Dr Hassan, Hospital Director Dr Ghulam, Laboratory Director · Al-Adwani General Hospital Saudi Arabia Dr Hassan, Hospital Director Dr Ghulam, Laboratory Director 0810 Working with

Al-Adwani General Hospital Saudi Arabia

Dr Hassan, Hospital Director Dr Ghulam, Laboratory Director

0810

Working with Roche to meet the growing demands of a local community

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Al-Adwani General Hospital, Saudi Arabia

•Privatehospitallaboratory

•200beds

•400,000ClinicalChemistryresultsperyear

•42,000Immunochemistryresultsperyear

When Dr Ghulam first arrived at the Al-Adwani Hospital in 1995, he could never have imagined the transformation that would take place in just a few years.Inheritingmanuallaboratorypracticeswithvirtually no quality control and slow turnaround time,hislaboratorystruggledtomeetthedemandsof the local community. Now, the hospital and hislaboratoryleadthewayinhiscity,providingdiagnosticservicesthatwouldbetheenvyofothercentres around the world.

The story so far “...with Roche we found a partner that shared our vision and the products that

could help us to get there and support our growth long into the future.”

Date System Tubes/Day No. Parameters Benefits

1995 Manual 70-80 25

1999 Hitachi 902 Elecsys® 1010

70-80 25 Improved quality control and allocation of staff time

2004 Hitachi 912 Elecsys® 2010

130 50 Faster turnaround time and broadertestmenu

2009 cobas® 4000 analyzer series cobas c 311, cobas e 411 analyzers

200 80 Increased test menu Faster sample turnaround Better tracking of information Greater control over quality On-line support Efficient reagent handling Direct-to-host reporting

The steps leading to cobas® 4000 analyzer series

Situated in the city of Taif, in the mountains three hours drive from Jeddah in Saudi Arabia,thehospital’sisolated,high-altitudelocationcombinedwiththeuniquedemandsof Saudi culture and legislation, places an unusualburdenonDrGhulam’slaboratory.Back in 1995, he knew that the amount of manualinterventioninthelaboratorywaspreventing him delivering the standard of service that his medical colleagues, and his patients, demanded.

“When every step in the testing process is conducted manually, it opens the door to inconsistency. For instance,evenafterthoroughtraining,everytechnician’spipettingskillswillbeslightlydifferenttothenextperson’sandamanualsystemmakesitverydifficult,ifnotimpossible,toruncontrols”explainsDrGhulam.

Amanualsystemisalsoslowandin1995hislaboratorywasonlyabletohandlearound80 samplesperday,5testspertube,andcouldonlycopewith25parameters.

“Aswelookedtoimproveandexpandourlaboratoryservices,I knew that staying with old manual technologies was simply notanoption,butforalabofoursize,automationwasquitea scary prospect. Fortunately, with Roche we found a partner that shared our vision and the products that could help us to getthereandsupportourgrowthlongintothefuture.”

But moving from a manual to a fully automated system cannotbedoneovernightandDrGhulamapproachedthetask with a sense of evolution, not revolution. He comments “thesedaysautomationisagivenandmystaffembraceconsolidationbecausetheyrealizeitgivesthemtimetoworkonother,moreinterestingaspectsoflaboratorywork.”

The impact of cobas® 4000 analyzer series “...the pressure to provide timely results with absolute confidence is ever-present and growing, and that was perhaps the single most important

reason Dr Ghulam gives for his decision to move to cobas® 4000 analyzer series”

The immediate impact of cobas® 4000 instrumentshasbeenonthelaboratory’sbreadthanddepthofserviceitcanoffertothehospital’scliniciansandthereforeitspatients. Because of the competition that existsbetweenprivatehospitalsinthearea,the pressure to provide timely results with absoluteconfidenceisever-presentandgrowing, and that was perhaps the single most important reason Dr Ghulam gives for his decision to move to cobas® 4000 analyzer series.

ThebenefitsofimproveddatahandlingarealsobeingrecognizedbyDrGhulam,whofrequentlyprovidesquality controlreportstotheSaudiauthoritiesonbehalfofhislaboratory.Beforecobas® 4000 solution, this time-con-suming process would have involved manual collation of dataandthedraftingofareportcarriedoutbyalabtech-nician.Nowthedataiscollatedbythesystematthepressofabutton,makingreportingmucheasier.

Withthelaboratoryworkflowanddatahandlingenhancedsignificantly,DrGhulamcannowbeproactiveintermsoftheassayshislabcanofferfortheAl-Adwanimedics.

“It’s amazing. With the medical studies and experiences from other centres around the world that Roche shares with us I now find myself presenting to our doctors on which new parameters are available and their clinical potential. For example we recently uncovered the value of NT-proBNP as a cardiac marker and IL-6 in the field of neonatal sepsis. These kinds of developments result in a constantly growing offering of diagnostic tools for the benefit of our clinicians.”

It’s the little things that matter The future for the Al-Adwani laboratory

The location of the Al-Adwani Hospital meansthatboththealtitudeandtheheatcancauseproblemsintermsofhandlingreagents.

RudyAguilar,theLaboratoryCoordinator,hasover30years’experienceandheknowsthesortsofproblemsthatcanaffectthesmoothrunningofalaboratory.Hekeepsaparticularly close eye on the reagents:

“Theissuewearealwaysworriedaboutisa consignment of important reagents not beingkeptcoolorevenworse,beingleftto

sit out in the hot Saudi sun. Roche understands this issue and they are very good at making sure we receive things on time and in good condition. In emergencies, they have even putreagentsinataxitoreachusintime.Nowthat’sservice.”

The way Roche supplies its reagents also offers intrinsic handlingandefficiencybenefits.cobas® 4000 reagent packs (c-pack and e-pack) are liquid, ready to use and come in ‘all-in-one’packagingperparameter,makingstorageandlogistics very easy to manage.

Next steps: Implementing the cobas® Work Area Management solutions will bring immediate benefits

•Datatransferfromsystemtoanalyzerwillmeannomanualinputtingofordersand therefore less margin for error

•Improvedworkflowmanagement

• Real-time results delivered straight to clinicians and patients.

Evolution, of course, never ends and Dr Ghulam and his colleagues are keen to keep on improving the services their laboratoryoffers.Alreadyonorderisa second cobas c 311 analyzer, which will allowtheexistingcobas c 311 instrument to bededicatedtowholebloodHbA1ctestingandspecialproteinssuchasCRP,Rheuma-toid Factor and ASLO.

RudyAguilarcomments:“Thesuitability of cobas c 311instrumentforwholeblood testing is perfect as, unlike competitor analyzers, there is no requirement for time-wasting preparation of the samples in advance:thewholebloodsamplecansimplybeloadedontothemachineasitcomes.”

Also planned for this year is the replacement of the two Elecsys® 2010 with two cobas e 411 analyzers. These new analyzers will ensure that the constant demand of high quality infectious disease, hormone and thyroid testing is met, while software commonalities with the cobas c 311 systemmeansefficienciescanbegainedintermsofstafftraining.

Manyoftheimportantnextstepsforthelaboratoryinvolveimprovementsindataandsamplemanagement,bothofwhich will result in even greater accuracy, administrative efficiencyandultimately,profitability.

Al-Adwani General HospitalSaudi Arabia

“I am incredibly pleased with the progress our hospital has made in recent years. Dr Ghulam and his laboratory team have played a major role in our success. It’s also important to recognize that we couldn’t have done this in isolation – we rely on high quality products from excellent suppliers, and Roche is one of our key partners for growth.”

Perhapsthefinalwordshould go to Dr Hassan, Hospital Director.