ARUP is one of the most automated laboratories in the U.S. An 1,100 foot transport and sorting system with a capacity of 8,000 specimens per hour is one of the key elements. Equally important to our success are two automated sorters that load finished specimens into storage trays and a two-story automated storage and retrieval system (AS/RS) which is housed in the world's largest clinical laboratory freezer. The AS/RS capacity exceeds 2.3 million specimens and individual specimens are robotically retrieved in less than 2.5 minutes. ARUP has also installed the world's first automated thawing & mixing workcell. It thaws and mixes frozen specimens on the transport system at a rate of more than 1,000 per hour, thus reducing pre-analytical preparation time. ARUP is committed to developing cutting edge automation that improves the overall quality of testing and reduces turn-around time.
Summary of Overall Plan:
Total Laboratory Automation (TLA), as well as modular laboratory automation, has seen widespread adoption in the past decade. Worldwide, there are now an estimated 800 laboratories with automation systems. However, ARUP's automation is unique when compared to the automation in these other laboratories. These laboratories have generally applied automation to centrifugation, aliquotting, and the interfacing to analyzers for serum chemistry, immunoassay, hematology, and coagulation tests. ARUP, on the other hand, has had to adapt automation systems to its esoteric testing environment. ARUP's accomplishments in automation are widely regarded in the industry and members of the ARUP team have been recognized in publications, and with speaking invitations and a major award.
Using the 20/80 rule, most labs that have implemented some form of TLA agree that 20% of their test menu makes up about 80% of their test volume. In these labs, 35 to 55 different tests typically comprise 80% of the total workload. These tests may include serum chemistry profiles, CBCs with differentials, thyroid profiles, some additional high-volume immunoassays, urine analyses, protimes, electrolytes, and a few TDM tests. Because ARUP performs esoteric testing that is often considered "sendout" testing for our clients, ARUP cannot follow a 20/80 rule. It takes more than 1000 different tests in ARUP's menu to comprise 80% of ARUP's test volume, with many of these tests being infrequent manual tests performed in small batches. ARUP’s automation needs have clearly been different. They have involved the elimination of excessive handling and sorting, improved tracking, storage and retrieval of specimens for repeat or additional testing, and real-time communication among all of ARUP’s laboratory-related software systems.
Automation by itself generally does not improve processes. Poor laboratory processes may function faster with automation, but they are still poor processes. That's why the key to ARUP's automation success lies in the other changes that were implemented in conjunction with automation - in the adoption of a standardized transfer tube, in the consolidation of higher volume testing in an Automated Core Laboratory, in the development of a new rules-based, intelligent order-entry and support software system (Expert Specimen Processing or ESP), and in the redesigning of the specimen processing workstations to be used with the Automated Transport and Sorting System (called Automated Track System for short). Also, as ARUP re-engineered its various processes, ARUP utilized its internal Continuous Quality Improvement program that uses employee teams to recognize and address improvement opportunities. Thus, ARUP achieved a superior overall outcome that has been successful from ARUP's perspective, as well as from the perspective of ARUP's clients.