Automate with Experience. Get Results.

Automate with Experience. Get Results.
 
Contact Us

With strong project management and practiced coordination, there is a large team of Siemens Healthineers experts working behind the scenes for our customers. Gain insight from the Lean experts, sales consultants, workload analysts, design engineers, and technical applications and field support specialists who contributed to our more than 1600* total laboratory automation projects. Siemens Healthineers turns collective experience into individualized guidance.


Which part of the automation process takes the most time?

In my experience, the phase between the initial installation and the final handover to routine operation can last 3–6 months and sometimes longer. More specifically, the stabilization and optimization activities that take place between a defined training period and a discrete handover deadline are typically the most difficult to predict. During this period, new processes and operating procedures start to take hold, as previously independent diagnostic empires begin to function as a holistic team leveraging a common transport and centralized data-management system. Siemens field service personnel and technical application specialists, who will support the site going forward, join the team. In addition to implementing fairly straightforward technical refinements to improve performance of the automation system, we frequently see human and process issues that were not visible when the automated laboratory was still theoretical. When this happens, the Siemens Healthcare Consulting Services team will help the customer organize rapid-improvement events and employ other Lean process strategies to better optimize overall laboratory operations. Although it can take time and be a bit unpredictable, the laboratory director and staff improve their change-management skills and are better equipped to drive for continuous improvements in their operation long after this discrete automation project has been completed.


--- Stan B., Senior Manager, HCS, ~12 years at Siemens



Is automation more challenging the first time or for next-generation expansion?

Both have challenges, but they tend to be different. For instance, during the implementation phase, a second- or third-generation project tends to require more planning and training to enable staff to temporarily adopt manual, stand-alone lab operations while the old track is dismantled and the new system is installed. This can be especially challenging when a site has been automated for a long time and the staff has limited experience in a nonautomated environment. Once the new track is up and running, however, adapting to a different automation and IT system tends to be comparatively fast. In contrast, laboratories automating for the first time do not experience the same degree of operational disruption when the new system is being installed and tested. However, more time and training may be needed during the post-implementation phase as the staff learns brand-new operating procedures and gets familiar with centralized data-management tools.


---Margaret P., Senior Manager HCS Training and Quality, ~15 years at Siemens



What is the ideal room temperature for an automated laboratory?

The environment must support the operating range specified for the most sensitive analyzer in the laboratory—not just temperature, but relative humidity, electrical draw, etc. And noise and light are equally important considerations in the working conditions for laboratory staff. Ensuring that the room stays within all ideal ranges is part of the design challenge. Effective planning and design considers the location of heating and air conditioning units and overhead lighting, thermal output of all the connected systems, year-round changes in seasonal temperatures and natural sunlight in rooms with windows, and more. The need to understand and address these factors often requires the support of the engineering and IT staff at the customer organization.

 

---Jack M., Senior Director Customer Service, ~34 years at Siemens



With no other changes, will automation alone improve my current processes?

Not necessarily. Laboratories should independently examine overall operations to understand all the opportunities for improvement before thinking about automating. With no other changes, automation simply mechanizes a portion of the overall process and is unlikely to yield the significant productivity and cost improvements desired. For this reason, Siemens performs a Lean process review of key workflows, both inside and outside the laboratory, as part of any pre-sales engagement. As all pre- and post-analytical processes are evaluated and optimized, it can become easier to improve the design and ROI for the total end-to-end solution. For example, if a laboratory can reduce the number of aliquots through process changes, there is no benefit in taking up valuable space, time, and money to buy and maintain an automated aliquot module on the track.

 

---Sue Y., Senior Manager, HCS, ~10 years at Siemens



Will automation de-skill my staff?

We have found quite the contrary to be true. Our customers have reported that the opposite happens. By its very nature, automation mechanizes many of the low-skill, non-value-added tasks, such as tube decapping, aliquotting, sorting and individual tube loading, locating and retrieving patient samples, capping and storing tubes for future testing, disposing of expired samples, manually checking reagent levels, and so on. Automating these tasks gives everyone more time to perform more-valuable activities.

Consider the impact of employing autoverification rules to release results: Laboratory staff needs only to consider the typically small number of results that have been held for manual review. This removes a great deal of pressure created by the sheer volume of results and encourages more thoughtful and considered decisions for the results that actually require attention. When the flagged results are accompanied by information about why the sample was held for review (outside acceptable range, QC rule exception, delta check, or an instrument or sample flag), staff can make an informed decision to release or retest, thereby avoiding unnecessary testing and the associated low-value tasks standing in the way of addressing the clinical issues that matter most.

For senior staff, this extra time can offer the opportunity to explore new testing protocols and further the patient-care mission of the lab. For all staff, free time can be used for enhanced training and development work to “up-skill” personnel. When released from the crushing volume of work, even nontechnical personnel can focus on further enhancing processes in ways that increase turnaround times to speed diagnosis and improve patient outcomes.

---Jeff A., Head of HCS Northwest Europe, ~9 years at Siemens



When should you perform a Lean process analysis?

Lean processes and analysis tools are used throughout all phases of a Siemens automation project, and the many of the experts on our Healthcare Consulting Services staff are Lean Healthcare-accredited by the University of Michigan. During process definition and project validation phase, we share best practices and use value stream mapping to reduce non-value-added activities for overall laboratory operations, not just the automated track. During the installation and stabilization phase, we may organize rapid-improvement events to optimize the period of stand-alone operation and set the stage for new processes to be adopted in the automated environment. Finally, the post-implementation and health check phase of a project may uncover new opportunities to streamline processes both on and off the track. For example, an analysis of error messages may highlight patterns in sample handling across three shifts. Likewise, with the automation and centralized data-management systems operating smoothly, it becomes easier to identify bottlenecks that delay reporting of results to physicians. In each case, new processes will be implemented, measured, and refined following the Plan-Do-Check-Act steps of traditional continuous improvement

---Denise O., Senior Manager, HCS, ~13 years at Siemens



Is it possible to calculate the total throughput and turnaround time of my system?

This is a valid question almost always asked by customers. When a design that includes only Siemens systems is agreed upon, it is possible to estimate track throughput with a high degree of accuracy using simulation tools. Projections are more difficult for open solutions that utilize diagnostic systems from other manufacturers. Interestingly, based on the volume of data that Siemens has collected in the development of its diagnostic analyzers as well as its automation projects, a variable that has a tremendous influence on throughput—the number of tests needed per tube—actually tends to be quite constant by region. The simulation uses the actual data stream from a heavy testing day for that specific site rather than estimating peak loads. Using real customer data, the actual time that samples arrived in the lab and the actual tests ordered are factored into the equation, along with the number and type of pre- and post-analytical modules and diagnostic systems that will populate the track. To improve the accuracy of the projection, Siemens methodologies utilize discrete event simulation so the testing path for one tube directly affects the testing path for the next tube, and so on. No estimate can overcome “people factors” that come into play when the actual system comes online, such as a random decision to start directly front-loading analyzers on the track. However, the calculation is done with a level of precision that has been successfully used to set performance benchmarks for final installations.

---Marc M., Automation & HCS Manager, ~9 years at Siemens



Is it common to initially focus on one aspect of an automation solution?

When customers come from an environment where pre-analytic workflow can be improved—for example, if batching has been creating constraints—the first impulse may be to request the largest-capacity and fastest systems in the belief this will solve workflow concerns. This can easily lead to underutilized diagnostic capacity that requires calibrations, controls, maintenance, and extra staffing. However, when we are able to show these laboratories how to smooth out pre-analytical processes to deliver smaller batches on a more-timely basis, they see how easy it is to get by—and even grow—with fewer and/or smaller instruments.

For example, dedicating three staff members to pre-analytics when only one person is responsible for demographic entry can create an imbalance that delays samples from moving to the track. Reassigning personnel with an eye toward establishing a similar pace or TAKT time for both processes can reduce or eliminate artificial peaks in workload. It’s also important to understand how phlebotomy procedures, courier routes, and other factors outside the laboratory contribute to batching.

The pre-analytical process needs to be as smooth as possible to support more-accurate and appropriate planning of diagnostics. In addition, the use of highly integrated, “smart” middleware on the track for intelligent routing and post-analytical processing can also prevent overinvestment in diagnostic systems.

---Alistair J., Regional Sales Manager, ~19 years at Siemens



Is automation more challenging the first time or for upgrades?

Both have challenges, but they tend to be different. For instance, during the implementation phase, a second- or third-generation project tends to require more planning and training to enable staff to temporarily adopt manual, stand-alone lab operations while the old track is dismantled and the new system is installed. This can be especially challenging when a site has been automated for a long time and the staff has limited experience in a nonautomated environment. Once the new track is up and running, however, adapting to a different automation and IT system tends to be comparatively fast. In contrast, laboratories automating for the first time do not experience the same degree of operational disruption when the new system is being installed and tested. However, more time and training may be needed during the post-implementation phase as the staff learns brand-new operating procedures and gets familiar with centralized data-management tools.

---Margaret P., Senior Manager HCS Training and Quality, ~15 years at Siemens



When is the best time for an automation system health check?

The timing and frequency of system health checks depend on the complexity of the project and the needs of the customer. After the implementation and initial optimization period, a first pulse takes place within 3 months of the go-live hand-off from the Siemens healthcare project manager to the Siemens field service engineer. If operations are smooth and performance (i.e., system utilization, turnaround times) is acceptable, ongoing health checks may only need to be scheduled annually. However, if performance is not what was expected, immediate action is taken to fine-tune systems, do more training, or hold a rapid-improvement event to further streamline processes, etc. Changes are implemented, measured, and refined as necessary and the health check repeated to ensure that improvements are realized. Learn more in this short article: Automation and Optimization: the Importance of the Health Check

---Dr. Alistair G., Senior Director HCS, ~18 years at Siemens


Check back periodically for new topics.

For more in-depth explanations about issues surrounding laboratory automation, we invite you to listen to the following on-demand webinars:
 

*Source: Siemens Healthcare Diagnostics shipment and orders reports, July 2017.

The products/features (mentioned herein) are not commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens organization for further details.