Problems and solutions Stuart Matthews Laboratory Manager
Department of Medical Microbiology Salisbury District Hospital
Slide 2 Service Requirements: To provide a 24 hour 7 day service To
remain within budget To conform to CPA standards To reduce overtime
costs To recruit and retain quality staff To maximise the efficient
and effective use of staff and resources To increase the quality of
life of existing staff Slide 3 The Problems: Insufficient qualified
staff Rising workload Increased overtime costs Recruitment problems
Late arrival of specimens Vacancies increase pressure on existing
staff Requirement to cover for absences of medical staff Danger of
increase in stress related sickness Slide 4 The Problems: Quality
of work going down Internal quality control being performed
intermittently Non-essential work not being done Danger of losing
CPA accreditation Increased use of locum staff (42644, 03 to date)
Only four qualified staff to cover out of hours service Requirement
to do overtime every night Slide 5 Solutions: 1.Increase the staff
establishment to cope with the work 2.Move all bacteriological
processing to a nearby hospital laboratory 3.Invest in total
laboratory automation Slide 6 Solution 1 ~ Increase establishment
Would need to increase our staffing levels by 4.6 wte (2 BMS 1 and
2.6 MLA) just to cope with current workload These figures are based
on average staff establishment in European laboratories This
assumes we could recruit qualified staff given the national
shortage This would greatly increase our budgetary requirements We
do not favour this approach Slide 7 Solution 2 ~ Sub-contract Can
another laboratory cope with our workload? Cost of couriers?
Requirement for a hot-lab? Transport delays Delivery of results
back to requestors Effects on service delivery Where would the
medical staff be based? Loss of staff here and recruitment problems
at contracting laboratory Slide 8 Solution 3: Automation - The
Paradigm Shift !!! Senior staff believe this to be the future of
bacteriological processing Allows more efficient use of scarce
resources (staff) Allows current staff to cope with workload Raises
the quality of life of staff Lessens the need to increase
establishment Eliminates the requirement for overtime to deal with
the current workload Slide 9 Solution 3: Automation - The Paradigm
Shift !!! The Kiestra approach: A truly new approach to
bacteriological processing Kiestra works in partnership with the
laboratory System being constantly developed System flexible to
reflect workload No extra space required Slide 10 Solution 3:
Automation - The Paradigm Shift !!! Will complement other
automation such as the blood culture urine analyser Full audit
trail to comply with CPA Can be interfaced with our LIMS (Telepath)
Slide 11 What can Kiestra offer us? A way to cope with increased
demand during a time of skills and financial shortage A more
efficient use of scarce staff resource Selection, labelling and
presentation of plates to staff ready for inoculation Selection of
plates post incubation for further work or discard Photographic
record of each plate presented to the BMS for interpretation or you
can work from the plates A full audit trail Slide 12 So what does
it look like? The system is configured to suit the individual
requirements of each laboratory Some examples of this are: Slide 13
General view showing tracking and stackers Slide 14 Tracking system
and workstations Slide 15 Plate sorters Slide 16 Bench height can
be adjusted to individual needs Slide 17 Workbench showing display
screen Slide 18 Laboratory view showing work stations Slide 19
Printing barcodes onto plates Slide 20 Plates entering the
incubator Slide 21 Plates are moved within the incubator on the
tracks Slide 22 Scanning images of plates Slide 23 Discard door,
track, and discard bin Slide 24 The plan for the Salisbury
laboratory Slide 25
