FULL AND RAPID AUTOMATION UPGRADE

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FULL AND RAPIDAUTOMATIONUPGRADE

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LEAN UPGRADE

In order to achieve this, Portsmouth hasinvested heavily in automation and newtechnology, ensuring the delivery of ahigh-quality, cost-effective and responsivepathology service to patients andclinicians alike. 

Long-standing managed service contractAs Portsmouth had held a long-standingpartnership with Beckman Coulter fornearly 10 years, in early 2015 it becameapparent that there was a need toupgrade the laboratory’s Power Processor

track system to ensure continuedoperational efficiency. Beckman, inconsultation with Portsmouth PathologyService, recognised the fact that eventhough there were just two years left on a renewed managed service contract(MSC), a solution to refresh equipmentwas necessary to maintain service.

Nathan Hunt explained: “Through theterms of the MSC, although Beckman is obliged to ensure that our service isoperational, it does not necessarily haveto upgrade us. On completion of theprimary seven-year contract withBeckman, as we were extremely happywith the equipment and customer service,we took up the option of a three and ahalf-year extension. This did, however,mean that by 2015 our equipment wasthen over nine years old, and, havingbeen very well used over the years, it wasbeginning to show signs of its age.”

Tom Coulson commented: “As we arededicated to working in partnership withour customers in order to ensure that they

Ensuring that its customers can achieve, or even surpass, their key performanceindicators (KPIs) for results turnaroundtimes is a top priority for Beckman Coulter,regardless of where they are within thecycle of their managed service contract.Portsmouth Pathology Service operates a 24/7 service and has used Beckmanautomation equipment for over a decade.Therefore, when a full system upgrade to its new-generation Power Expressautomation was required, Beckman rose to the challenge and implemented withabsolutely no interruption to pathologyservices.

Portsmouth Pathology Service is one of the largest pathology services in theUK, employing more than 350 staff,performing over 10 million individual testsper year in the blood sciences laboratoryalone. Operating 24/7 from a purpose-built laboratory complex located on the Queen Alexandra Hospital site,Portsmouth Pathology Service provides a full emergency, routine diagnostic and clinical interpretative service for in-patients and out-patients, as well as for over 90 GP practices. In addition, it provides specialist services on behalf of other NHS and private healthcareorganisations.

Given the scale of PortsmouthPathology Service’s operation, it isessential that it meets its KPIs forturnaround times (TATs) consistently.

Pathology in Practice speaks with Portsmouth PathologyService’s Nathan Hunt and Beckman Coulter’s Tom Coulsonabout how Beckman smoothed the transition from amature automation system to a modern Lean automationconfiguration to eliminate bottlenecks for even workflow.

Full and rapid automationupgrade with nointerruption to service

Installation work in progress, with biomedical scientist staff needing to operate analysers manuallyin the absence of track.

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LEAN UPGRADE

to remain in the same locations, weeffectively had to do a straight swap outof the old track with the new PowerExpress in the same position. Fortunately,Beckman has a lot of engineering andproject management expertise andexperience of such challenges and wastherefore able to fully support usthroughout the implementation.”

In-depth planning was a critical factorduring the entire process. “Beckman hadto be extremely flexible and redesign thePower Express around our existing powerand drainage. Therefore, all of ourinstruments were reconfigured to providethe best possible fit within the confines ofour fixed laboratory layout,” explainedNathan Hunt. “Another consideration wasthe fact that this all had to be undertakenin consultation and agreement with ourPFI provider. They required a detailed

project plan, risk assessment and methodsheets, which all had to be approved by them prior to any enabling workstaking place or equipment being moved. This involved a vast amount of paperwork and liaison, which Beckman fullysupported as this was anothercomplication in an already verycomplicated process. They had theexperience to be able to put together anin-depth project plan detailing everythingright down to the last plug socket.”

Precision planning andimplementation Having agreed on the detailed plan andtimeframe, the next step was to followthis to the letter/hour during theinstallation. “It was absolutely critical thatthere was no deviation from the plan. Thisis because the only way of maintaining a seamless service to our customers wasto utilise manpower. Our biomedicalscientist staff had to keep instrumentsfully operational manually without theusual automation delivering samples tothese instruments, and also filing awaysamples post-analysis, all whileequipment was being removed from all around them,” said Nathan.

To achieve this scale of manualoperation at certain preplanned stageswithin the project, Nathan had to pre-agree all the biomedical scientistovertime required with the trust. “It wasessential that we all stuck to the planbecause absolutely all of our additionalstaffing resources were pre-approved

can meet their KPIs, we appreciated thatthere was a need to replace PortsmouthPathology Service’s equipment. Given thescale of its automated operation, wedecided that a full modernisation to ourvery latest total laboratory automationsolution (Power Express) was best to meet their needs.”

Challenges of rapidimplementationHaving agreed to modernise Portsmouth’sblood sciences laboratory through anautomation upgrade, the challenges ofachieving this then had to be overcome.This meant Portsmouth and Beckmanworking extremely closely together. The main challenge was how to manage afull automation installation into an alreadyautomated laboratory with no interruptionto its KPIs. Table 1 and Figure 1 detail thescale of the installation.

“One of the biggest potentialchallenges for any laboratory manager,whose entire laboratory’s processes andworkflow are built around having anautomated system, would be to lose this for any length of time,” observedTom Coulson. “Due to the set up inPortsmouth, we had to work out a way of removing the old track and installingthe new one into the very same locationwithout interrupting service.”

A new and straightforward automationinstallation generally takes around fourweeks, even without the removal of an old track. “In order to minimisedisruption to Portsmouth, it was decidedthat we should halve the standard time and aim for two weeks from start to finish.A challenge that ultimately came down to time management and a very detailedproject plan by both parties,” addedTom.

Nathan Hunt also recognised the scale of the challenge. “As PortsmouthPathology Service is housed in a PFI-ownedbuilding, we operate under very strictrules on what we can and can’t do withinthis. As all walls, power and drainage had

Fig 1. Floor plan of the Portsmouth Pathology Services blood sciences laboratory.

Table 1. The elements of Beckman Coulter Power Express equipmentinstalled at Portsmouth Pathology Service.• Inlet• Error lane• 2 x centrifuges• Decapper• 2 x AU5812 clinical chemistry analysers (connected)• 2 x UniCel DxI 800 immunoassay analysers (connected)• Recapper• 5000-tube online refrigerated storage• 2nd decapper• Outlet

Portsmouth has invested heavily in automation andnew technology, ensuring delivery of a high-quality,cost-effective and responsive pathology service

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LEAN UPGRADE

Portsmouth has found that reliability ofthe Power Express is excellent, along with its rapid and efficient delivery ofconsistent results. Even if there is a rare need for a manual intervention, asNathan observed: “The Power Expresshas minimal downtime due to itsconfiguration; it operates like a spine withdifferent lanes feeding off it to differentinstruments and modules, meaning thatsamples can be routed efficiently aroundany issues, eliminating any bottlenecks.”Although very up to date in its time,Portsmouth’s old track had been linear,meaning that one component fed into the next, so any issues would causebottlenecks until resolved.

Nathan also noted: “In addition to its flexibility, the Power Express also has greater contingency built in ascomponents have inbuilt backups. Also,because it’s modular, the new systemgives us the option of scalability as ourtest volumes increase – Beckman hasbeen able to leave space betweeninstruments should we need to add more capacity in the future.” The PowerExpress will enable the laboratory to

respond to growing demand through theability to add up to 16 instruments, fouronline refrigerated stockyards and fourcentrifuges, as required.

Partnership is keyBoth parties observed that a truepartnership approach is essential in orderto work together effectively, not only incases such as a rapid installation, but alsoduring routine operation. “Our priority is to support our customers at all times. In the case of Portsmouth PathologyService, our primary objective was to take the headache of the implementationaway from them as much as possible.Working closely with them, we dedicatedour resources to the installation andapplied our experience to deliver theautomation upgrade rapidly and withoutany impact on their 24/7 service,” notedTom Coulson.

“Over our many years of workingtogether, Beckman has delivered anexcellent service and support to us. The fact that it was prepared toimplement a full automation upgrade soclose to the end of our contract certainlydemonstrates the company’s commitmentto ensuring that we can always provide a good service, meeting all our KPIs. We also feel that we have a truepartnership with Beckman, which weparticularly noted when working aroundthe clock together to achieve thisexceptionally rapid installation,”concluded Nathan Hunt. PPiPA

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and allocated depending on what washappening and when, as detailed inconsultation with Beckman. In doing so, it meant that we never had to scrabblearound at the last minute trying to findstaff to cope when manual processeswere necessary in the absence ofautomation.”

Portsmouth observed that a crucialsuccess factor in the incredibly smoothrunning of the implementation washaving a Beckman project manager onsite every day. “Having a single point of contact throughout the entireimplementation for both hardware and ITwas ideal. Stuart McClure was a fantasticproject manager for Beckman. He wasextremely dedicated, flexible andgenerous with his time. He was constantlyavailable, meaning that there were alwaysvery strong lines of communication,”commented Nathan.

The ultimate success factor during the implementation was the fact thatPortsmouth was able to maintain its KPIsthroughout the process. By ‘triaging’workload, the most urgent samples werealways prioritised and processed first.“The KPI we use is the turnaround timefrom receipt in the laboratory to the resultbeing issued, and the most important KPI is a one-hour TAT for samples fromthe accident and emergency (A&E)department. This one-hour TAT wasmaintained at all times during theimplementation. The next most importantKPI is a four-hour TAT for in-patientsamples, which again was maintained,”highlighted Nathan.

Benefits of smooth operationOne year on since the completion of the installation in December 2015,

Nathan Hunt is Blood Sciences LaboratoryManager at Portsmouth Pathology Service;Tom Coulson is Beckman Coulter’sAutomation & IT Product Manager.

Two views of the completed Power Express automation installation at the Queen Alexandra Hospital, Portsmouth.

The main challengewas how to manage a full automationinstallation into analready automatedlaboratory with nointerruption to its 24/7 service delivery