Feature | May 21, 2006

Creating the Error-Free Lab

Speaking Out...with Lynda Banig

Lynda Banig has 20 years experience in executive management roles in a variety of industries. Today she is president of Radiometer America Inc., a Westlake, OH-based provider of acute care testing solutions.

Patient safety is on everyone's mind today. In the lab setting, what types of errors are most prevalent in your opinion — what do hospitals struggle with the most in the area of blood gas testing?
There are basically four types of errors that can occur in the analytical process for blood gas testing: (1) specimen mislabeling, which means there’s been a mismatch of the patient ID and the specimen; (2) improper mixing of the specimen; (3) adding air bubbles in the sample; and (4) samples delayed in transport that begin to separate and aren't good for blood gas analysis.
These could all lead to inadvertent errors in patient care and treatment.
Blood gas errors can lead to incorrect patient treatment, delays in treatment or no treatment. You also may have the situation of having to go back and do a redraw, which is never pleasant for the patient at any point.
What are some specific ways that analyzers can help prevent errors?
Blood gas analyzers, in and of themselves, don't prevent errors — they are only one phase of the testing process. What we look at and what we provide at Radiometer is a total system approach that links those tools used in each phase of the process as a way to minimize the opportunity for error.
Our program is called 1st automatic and it's the first complete blood gas analysis system that combines instruments, blood gas analyzers, samplers and IT solutions to reduce steps in the analytical process and improve both patient and operator safety as well as minimize errors.
We have our FLEXLINK software, which, through a bar code scanner at the bedside, you can use to link the operator, the patient and the sample via the bar code on the sampler and translate that to our FLEXQ analyzer that has automated sample scanning, automated mixing and automated aspiration.
‘Automated’ seems to be the operative word. Elaborate on the connectivity and IT arm of this discussion.
Blood gas testing is an entire process linked by a strong IT backbone as part of the solution to reducing errors and improving both patient and operator safety. I think that the IT portion of the equation probably has the greatest impact on patient care by being able to decrease the turnaround time of getting good information back to physicians to make treatment decisions.
The benefit to the patient is quicker results for quicker clinical intervention and having clinicians who are able to correlate their situation to the measured result.
Our 1st automatic is the solution for not only patient care but we also use it to help manage results and data flow. We try to capture all the critical patient data right at the bedside with FLEXLINK software, and that's linked to the patient and the sampler. So hopefully we improve the continuity of information. FLEXLINK also helps us prevent any patient ID mix-ups and return results quickly to the clinician.
FLEXLINK is a module of our RADIANCE data management system that allows our analyzers to communicate in common standard format to lab information systems, hospital information systems, medical records systems and other systems so  we can provide clean linkages of information across all the hospital systems from the testing environment.
Tell me some more of the variables that make customization so important. What kinds of things can be customized with analyzers?
The biggest issues we face in customization stem from the fact that from hospital to hospital and even from department to department within a hospital, their processes for delivering results to clinicians can vary. So we have to be in a position to have a relatively open architecture that will allow us to use our analyzer data and get relevant clinical information available to the physician as quickly as possible. That information can vary quite a bit even depending on the patient. We have the ability to customize data input screens for different patient conditions; you know, neonates versus adults.
We also have the option to access this information at the bedside, even if the analyzer is not there. It is a function of working with our hospital partners through what we call process analysis in order to define the best way to lay out the program — to look at ways we can help them improve their processes, lean-out their processes, if you will, to make their operations more efficient.
What are all the elements that comprise an ideal, high-efficiency, error-resistant testing environment?
One of the biggest opportunities we see in creating this kind of environment is to work with our hospitals to identify their needs for blood gas testing beyond just the specific analyzer.
We want to look with them at their goals for improving staff and patient safety; we want to look at their samplers — are they properly identifying patients with the samples? We want to work with them on how they are handling patient ID at the bedside and throughout the process.
We want to work with them on how can they optimize their requirements to address blood-borne pathogens. Are they protecting their caregivers? Are they using a collection product with an integrated needle safety device?  Are they capturing all the information at the bedside and making it available as quickly as possible to the physician as well as the lab and billing systems?
We also help them optimize their regulatory responsibilities for quality assurance, helping them substantiate that they are providing high-quality blood testing solutions at their hospital.
We look at it not just in terms of the analyzer alone, but we view a really high-quality testing environment as one that is concerned with how they collect the samples, how they transport the samples, how quickly and efficiently they process those samples and then how they substantiate their QA.

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