Auto Validation and Management Reports Using Sysmex WAM. Alfonso Ziccardi Laboratory Operation Manager for AP/CP/Safety Officer

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2 Auto Validation and Management Reports Using Sysmex WAM Alfonso Ziccardi Laboratory Operation Manager for AP/CP/Safety Officer

3 SUCCESS BEYOND FINANCES

4 Hematology Testing Breakdown NYHQ Descrete testing CBCD 42% HH 0% CBC 45% PLT 0% HGB A1C 5% Retic 1% ESR 3% HGB 2% HCT 2%

5 Justification of Lavender Top Management Combine Hematology & HBA1c Run HBA1c more frequently Random Access & paperless Free up tech time Few differentials Auto-verify Bring in additional testing Faster turnaround time/earlier decision

6 Automating Data Review with WAM NYHQ WAM A1c Rules Automates Review

7 Rules Set for Hematology and A1c Comprehensive Hematology Rules Database- Examples Test Rule Action Operator Instruction WBC If dimorphic population? (Instrument suspect FLAG) ISLH Criteria Sample Handling Critical Value cutoffs Reflex Smear and Hold ADIFF Review smear RBC HGB If WBC >20 and LOC = PEDs and age < 2 years (Instrument Laboratory value, location & age) Specific Criteria If HGB > 16.0 and Requestor = Smith and no previous result (Instrument value, doctor, previous result) Reflex smear and hold ADIFF Reflex Smear and HOLD all tests Delta rules Re-run and call ward Review smear and call Dr. Smith PLT If PLT ABN distribution and retic ordered and PLT < 80 Instrument Flags (Instrument flag, sample order and instrument value) Hold PLT Review smear and verify PLT count Rules based on previous results

8 Auto-verification Outcomes A1c Milestones to be Achieved: 1. Auto-verification of A1c s 2. >90% will auto-verify - 10 % flagged by the rules. Either repeat or reflex to another platform DI-10 Hematology Milestones Achieved: 1. Auto-verification from Day 1 of live 2. Over 85 % of samples auto-verify 3. Paperless

9 LEAN Achievements Workflow improvements: One tube for CBC and A1c Single piece flow Data Review auto-verification Over 85% of CBC s Achieved >90% of A1c Reduction Testing and result TAT for CBC & HBA1C Labor Savings/Resource Reallocation for new testing

10 Our Lavender Top Management Configuration Bio-Rad VARIANT II TURBO Link- A1c TS-500- Automated sorting, re-routing and archiving SP-10- Smear prep 3 XN Hematology testing

11 All-in-One Data Station Multi-application Sysmex WAM workstation: Review of exception results: CBC and A1c Smear review /diff station LIS access

12 Reduced maintenance: Once / daily More Walk-Away Time Hands-free maintenance and QC Single aspiration pathway

13 Lavender Top Management with A1c Testing

14 Enhanced Workflow Automated Rerun/Reflex Testing Reception Sample Review Manual Diff/Scans Critical Value documentation Paperless environment Digital Cell Image integration

15 Comprehensive Data Review / Management

16 All In One Review HBA1C

17 Efficiences with Sysmex WAM Decrease data TAT: Typical Heme and A1c Auto-validation rates of ~85% + Automatic identification of STAT exception samples Reduce non-productive tech time: Advanced hematology technology and comprehensive smear rules Standardize review and process across techs, shifts and lab Reduce waste and cost: Paperless environment = decreases costs around paper, printing storage, destruction of printouts 2 years data storage for easy access

18 Impacts We Have Realized Auto-verification (hematology and A1c) Paperless environment Capacity and opportunity to add new tests Reduce opportunities for error Standardized sample and data workflow Staff cross-training TAT improvements HBA1c on demand

19 Compare rerun/reflex Use: Compare rerun/reflex & STAT rates Review auto / manual validation rates Benefits: Measure laboratory performance & efficiency Compare user productivity

20 Turnaround Statistics Report

21 Turnaround Time Chart

22 Counts Statistic Report

23 On-Demand Management Reports

24 Critical Alert Documentation Step 1 Step 2 Step 3 Result Review Enter Call to info in WAM Save and transmit to LIS

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