• 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

Yamaguchi University Hospital Jun.2005

I. Preface

Yamaguchi University Hospital Laboratory Department started out in 1949 as the General Testing Room. Two years later in 1951, opened the first nationwide clinical pathology session (Prof. Susumu Shibata) and renamed General Testing Room to Clinical Pathology Division. Later on, with the transition to becoming state run, it is set up as the hospital attached laboratory in 1967 to the present day. As a national university hospital, they were the first to be certified by Japan Council for Quality Health Care Foundation. Their certification has been renewed in March, 2004 after documentary examination and visitation examination evaluated that they have met the standards set by the council.

<Yamaguchi University Hospital>

Address: 1-1-1 Minami-kogushi, Ube-shi, Yamaguchi-ken, Japan 755-8508
TEL: 0836-22-2111 (main number)
Website: http://www.hosp.yamaguchi-u.ac.jp/
No. of Dept.: 34
No. of Beds: 759
No. of Staff: 1,136

Yamaguchi University Hospital

II. Overview and principal of Laboratory

We have 34 clinical technologists at the laboratory who handle 300 to 400 samples a day (including 100 to 200 STAT samples). In order to provide patient centered medial care, we continue our effort in making improvements, developing and researching new testing methods and providing advanced medical technology as well as training and educating testing technology and medicine for the training of personnel.

III. One-floor laboratory

The layout of our laboratory is designed in a way that samples are transported smoothly from blood collection to measurement without moving through different testing fields in separated rooms so that patients and medical personnel from other divisions can visually see the testing operations in an open laboratory.

One-floor laboratory

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IV. Preparation of blood collection tube to sample reception

Outpatient blood collection room
Blood collection tubes with barcodes are prepared by the blood collection tube preparation system after patient registration. The outpatient blood collection room is adjacent to the laboratory and the samples are tested rapidly.

Outpatient blood collection room

Hospital ward sample transportation box
Samples collected in the hospital wards are delivered in a box by a messenger so that patient privacy is protected and also loss of samples and infection to messenger are prevented.

Hospital ward sample transportation box

V. LAS (Open LA21 Module System)

LAS

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Sample loading
STAT and normal samples are separated when loaded. STAT samples are prioritized.

De-cap
At our hospital, we use rubber top test tubes of length, 100mm and 75 mm.

Aliquot
We use 2 units of aliquot modules. With Open LA21 Module System, more than one unit of the same module can be installed.

Buffer Module (1st run)
Temporarily stores pre-analytical samples. STAT are prioritized and pass normal samples here.

OpenLA21 Module System

Sample loading Module / De-cap Module

Aliquot Module / Buffer Module (1st run)

AIA-1800LA

AIA-1800LA

AIA-1800LA by Tosoh is suitable for rapid testing because of its high throughput and short reaction time. (Antigen-antibody reaction time of ST reagent is 10 minutes.)

JCA-BM2250

JCA-BM2250

Installment of JCA-BM2250 by JEOL enabled cost reduction by reducing the amount of reagent and sample used.

ARCHITECT i2000

ARCHITECT i2000

ARCHITECT i2000 by ABBOTT Japan measures 14 mainly hormone and immunology items (TSH, FT3, FT4, T3, T4, LH, FSH, Prolactin, CA19-9, PSA, Free-PSA, HBs-Ag, HBs-Ab, HCV).

VI. Effects of LAS implementation

Chief Technologist Nakamura:
Test results are reported within 40 minutes for 60% of normal samples, within 70 minutes for 90 % of them, and for STAT 90% within 40 minutes. Because of this system, we are now able to report pre-examination test results and perform urgent testing within time. Also, consolidating test items contributed to cost reduction and lessened strain on patients by reducing the amount of blood sample collected. Even from a risk management perspective, we were able to make improvements by preventing sample mix-ups and infections by reducing direct contact with samples.

VII. LIS – Laboratory Information System

Chief Technologist Nakamura:
We installed the clinical testing system by A&T, CLINILAN GL, which is highly compatible with the CLINILOG V3, the sample transportation system, and unifies management of sample testing and testing during duty. This system is connected to HIS ordering system via LAINS, clinical testing system by Fujitsu. We operate with the sample transportation system, CLINILOG V3 by A&T which enables rapid pre-examination testing for outpatients.
In the near future, we plan to operate real-time independent data check by Zone Verification Method to unify rerun range of abnormal values that differs between technologists and continue our effort in saving labor and faster operations.

LIS

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VIII. Establishing a testing structure suitable for patient centered medical care

Chief Technologist Nakamura:
What I keep in mind everyday in daily operations is to get test results back to the clinical side – doctors and nurses – as quickly as possible. After implementing this system, we have been carrying this out even further. Implementation of LAS not only saved labor in daily operations and sped up reporting of results, but it enabled cutbacks in testing costs and efficient assigning of personnel. In addition, fewer burdens are put on patients. For example, conducting per-examination testing or requiring less sample collection amount from children adds to the improvement of outpatient medical service.
From a laboratory stand point, infection prevention safety measures for operators and prevention of sample mix-ups are taken. Since partial adjustments and outside extension can be done, it is an advantage in future renewal and addition of automated analyzers for cutting back cost. We would like to continue operating resourcefully even further in the future.

Chief Technologist Nakamura

Chief Technologist Nakamura

Prof. Hinoda and laboratory staff

Prof. Hinoda and laboratory staff

Special thanks to Chief Technologist Nakamura and staff at Yamaguchi University Hospital.