Comparison of performance characteristics between first- and third-generation hematology systems.

In 1996, Barnes-Jewish Hospital introduced the first fully robotic hematology system in North America. This first-generation Coulter/IDS robotic automated system consisted of a series of transport lanes, inlet and outlet stations, 2 robotic arms, and an on-line slide maker/strainer. The success of the system and its exceptional performance was detailed in an article published in 1998. In 2004, our laboratory replaced this system with a new third-generation robotics system, the LH 1502 from Beckman Coulter, Inc. The new system consists of 2 LH 755 workcells (LH 750 plus slide maker/stainer), an inlet/outlet unit, and a stock-yard. The system has been interfaced to our laboratory computer system (Cerner Millieum) by customized software that allows auto-verification and testing rules to be applied to individual samples. Since its implementation in January 2005, we have monitored its performance characteristics relative to the previous first generation system. We report here on our findings through June 2005. We compared and contrasted the two systems with respects to the following parameters: (1) sample handling; (2) reduction in staff exposure to hazardous materials; (3) stat and routine turnaround times; (4) productivity; (5) reduction in backup testing; (6) operating costs; (7) payback; and (8) reduction in FTEs. We found that manual sample handling was virtually identical between the two systems. The LH 1502 holds a slight edge over our older system with respect to staff exposure mainly due to further reduction in manual backup testing. Stat TAT after introduction of the LH 1502 showed an additional 44% drop from 50 to 28 minutes, while the routine TAT was reduced by 23%, down from 61 to 47 minutes. Gains achieved in productivity after installation of the first-generation system were maintained with the LH 1502, with significant extra volume capacity yet to be utilized. The space required for operating the system was also reduced by nearly 49%. There was a 20.3% reduction in backup blood smears that required manual review (due primarily to the lower flagging rates for the LH versus STKS). The improvements in overall operating costs (> dollar 195,000) were also maintained. Payback was not considered since this was a replacement of our previous system, which had already eliminated more than 6 FTEs.