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By Charles Miraglia
10/09/07
It’s 11:00 p.m. Do You Know Where Your Specimens Are?
Charles Miraglia
One of the greatest challenges for any clinical laboratory is the tracking
of specimens. The larger the lab, the greater the challenge. The obvious goal
is to create a system whereby at any point in time the exact location of a
particular sample (or any item for that matter) can be pinpointed with ease.
The technology available to the clinical lab industry has improved to the point
of making this daunting task not only possible, but a very important part of
standard operating procedure for most large labs. While I will share our experiences
and describe some of the benefits we have realized, I am in no way endorsing
a particular product or suggesting that this is the best or even the only way
to approach these issues.
Following a considerable amount of investigation and discussion, PA Labs’ support
operations team chose Gajema (Cerner Corporation, Kansas City, Missouri) as
a way to meet the set of goals they had established for dealing with the most
common logistics issues we face on a daily basis. Gajema is an information
management system that integrates handheld devices used in the field with an
array of functions that can be loaded onto your desktop to help integrate complex
laboratory operations. In our hands, the departments or areas of the laboratory
to which it proved most useful were the courier or transport, distribution,
client services, and phlebotomy.
Before Gajema, each courier route was assigned a “route book” containing
all the information necessary to accurately perform the route. As anyone who
manages a logistics operation knows, keeping these route books up-to-date is
a huge challenge. With Gajema, all changes, additions, and deletions are put
into the system and downloaded to the handhelds when synchronization occurs
before each route departs. If a client is added, the address and all pertinent
information also are available on the handheld. And if a client calls for an
additional pickup, the stop is added to the route for that day. These details
are organized in the handheld and virtually eliminate missed pickups or unnecessary
stops. The courier is able to record exceptions to the route in the handheld as
they occur, which improves communication throughout the organization.
Since its implementation, Gajema has allowed us to combine the islands of
information that historically existed throughout the company. For example,
the courier department may have in its possession one piece of information
while the marketing department has another, client services has yet another…you
get the picture. With the new system in place, everyone has access to those
centralized pieces of information from the same source. In addition, the software
allows the information to be viewed in multiple formats from raw data to bar
graphs, pie charts, summary tables, and formatted reports.
At PA Labs, we have nearly 1,000 clients scattered across the state of Indiana
with 50 couriers traveling almost two million miles a year to move specimens
and supplies from point A to point B. Keeping track of the exact location of
millions of specimens is a significant challenge. With barcode technology,
date and time stamps can be recorded for pickup or delivery at a particular
location. Once again, standardization across the organization can be accomplished
if the handheld devices are used appropriately and the location of any data
entered into the system is a few stylus or keystrokes away.
In addition to picking up specimens from clients and dropping them off at
one of the lab facilities, it is critical for our business to be able to follow
the movement of containers from one of our hub cities to another. For example,
from Muncie to Fort Wayne or Indianapolis to Muncie. A double-check of items
is performed at the initial specimen or container receipt, and both the origin
and destination locations can access the electronic manifest to determine current
status. This helps greatly when a particular specimen is deemed “missing.” The
processes put in place allow a quick narrowing of potential locations and speed
the recovery of any potentially “lost” sample/item.
Client interactions are also recorded in a centralized call log or case log
by multiple departments within the organization. Authorized personnel then
have the ability to review the client’s history and monitor for patterns,
thereby providing the opportunity for a proactive approach to each client’s
particular challenges or requirements. There is no need to wait for the client
to inform us of a problem. We can identify the problem, determine a solution,
and present it to the client—impressing them with our high level of service
and attention to their needs.
By simplifying the planning process for routine maintenance, vehicle safety
and longevity are also enhanced by using Gajema. Appropriate personnel are
able to track required maintenance based on a specific schedule that optimizes
vehicle performance and condition. Financially, Gajema provides expense tracking
and forecasting for vehicles. Past expenses provide a history of the real cost
of vehicle operation allowing accurate prediction of future vehicle maintenance
as well as the best timing for vehicle replacement or updating the fleet. Functions
that previously required various manual logs, special calculations, and reporting
processes are now fully automated resulting in improved efficiency.
Supply tracking is another area where Gajema has become a valuable tool. The
deployment of supply tracking allows the accurate and timely monitoring of
the delivery of supplies to clients. Because Gajema is capable of counting
both outgoing and incoming supplies, we are in the process of implementing
the tools to monitor appropriate utilization by our clients. (For example,
if we send a client 100 red top tubes, we are able to monitor whether they
send us the same number of samples in red top tubes for testing.) This enhances
our regulatory compliance efforts ensuring that we provide to clients only
those supplies that are for the sole purpose of collecting and submitting a
patient sample.
Overall, we have found Gajema to be an extremely valuable tool in our daily
operations. It has helped us to automate many of the manual reporting and tracking
mechanisms common to a laboratory operation. More importantly, it has given
us greater confidence in our ability to deliver the kind of service that our
clients expect in today’s demanding health-care market. As our business
continues to grow and become even more complex, we are prepared for the logistics
challenges we will no doubt face.
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