off it goes. Every instrument within the laboratory now knows that there is a specimen coming in that requires specialist investigations. Every tube going around the track is a patient journey, and with Aptio Automation, we’ve started to get some insights into the speeds with which that journey can be achieved.”
Coming up next
Looking into the future, Bartlett continues, “It’s clear that when the system is fully configured, we can start thinking about moving away from classifying some samples as stat samples – which means they have to be managed faster – to saying, ‘well, the turnaround times on the system are such that [the samples] no longer need to be managed any differently. We are also about to undertake a project, looking at how we start building on the flexibility within the Aptio Automation system to redirect critical workloads and prioritise them, improving turnaround times for particular areas in the hospital.”
“As I said earlier, we have an acute receiving ward, the role of which is to triage patients and get a good idea of what’s going on with them. The faster we get our results, the faster we can redirect them to other parts of the organisation. We don’t want to be the people who cause the waits that distress patients.”
Ed Targett is a freelance journalist based in England. His news reports have been published and broadcast in a number of media outlets, including the BBC, the Daily Mail, South Korea's Yonhap News Agency, Yahoo! Asia, and others.