Banner--Univsersity Medical Center Phoenix Phoenix, Arizona, United States
Background/Case Studies: A trauma center is equipped and staffed to provide expedited care for patients suffering from major traumatic injuries such motor vehicle collisions, or gunshot wounds. In such situations, time is critical for laboratory staff. Automated instrumentation may reduce result turnaround time and improve availability of blood products by allowing staff to multi-task during trauma cases. When automation is unavailable, manual testing is required despite increased potential for error and labor cost. Instrument service maybe delayed due to traffic, weather, remote hospital location, or other limiting factors. Technical Support/Remote diagnostics (rDx) may increase instrument uptime resulting in a decreased potential for manual testing error, less staff stress and better overall patient care. The purpose of our 4-year retrospective study was to determine the impact of instrument uptime facilitated by remote diagnosis across our four high volume trauma centers.
Study
Design/Methods: From 2019-2022, ~19,750 type and screen tests were performed at each trauma center. Each site leverages two Echo Lumena instruments (Immucor, Norcross GA). All calls to tech support were evaluated to determine if the issue was resolved using rDx (Blud_Direct, Immucor, Norcross GA) or required an on-site engineer (OSE). Calls not resolved using rDx were categorized based on instrument status at the time of OSE: operational vs inoperative. For all OSE with an inoperative instrument, down time was calculated from the time the engineer was dispatched until the instrument was fully functioning. This included our system’s required supervisor review and approval. The annualized overall uptime was calculated based on total hours less the total down time hours.
Results/Findings: For all eight instruments, a total of 133 calls were referred to technical support (Table 1). Of these 96 (72%) were resolved with rDx. For the 37 calls requiring OSE, the instrument was inoperable for only 17 instances over 4 years. The downtime for these 17 occurrences was 118 hours which calculates to an annualized overall uptime of 99.7%. Conclusions: Uptime is important for all facilities but especially impactful in trauma centers. All instruments will have downtime and require service. However, rDx has a significant positive impact on instrument uptime, turn-around time, and patient safety, as demonstrated with these 8 instruments and an uptime of 99.7%.
Importance of research: Technical Support/Remote diagnostics (rDx) may increase instrument uptime resulting in a decreased potential for manual testing error, less staff stress and better patient care. The purpose of our 4-year retrospective study was to determine the impact of instrument uptime facilitated by rDx across 4 high volume trauma centers. All instruments will have downtime and require service. However, rDx has a significant positive impact, as demonstrated with these 8 instruments and an uptime of 99.7%.
