LAB MANAGEMENT :: LAB OF THE YEAR
The laboratory completed a multimillion-dollar expansion in 2014. The original square footage of 28,000 expanded to a 43,000-square-foot laboratory that performs more than two million tests each year. The clinical laboratory renovation was a five- phase project spanning five years.
Customer service
Both inpatient and outpatient providers order tests through the electronic medical record (EMR). Orders are placed directly in the EMR by the physician—eliminating transcription order errors. Inpatient orders are downloaded to the phle- botomy hand-held units. Upon receipt of the test order the phlebotomist scans the patient ID brace- let, confirming the correct patient, and prints the labels for bedside collection. Since the implemen- tation of hand-held scanning devices and print- ers, the phlebotomy department consistently maintained a low deviation rate for misidentified samples. In 2018, the phlebotomy department reached 356 days without a defect. The phle- botomy department was awarded the Penn Sys- tem 2018 Quality and Safety Award, Honorable Mention for Positive Patient Identification. LGH laboratories offer convenience and easy access to outpatient services. There are 15 ambulatory draw sites in Lancaster county and two surrounding coun- ties. Each site offers POCT for Protime/INR, and some sites offer additional POCT based on the services provided on-site, as well as pregnancy and creatinine for diagnostic imaging. The hospital courier depart- ment provides services to each ambulatory draw site, as well as Lancaster general physician offices. The samples are delivered to the LGH or WBH labo- ratories. The ambulatory draw sites use the labora- tory information system (LIS)—samples are tracked on transport lists and lab pending lists to ensure specimen safe delivery. The Off-Site Services department provides patient
Productivity
The Microbiology department has implemented the BD (Becton, Dickinson and Company) Laboratory
Microbiology Technologists logging samples in LIS
Automation System. In 2013 the LGH laboratory went live with the InoqulA—an automated plating system which brings standardization to specimen plating. The final phase of the automation system was completed in 2017.
services for 25 extended care facilities in Lancaster and Lebanon counties with 4,157 skilled care beds overall. Routine and 24/7 STAT phlebotomy are pro- vided. Starting this year, the team will be working with 23 area group homes to bring phlebotomy to their individual residences. This program is designed to help patients who are fearful of phlebotomy pro- cedures and avoid compliance to necessary testing. This volume results in over 115,000 tests annually. The Lancaster General Blood Bank is self-sufficient in that 90 to 95 percent of products transfused are collected at the Lancaster General Donor Center. The Donor Center supports a fixed site and mobile blood drive operations. Three community blood drives occur each week in the county. The Donor Center collects and processes approximately 10,000 dona- tions per year including platelet pheresis for single donor platelet products. A hospital transportation service is available to community members for transportation to and from blood drives. Many of the donor population comes from the Amish community and others in the community who want to participate but face transportation barriers.
Microbiology is the 2018 LGH Patient Safety overall winner for the Most Enhancement to Safe Practice and the 2017 Operational Winner of the Penn Medicine/Lancaster General Health Quality and Safety Award for Microbiology automated sys- tem improvements. It was designated as a Cepheid Center of Excellence in 2018 by the company. The fully automated Core Lab has a front-loading system connected to a line that transports samples to the chemistry, immunology, and urinalysis instruments. Another line for Hematology trans- ports samples through the hematology analyzer/ slide stainer and WBC differentials are read on a digital cell reader. Middleware is utilized to monitor and automatically release patient results from the LIS into the EMR based on defined limits. Pathology utilizes a bar coding system, Vantage, for patient identification for sample grossing and processing in histology, reducing labeling errors by 94 percent.
In the Blood Bank, 6-/7-day platelet product expiration extension with bacterial detection test- ing was implemented which resulted in discarding 39 percent less single donor platelets. This resulted in less recruiting/collection of donors and the conservation of the donor pool.
Teamwork LGH’s laboratory is focused on the continuum of care. Working closely with physician practices, they realized how the lab could assist in help- ing their patients meet screening requirements for colorectal cancer. An in-home testing product was selected by the Medical Director based upon sensitivity and specificity as well as ease of use for
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