• Iizuka Hospital
  • Kochi Medical School Hospital
  • The Fraternity Memorial Hospital
  • Gifu University Hospital
  • Kitano Hospital
  • Iwate Medical University Hospital
  • Yamaguchi University Hospital
  • Kurashiki Central Hospital
  • Goto Central Hospital
  • Kishiwada City Hospital
  • Aso Iizuka Hospital
  • Kochi Medical School

Laboratory Reports

The Fraternity Memorial Hospital Mar.2007

※Name of facility and titles are from the time of visit.

Reconstruction of the Clinical Laboratory with the Installation of LIS and LAS

I. Preface

The Fraternity Memorial Hospital was established as a foundation hospital in 1924 with donation from the American Red Cross after the Great Kanto Earthquake on September 1, 1923. Named in remembrance of the humanity of the American people and their deep concern of the devastated victims, the hospital began its operation in June, 1929. Although it was taken over by the occupational army for 10 years after Japan was defeated in WWll, it resumed providing medical care as a social welfare corporation in April, 1956.

<The Fraternity Memorial Hospital>

Address: 2-1-11 Yokoami, Sumida ward Tokyo 130-8587
TEL: 03-3625-6381
URL: http://www.doai.jp/
No. of Depts.: 16
No. of Beds: 427
No. of Staffs: 530

The Fraternity Memorial Hospital

Hospital specialties

ESWL (Extracorporeal Shock Wave Lithotriptern) was undertaken in their urology department from the start, and endoscopic surgery is actively operated in their orthopedic surgery department performing over 130 arthroscopic surgeries a year mainly for sumo wrestlers and other athletes. In addition, it established a nursing and convalescent ward providing 30 beds and built a special nursing home, The Fraternity Memorial Home, containing 100 beds in the same property to better serve the community and anticipate the needs of the aging community.

II. Overview of clinical laboratory

Hospital Staff(As of Jan. 2007)

Physicians (Lab. Director) 2
Medical Technologists 28
Contract Medical Technologists 3
Clerks 2
Photographic Engineer 1

No. of Tests (2005)

Urinalysis 574,290 Serology, Blood Trans 75,219
Hemato. 450,777 Pathology 12,635
Biochem. 1,149,204 Physiology 52,273
Microbio. 29,298 Non business hr testing* 14,632
Total 2,358,328

*For Jan. – March. April to Dec. are added to each dept. in Urinalysis – Physiology.

The Fraternity Memorial Hospital has been operating with our Laboratory Information System, CLINILAN since 1994, and Laboratory Automation System Open LA21 Module since May, 2006. Chief Technologist Mr. Okita told us their reason for implementing the systems and the effects.

III. Path to installation of LIS, LAS

LIS

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LAS

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Installation and update history

Oct. 1994 :
Installation of Laboratory Information System (LIS) CLINILAN Ver.7.5
Dec. 2004 :
Updated to LIS CLINILAN Ver.8
Feb. 2005 :
Order Entry System begins operation
May. 2006 :
Installation of Laboratory Automation System (LAS) Open LA21 Module System (CLINILOG Ver.3)

During the 10 years between the installation of CLINILAN Ver.7.5 in 1994 and the Order Entry System in 2005, we used FAX to report results. But because we only had three fax machines, reports were delayed during rush hours. In addition, since many additional orders were requested, we had to communicate each time by telephone which was problematic.
By implementing the Order Entry System and linking it to CLINILAN Ver.8, we were able to decrease the amount of report paper used by terminating preparation of reports, improve quality control tasks, and have access to client data in real-time. We were able to solve problems we had all at once.

Trigger for LAS installation

Although many issues were solved by the installation of the Order Entry System, problems with operations of analyzers remained. Because analyzers were operated separately on their own, we had to assign one clinical technologist for each of the larger analyzers. The responsibility of each technologist was limited to operating a specific analyzer which restricted their growth, needless to say it was very inefficient. Most of the analyzers needed to be upgraded so we considered the installation of the Open LA21 Module System which connected all to a single line.

IV. Effects by the installation of LAS

Shortened reporting time and reduced cost

The central blood collection room is located on the second floor surrounded by the outpatients and samples are sent to the laboratory on the forth floor by a dedicated elevator immediately after blood is collected. Currently, results are reported within 40 minutes after blood collection which is much faster than before. Also, because the analyzers are connected to Open LA21 Module System, consumables (tips, cups, etc.) are collected which contributed to the reduction in cost.

Central blood collection room
Central blood collection room

Elevator dedicated to sample transfer
Elevator dedicated to sample transfer

Reconstructing staff assignment

We were able to reevaluate staff assignment and improve efficiency in operation because several technologists are assigned to the single-line Open LA21 Module System reducing the burden on each technologist. Starting this April, the staff in charge of biochemistry is being assigned to blood transfusion department since blood collecting will be done only by a technologist without a nurse. The clinical engineering technician who was trained and recently assigned to a different department, had studied and acquired the certification while keeping the job.
It has almost been a year since we installed LAS but I believe there is still room for improvement in staff assignment. The transferring of technicians from laboratory testing to physiological testing will be reevaluated so that the right people will be placed at the right jobs.

V. New approach and changes

Beginning of emergency testing during evening hours by LAS

Because our hospital is a designated hospital for emergency care including hospitalization and surgery, we provide emergency testing during evening hours (24 hours on weekends and holidays) with one staff assigned in the evenings and two during day time on weekends and holidays.
Starting October, 2006, we started emergency testing with Open LA21 Module System even during evening hours. Operating 24 hours on the same system has enabled us to provide test results with the same quality regardless of the time.

Changes brought by appointment based patient examination

We began providing patient examination based on appointments starting November, 2006. In the past, tests ordered from wards and outpatients concentrated in the morning. Now appointments are spread out throughout the day and so are the test orders.

VI. Further improvement measures

I believed that LAS implementation could also play a big role in hospital operations. So a proposal was made to the hospital regarding operations.

Evaluation of expanding corporate medical checkup business

More time is available now with the reduced daily tasks by the implementation of LAS. So using that time available, business expansion would be the key to hospital operations. As something that could be reasonably implemented, I proposed expanding corporate medical checkup business.

Opening up the clinical laboratory

While expanding the corporate medical checkup business, we plan to provide new services such as offering information on tests and setting up a laboratory tour for the examinees. Although physiological testing would not be shown, we could show laboratory testing which would give patients an idea how tests are conducted and results are obtained. Our goal is to open up the laboratory and have more interaction with the clinical side by being able to provide consultation when requested or collaborate on researches with summarized and analyzed test data which would give our technologists more opportunities.

Open LA21 Module System
Open LA21 Module System

VII. Goals in the future

Currently, our daily operations are performed with stabilized systems, LIS, Order Entry System, and LAS. Our top priority now is training of personnel corresponding to the changes in generation of clinical technologists. In opening up the laboratory, there is much to do: exchanging ideas with physicians, collaborating on research, conducing individual research, and submitting research papers. In surviving the difficult times in the medical environment, technicians will be demanded to think what improvements would contribute to cost reduction and efficiency in daily operation. As a clinical laboratory, we will continue to propose business expansion ideas, plan projects that would help patients better understand about testing, and contribute to hospital operation as well as higher satisfaction from patients.

Chief Technologist Okita
Chief Technologist Okita

Laboratory Staff
Laboratory Staff

We thank Chief Technologist Okita and all staff at The Fraternity Memorial Hospital for their cooperation and support.