The timing for selecting new automated chemistry and immunochemistry analyzers usually relates more to necessity than desire. Instrument life spans, testing catalogue and volume changes as well as departmental or institutional capital budgets are much more likely than analytical or clinical needs to dictate when platform upgrades occur. Consequently, frontline technical staff frequently are more in tune with the daily shortcomings of current platforms and stand to have their work much more directly impacted by these decisions than lab medical directors, pathologists, or administrators. That is why staff input and expertise should factor prominently in the decision process.
In our recent experience selecting a new automation line we needed to consider many aspects of these platforms. Current systems offer many attractive features, from inventory management to clinical decision support and real-time remote system monitoring. These broad functionalities underscore the benefits of leveraging stakeholder expertise, both within and outside a lab, to make the best overall decision for an institution.
With that in mind, before contacting any vendors, we recommend defining a lab’s current scope of practice: Who are the lab’s primary users? What are their needs? When is the busiest time of day? Where will the equipment live, and are there space constraints? Why are we selecting new equipment/automation?
Armed with answers to these questions labs will be ready to determine which vendors best meet their needs. This may be a very short list with just one or two vendors. More than likely, however, there will be several choices. So labs will need to narrow the possibilities, which is where technical staff expertise becomes invaluable.
We highly encourage an open dialogue when soliciting proposals from vendors to get the most accurate and comprehensive solution for your lab’s needs. Consider current workflows extensively and how a new Lean 5S laboratory could bring efficiencies. Most major vendors employ experts who will work with you and develop a plan to get the most out of a new platform.
Bringing Staff on Board
Eliciting staff input is not always straightforward and may require some out-of-the-box ideas to extract the most useful advice. We involved our team early on, encouraging participation in vendor presentations and on field trips to other facilities that recently upgraded instruments. Many vendors will truck in a scaled down version of a lab so that staff can interact with the instruments and pose questions.
Once our staff had a good grasp of the options each vendor was proposing, we surveyed team members via an online doodle poll to learn which features they felt were most important and why. This was eye-opening, as we found our technical staff valued things quite differently than our medical director or administrator. For example, they insisted that any instrument we chose had to allow reagent loading on the fly. We never would have considered that a critical feature but our team’s knowledge of the intricacies of our daily workflow made clear that this was an essential feature.
Identifying Key Attributes
We selected three vendors based on test menus, throughput size, equipment footprint, our experience, and their presence in our region, the latter considered crucial in case we might need to share experiences with or borrow reagents from a local lab. We posted in staff areas side-by-side comparisons of all the vendors’ features. We then elicited staff members’ feedback via an online survey to identify the five most important features based on their daily operations experience and drawing upon their many years’ interacting with different instruments at multiple employers (Figure 1). From this, eight attributes rose to the top, including: hands-on time for maintenance; field service availability and skills; ready-to-use calibrators; calibration frequency; user-friendly software; handling short samples; reliability; and automatic retrieval of add-ons.
We included these in a second staff survey after the vendors made presentations and gave demonstrations. We asked staff to rate each vendor across all features and included open comment fields for each vendor. We also had many lab huddles on the vendors’ relative merits so our team would know administrators took their insights seriously. We asked vendors follow-up questions that came from this process so we were confident we had a good comparison of their capabilities.
We also considered each vendor’s ability to connect automation with third party platforms. Being able to add (even later) hematology and coagulation equipment to an automation line is essential to creating a truly centralized multidisciplinary core laboratory. In addition, we asked each vendor to propose installation in phases so we could see how daily operations would be disrupted along the way, as we have to continue serving our patients while placing a new line and new equipment.
As we roll out our implementation, we are confident that we thoroughly considered the key variables by capturing the best thinking from the people who will use our new automation line and all its associated equipment. Our staff members are excited about and engaged with the new lab project because they know they had a major influence over the decision-making process.
Matthew Feldhammer, PhD, is an assistant professor of pathology and laboratory medicine and medical director of clinical chemistry, toxicology, and point-of-care testing at the University of Florida College of Medicine in Jacksonville. +Email: Matthew.Feldhammer@jax.ufl.edu
Robert Ainslie, PhD, is interim laboratory director at UF Health Jacksonville. +Email: Bob.Ainslie@jax.ufl.edu