Effective utilisation of automation on the urine bench

Serious, widespread problems exist in the quality of pathology services: too many patients are exposed to the risks of unnecessary errors and inefficient processes. Advanced practitioners of industrial-quality management, like Motorola and General Electric, have committed themselves to reducing the frequency of defects in their business processes to fewer than 3.4 per million, a strategy known as Six Sigma Quality. In healthcare, quality problems frequently occur at rates of 20–50%, or 200,000–500,000 per million. The best tool for improvement is the Lean Six Sigma concept which reaps the full benefits of automation.

So, why has healthcare in general been slow to adopt these proven methodologies? They help to identify inefficiencies, uncover opportunities to free capacity, reduce turnaround time, lower costs and ensure the best outcomes. This is even more pertinent to pathology because of the inherent need for statistical precision and quality control, a high degree of automation, as well as the highly repetitive nature of laboratory work, which lends itself to Lean and Six Sigma methodologies.

The times they are changing
Microbiology has seen some of the fastest changes over the past 10 years with regard to automation and new technologies. Urine automation is quite widespread throughout the UK; however, the transition to primary tube sampling for urines has fallen behind. Wexham Park Hospital, now part of the Frimley Health NHS Foundation Trust, serves a wide area of Berkshire from its base in Slough. The Infectious Disease Department at Wexham processes around 450,000 samples a year, received from surrounding hospitals and GPs. Over the past few years the department has undergone a programme of automation, taking into account workflow, turnaround times and Lean Six Sigma processing principles. One area which has seen considerable change is the urine bench.