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UNDER THE MICROSCOPE
At the time, Alverno was facing significant growth
in histology with an influx of work coming from hos-
pitals and clients, but lacked an e ective way to track
all the work, says Sam Terese, who oversees opera-
tions at Alverno as chief operating o cer of Sisters of
Saint Francis in Hammond, and serves as a member
of HealthTrust's Lab Advisory Board.
Because of the number of hando s and potential
for human error, "there were lots of risks to patient
safety," Terese says. "We wanted something that
brought more control into the process."
Enter Vantage, a product from Ventana that uses a
series of unique systems to positively identify patients'
slides throughout the entire process. (HealthTrust
currently has an agreement with Ventana for its
Benchmark Ultra, Benchmark XT and NexEs Special
Stainer, though not its Vantage product.)
According to Terese, the decision to implement a
positive ID workflow solution at Alverno came down
to two issues: first, improve patient safety, and second,
Workflow solutions significantly reduce the risk
of mislabeling, leading to positive patient identifica-
tion through all of the necessary hando s. The first
step is assigning a barcode, which is then scanned at
every stop along the way, providing a slide's status
instantaneously when needed. By automating the
identification process and capturing data in real time
for associated reports, Alverno was able to double its
productivity with minimal personnel increase with
an ROI of approximately one year, Terese says.
"So far it's pretty golden if you can do those things,"
Linda Harmon, manager of histology at Alverno,
says workflow solutions are helpful because they
utilize barcodes to eliminate manual steps such
as manual keyboard entry, manual logs and slide
labeling, including handwriting on tissue cassettes
"The specimen is tracked from start to finish, with
milestones at all steps of the process---registration,
gross exam, embedding, staining, microtomy and
case assembly," Harmon says. "The system allows
us to track who was responsible for each step of the
process. Having this information available allows us
to quickly resolve questions involving a particular
case. Quality is improved because comments can be
attached to a case, which assures better communica-
tion throughout the process."
Vantage also meets LEAN Sigma Six standards, an
advantage Terese considered when he adopted the
system. With eight certified LEAN experts on sta ,
Alverno has completed LEAN activities at all of its
"Our goals' requirements span across the LEAN
system at every site, plugging into histology as well,"
Terese is quick to point out that medical facilities
considering a workflow solution program should first
look at how its overall laboratory processes operate
from a LEAN viewpoint.
"The machines are very good at doing the same
thing over and over again precisely. However,
they will also do the wrong thing over and over
precisely. LEAN doesn't necessarily evaluate a full
project," Terese says. "You don't want to automate
In addition to increased patient safety, another
patient care benefit comes from the expediency the
system also provides, Terese says.
To bring into focus what he and his sta do each
day, Terese keeps in mind a saying he heard a long
"A delay in time in a biopsy means someone sleeps
one less night," he says. "Someone is waiting and
wondering, 'Do I have cancer? Is it malignant?' We
have to take that into account in histology more than
any other area.
"The turnaround time is a patient-care issue,"
Terese adds, noting that a workflow solution's auto-
mation typically lessens the time it takes to process
"Just because somebody doesn't have a workflow
solution program doesn't mean they are a bad lab.
Your risk is that the bigger you get, the busier you
get," Terese says. "You get so busy, you can't accept
While Terese hesitated to give specific ROI esti-
mates, he estimates the payback calculation is less
than three years for most facilities. Alverno's quick
ROI of approximately one year was because of volume
growth, he says.
"When you consider mislabeling a biopsy and hav-
ing a patient undergo a surgical procedure they don't
need, sometimes you just have to look at such a system
as the right thing to do---assuming, of course, you
can," he adds. •
continued from page 18
By automating the identification process and
capturing data in real time, Alverno was able
to double its productivity with minimal
personnel increase. "In a lab, turnaround time
is a patient-care issue. The automation of a
workflow solution typically lessens the time it
takes to process a specimen." ---Sam Terese
Third Quarter 2012 | The Source 21
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