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Dome - A big move for Pathology

March 2011

A big move for Pathology

Date: March 4, 2011

The new Core Lab expands and updates diagnostic services for clinical customers near and far.

Judith Frazier (l) and Rhonda Cole look forward to the fully automated Core Lab that will serve the new clinical buildings with streamlined workflow and expanded diagnostic testing capabilities.
Judith Frazier (l) and Rhonda Cole look forward to the fully automated Core Lab that will serve the new clinical buildings with streamlined workflow and expanded diagnostic testing capabilities.

Every day, thousands of specimens taken from inpatients travel to and from the Core Lab at The Johns Hopkins Hospital by way of a pneumatic tube system. Still, backups can occur when the carriers that hold blood and urine samples accumulate at one end of the two-way tube system.

But these traffic jams should cease with the introduction of dedicated “inbound” and “outbound” tubes in the new Core Lab, set to open early next year in the Sheikh Zayed Critical Care Tower. 

The reconfigured pneumatic tube system is just one feature of the full-service pathology lab, which will cover 26,000 feet on the B1 level of the adult critical care tower. “It’s like Star Wars,” says processing supervisor Rhonda Cole. The state-of-the-art machinery will streamline workflow, expand the lab’s diagnostic testing capabilities and meet the clinical needs of Johns Hopkins Medicine care providers, ranging from Hopkins Hospital and Howard County General Hospital to the more than two dozen Johns Hopkins Community Physicians clinics as distant as Hagerstown.

The new lab will be equipped with a chemistry automation line with 11 analyzers and a new hematology automation line. Cole is particularly enthusiastic about the hands-free robotic system that will automatically transfer specimens to a storage refrigerator that can hold 27,000 samples. By reading the barcode automatically attached to each tube, “the machine will even go and retrieve a specimen and physically dispose of it after it expires at seven days,” she says. 

A merger of convenience

When the new lab is up and running, it will absorb a number of “satellite” labs that are scheduled to close, including the Emergency Department lab and the Weinberg hematology lab. The Core Lab will be located directly below the ED in the new building, promising a swift response to ED orders. One of the lab’s three pneumatic tube stations will receive samples solely from two-way tubes linked to the adult and pediatric EDs and trauma services. 

In many cases, consolidation with the ED lab will also simplify blood collection procedures. For example, today a routine order from the ED for both a blood profile and a test to detect trauma through the presence of the enzyme lactate dehydrogenate requires the collection of two tubes of blood, one for the Core Lab and one for the ED lab. After the move to the critical care tower, all testing will occur in the Core Lab, eliminating the need to draw a second tube of blood from patients in order to send specimens to two different labs.

Relocating to the new building will bring other high-tech methods for improving efficiency and patient safety to the lab and supporting services. Core Lab staff members are mastering a new laboratory information system. Called SoftLab, the system links together all lab operations and support services and creates a central location for entering, reading and analyzing data.

And soon, phlebotomists working on inpatient units will receive training on how to read orders for blood collections on a handheld device manufactured by CareFusion. “Instead of handing them their list of work as they go out, they will be able to see where they need to draw blood in the new system. It’s paperless,” says Lois Tissue, a pathology support services supervisor who is overseeing the transition to the electronic system.

In the new building, phlebotomists will also use portable printers to produce labels for blood specimens at the bedside. “It’s important for a positive patient identification,” Tissue says. “Too many preprinted labels can be misread and intended for a different patient. For patient safety, it’s extremely important.”

—Stephanie Shapiro