Evaluation of biochemical and immunological assembly line in emergency test

Objective To explore the application value of biochemical and immunological assembly line in emergency test by comparatively analyzing the changes in sample test process and turnaround time (TAT) in emergency test before and after installation of the assembly line. Methods A retrospective study was performed with the run data of the emergency biochemical and immunodetection project in Department of Clinical Laboratory in Tongji Hospital Affiliated to Tongji University from July to September in 2017 and from July to September in 2018. (1)The changes in sample circulation mode and test process were compared in emergency test before and after installation of the assembly line.(2)The changes in TAT of sample test and distribution of time interval in emergency laboratory report were statistically analyzed before and after installation.(3)The number of samples tested between instruments and occurrence of instrument failure were statistically compared before and after installation. (4)Biosafety risk assessment was performed on the sample test process before and after installation to analyze the effects of the assembly line installation on biosafety control in emergency test. Results (1) By applying the assembly line, the sample test process was well controlled and the workload for laboratorians was eased greatly through reduction of manual work.(2) Report TAT was remarkably shortened after installation compared to that before installation; the TAT of dry biochemistry and myocardial zymogram report in emergency test was shorted from 39 min and 48 min to 34 min and 42 min respectively, with a reduction of 12.82% an 12.50% compared to those before installation; the TAT of dry biochemistry and myocardial zymogram report in inpatient emergency was shorted from 37 min and 43 min to 29 min and 35 min respectively, with a reduction of 21.61% an 18.60% compared to those before installation; distribution of report TAT was comparatively analyzed, the percentage of reports in 0-30 min and 31-45 min increased remarkably compared to that before installation, the percentage of TAT of dry biochemistry report falling into 0-45 min increased to 74.58% and 85.66% after installation from 57.91% and 78.28% before installation, respectively in emergency and inpatient emergency. (3)For the model VITROS5600, the percentage of samples tested changed from 30.29% and 69.71% before installation to 47.63% and 52.37% after installation, respectively; for the model DXI800, the percentage of samples tested changed from 28.77% and 71.23% before installation to 53.49% and 46.51% after installation, respectively. After installation, there was a tendency of balance in the number of samples tested between instruments. Instrument failure was significantly reduced: for the model VITROS5600, the frequency of instrument failure decreased from 3.5 times a month/instrument before installation to 2 times a month/instrument after installation on average; for the model DXI800, the frequency of instrument failure decreased from 2.8 times a month/instrument before installation to 1.8 times a month/instrument after installation on average.(4) Installation of the assembly line lowered the risks biosafety events in sample test process in emergency test and the two risks of accidental contact with aerosol in sample tubes before detection and accidental contact with biological specimen due to overturning and spilling during detection were reduced from a high level before installation to a low level after installation. Conclusion In emergency test, biochemical and immunological assembly line is of certain value in process improvement, reduction of workload for laboratorians, improvement of work efficiency, TAT reduction and optimization, as well as control of biosafety conditions. Key words: Biochemical and immunological assembly line; Emergency test; Sample test process; Turn-around time