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Impact of total laboratory automation on workflow and specimen processing time for culture of urine specimens

  • Melanie L. Yarbrough
  • William Lainhart
  • Allison R. McMullen
  • Neil W. Anderson
  • Carey-Ann D. BurnhamEmail author
Original Article

Abstract

Total laboratory automation (TLA) has the potential to reduce specimen processing time, improve standardization of cultures, and decrease turnaround time (TAT). The objective of this study was to perform a detailed interrogation of the impact of TLA implementation in all aspects of the workflow for routine culture of urine specimens. Using a detailed motion capture study, the time required for major steps of processing and result reporting were prospectively assessed for urine samples prior to (n = 215) and after (n = 203) implementation of the BD Kiestra TLA system. Specimens were plated on all shifts, but cultures were read only during the day shift for both time periods. Significant increases were noted in the time from receipt to inoculation (23.0 min versus 32.0 min, p < 0.001) and total processing time (28.0 min versus 66.0 min, p < 0.0001) for urine specimens post-TLA. Rates of positive (18.6% versus 16.3%) and negative (71.2% versus 79.3%) urine cultures remained stable through the pre- and post-TLA time periods (p = 0.58). There were no changes in TAT for organism identification or susceptibility results. The time to final report was decreased from 43.8 h pre-TLA to 42.0 h post-TLA, which was attributed to significant decreases in TAT for negative cultures (42.0 h versus 37.5 h, p = 0.01). These findings demonstrate that changes in laboratory workflow are necessary to maximize efficiency of TLA and optimize TAT.

Keywords

Total laboratory automation Urine culture Turnaround time Kiestra 

Notes

Acknowledgements

We thank Angela Shupe and Colleen Haug for assistance in collection of observational data. We thank Christopher Coon for assistance with data entry. We thank the staff of Barnes-Jewish Hospital for their ongoing efforts for the patients served by the clinical laboratory.

Compliance with ethical standards

Conflict of interest

Carey-Ann Burnham has received honoraria from BD for development of educational sessions on laboratory automation. MLY has received personal fees from Bio-Rad and Agena Biosciences. WL, ARM, and NWA have nothing to declare.

Informed consent

No informed consent was needed for this study since no personal data were involved.

Ethical approval

Approval by the institutional review board was not required for this study.

Supplementary material

10096_2018_3391_MOESM1_ESM.pdf (100 kb)
Online Resource 1 (PDF 100 kb)
10096_2018_3391_MOESM2_ESM.pdf (99 kb)
Online Resource 2 (PDF 99 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Melanie L. Yarbrough
    • 1
  • William Lainhart
    • 1
  • Allison R. McMullen
    • 1
    • 2
  • Neil W. Anderson
    • 1
  • Carey-Ann D. Burnham
    • 1
    Email author
  1. 1.Department of Pathology and ImmunologyWashington University in St. Louis School of MedicineSaint LouisUSA
  2. 2.Department of PathologyMedical College of Georgia at Augusta UniversityAugustaUSA

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