SelectScience’s Clinical Editor, Sonia Nicholas, interviews Greg Caruso, WellStar Kennestone Hospital Laboratory about the installation of a completely new chemistry and water system in five busy hospital laboratories. This article is the interview transcript from a recorded audio podcast.
SN: Hello, I’m Sonia Nicholas and I’m the Clinical Editor for SelectScience. I’m here today with Greg Caruso. Greg is a Resource Medical Technologist at the WellStar Kennestone Hospital Laboratory in Georgia, US. Greg thank you for joining me today.
The needs of a busy hospital laboratory
SN: Could you start by telling me what your job involves and what departments you work in?
GC: My duties include project management, maintaining supplies and inventory, safety officer, scheduling technical staff, and I also do a lot of things that everyone else doesn’t! Our hospital is the flagship in our five hospital system and our chemistry department is the biggest department in our laboratory, as it is in most laboratories.
We process about 1000 specimens a day in our chemistry department and we have the busiest Emergency department in the State. We are a level 2 trauma center and we have a very busy and ever growing outreach center. We serve the doctors in the community, we have courier service that collects all of their samples and brings them to our laboratory as well. So we really are very busy.
A new solution
SN: You’ve had an even busier time than usual lately and you’ve been making some changes in your labs. Could you tell us a little more about that?
GC: Yes it’s been quite a trying few months! We were formerly a Beckman Coulter laboratory and we have switched to the Roche platform, and that was a major undertaking. As it is in most laboratories, space is a premium and we didn’t have any, so it was quite a challenge to juggle correlations between two different chemistry platforms like that.
We had to gut half of the laboratory to clear an area for the new Roche platforms. We have two cobas 8000’s, we have an MPA (Modular Pre-Analytics) which is the pre-analytical portion, we also have a large cobas p 501 which is the refrigerated stockyard. It’s quite big, it takes up about half of the laboratory and we’ve been live for about a month now.
In addition to the new chemistry system we have also renovated much of the laboratory including our specimen processing area, and moved several departments around to accommodate the larger chemistry footprint in the laboratory. It has been very, very challenging.
SN: I believe that you’ve also made some changes to your water supplies?
GC: That is correct. With the introduction of the new chemistry system we had an opportunity to review our existing water system. We felt that we could do better so we started looking and we came upon Millipore. They have a reputation for quality and their technology was very attractive to us. It was a decision made by the laboratory leaders of the five hospitals to go with Millipore, and we’ve been very happy with that decision.
SN: How has Millipore helped you to implement your new systems?
GC: Both the Account Representative and Millipore’s Chief Engineer were very involved. We travelled to all of the sites, looking at their needs, their space requirements, the equipment they would be getting. They worked with us to tailor the systems that were required for the water flow that we needed for the various instrumentation that we have.
We ended up here at Kennestone with two AFS® 120E’s, because of the demands of the two Cobas 8000’s. The other sites have either one AFS® 120E or another configuration. The Chief Engineer was extraordinarily helpful during the implementation process. He worked closely with our plumbing contractors to make sure that everything was routed to spec and to code, that everything was placed in the optimal position, and that we had sufficient drainage and power supply. He was very, very helpful and we were extremely glad that he was here. It made a big difference.
SN: Are you happy with how the systems are all working now?
GC: Very happy, we have had zero problems since we went live. Well actually, we did have one issue which was totally unrelated and almost funny. The house-keeping staff was mopping the floor. There is a leak detector on the AFS that shuts down the water and they happened to get it wet. Our instruments stopped running and said they were out of water. We couldn’t understand it and it took us about an hour to work out what had happened!
But we have been extraordinarily satisfied with the Millipore system. Very high quality, easy to use, it has a nice interface. The operator can monitor its systems. It is attractive, it’s small and out of the way. We have just been very happy!
SN: Any change like this is quite challenging, how have your staff adjusted to the whole process?
GC: Well we’re still working on it, a month is not a very long time to be live so there are still challenges. We’re getting used to the system, we’re going live on a new refrigerated stock yard in about a week. That’s the last component to go live. We are still trying to migrate to this new way of doing things but they are coming along. Like anything else it is just a matter of getting used to it, practicing while still maintaining a very heavy and sufficient volume of work. It’s falling into place and we have been very happy with our Millipore system.
Advice for other Managers
SN: Finally Greg, do you have any advice for other Lab Managers and laboratories who are about to go through the same sort of implementation procedure?
GC: Well, just learning from experience, don’t take anything lightly. Even the smallest decision can have a great impact on the back-end. Do your due diligence, look at as many systems as meets your needs. Ask questions that you may not normally ask, especially when you are on site visits. When you look at another site that has something that you are thinking about getting, don’t be afraid to ask questions because you don’t always see on a site visit, what ends up being the case in your laboratory. Be methodical, make sure your staff is involved in the change and don’t make this just a leadership decision. Give your staff the opportunity to chime in, they often have very, very good ideas.
SN: I’m sure other labs will find your experience very helpful so thank you for your time today. I know you’re really busy, especially at the moment so I really appreciate it.
GC: Any time, thank you so much Sonia.