Unexpected findings

July 2007
Feature Story

Anne Paxton

Urinalysis automation has been around for more than 25 years. But until recently, it basically consisted of stick readers or photo-optical systems that would read color changes in a chemical strip that was manually dipped into a urine, says Diane Berry, MS, CLS, MT/ SH(ASCP).

When Iris Diagnostics came up with the iQ200 automated urinalysis system, which included a physical bridge that married the manual microscopy part with the machine that did the dipping and transferred the rack of urine tubes between them, “we felt that was complete automation.” The key benefit: “Simply not having to take the tubes from one machine and physically put them on a second machine frees up people to do something else.”

But when Berry did a study of turnaround time to calculate the impact of complete automation, she was surprised. “Because we were able to hasten the turnaround time for urinalysis, people got CBCs and bone marrow stats faster than before.”

When comparing the number of tests that are resulted at 30, 45, and 60 minutes, Berry found post-implementation improvements for urinalysis of 30 percent at 30 minutes, nine percent at 45 minutes, and 3.2 percent at 60 minutes. But those weren’t the most remarkable gains. The urinalysis staff also handled hematology duties, and the post-implementation improvement for CBCs was 44 percent at 30 minutes, 22 percent at 45 minutes, and eight percent at 60 minutes.

“We weren’t expecting that all of a sudden our CBCs would have this phenomenal improvement. We thought, well, this is a fluke, and we tried to think what in hematology was being done differently, and we had changed absolutely nothing except the way we did urines.”

By looking at variables like that, it is fairly easy to make the case that an automated urinalysis system pays for itself, she says. “You can’t just look at costs per test as lots of laboratories do when they look at automation. Usually a patient comes into the emergency room and gets a CBC, a urine, and a basic chemistry profile. If those results are delayed, the process of getting the patient through the ER has an extremely high cost per minute.” And it’s there that automation helps, not only because the urine result is produced faster, but also because no matter which department the machine is placed in, the staff will to be freed up to do other work.

Anne Paxton is a writer in Seattle.