Automate with Experience. Get Results.

Automating an entire diagnostic laboratory is complex, time-consuming, and disruptive and carries the risk that, once implemented, the project may result in suboptimal return on investment. But when a project is planned, engineered, installed, and supported with sufficient expertise, it doesn’t have to be daunting. Siemens Healthineers turns tough projects into smooth processes.

Nearly a generation ago, Siemens Healthineers brought core competencies in engineering, Lean manufacturing, and project management cultivated in large-scale energy and industrial projects to innovative diagnostic laboratories on the frontier of healthcare. Today, we have completed more than 1600* total laboratory automation projects in over 50 countries. We use a performance-proven process of delivering medical automation systems to improve laboratory management. Each phase of the process is carefully designed, and Siemens Healthineers is with you every step of the way.

We start with an understanding of your current process: what works well, what areas you would like to improve, what constraints exist, etc. Rather than simply mechanizing the existing process for marginal improvement, our goal is to help you create new and better relationships between people, technology, and processes to significantly increase productivity, reduce costs, and smooth operations.

The Healthcare Consulting Solutions (HCS) expert assigned to your project is part of a team that conducts more than 900 workflow consultations each year. He or she brings a holistic viewpoint to the project that extends beyond the diagnostic systems and track to consider how samples are collected, how tubes are transported to and from the lab, what happens when samples arrive, how errors occur and can be avoided, how reports are sent out, etc. Together, you will determine key performance indicators, map out and test an ideal process against simulation tools based on current and anticipated workloads, and set up a plan for monitoring performance and measuring success. By the end of this phase, you will have a clear and compelling vision that is easy to communicate and appeals to your board, internal and external customers, and employees.

The vision of the new, or next-generation, automated lab is exciting, but the project cannot proceed until a comprehensive implementation plan—and a project leader with sufficient time and decision-making authority—are in place. Siemens will help you establish realistic timelines, resource requirements, and milestones. We will also help you identify how team members inside the process, as well as facilitators and vendors outside the project, may be impacted by proposed schedules.

Siemens’ expertise in project management is not limited to total laboratory automation solutions. Our systemic approach to professional project management is employed by some 15,000 Siemens project managers working every day on large-scale energy and industrial projects worldwide. Our goal is to continually improve our processes. Our commitment to managing projects in an excellent, innovative, and responsible way guides us in doing so.

Download: Consider five powerful principles for automation success

During the installation of a new track, it’s easy to get lost in the hardware. As new diagnostic systems, pre- and post-analytical modules, and data-management systems are being delivered, assembled, tested, etc., it is critical to perform load and menu balancing to establish productivity benchmarks that will be used during optimization and ongoing health checks. However, it is also crucial to slow down and carefully address an important, yet intangible, factor that impacts success: effective change management. Whether this is your first automation project or an expansion, you are not only integrating chemistry, immunoassay, hematology, and hemostasis testing—you are uniting people.

Change management looks deeply at the work culture: the beliefs, values, and assumptions that influence how quickly and easily the organization adapts to the changes in workflow. For example, although new procedures for loading samples may have been identified during planning, unspoken perceptions such as fear of job loss, lack of skills, comfort zones, negative history of change, etc., can impede the adoption of these new activities. Without a carefully managed approach, newly automated laboratory operations may be subject to confusion, anxiety, frustration, false starts, and only gradual change. Successful transitions incorporate vision, skills, incentives, tools, and a formal action plan.

For Siemens, delivering a laboratory automation solution includes supporting transition management. With more than 1400* projects to our credit, we can offer techniques to help a project leader create a sense of urgency, form power coalitions, communicate a vision, empower others to act, and establish the short-term wins, celebrations, and recognition that contribute to success.

During implementation, the focus is on ensuring that the track, pre-and post-analytical modules, diagnostic systems, and IT tools are in place and functioning correctly. In contrast, the goal of this phase of the project is to understand how the process as a whole is working. The health check analysis examines the human-machine interaction from the time a sample enters the laboratory until the result is generated and the tube is disposed. This optimization is recommended within 3 months of the official “go-live” date.

To help create a snapshot of the laboratory’s performance, 2–3 days’ worth of log and middleware files are analyzed in four distinct categories: production, utilization, turnaround time (TAT) analysis, and errors. After data collection and analysis, a 1-day, on-site observation allows integration of the collected data with what is actually happening in the laboratory. If performance is below target, an action plan is devised. It may call for technical refinements, additional training, or even a rapid-improvement event to dissect and rebuild the current process to remove non-value-added steps. The new process is then implemented, measured, and refined as necessary and the health check repeated to ensure that improvements are realized.

Read the complete article: Automation and Optimization: The Importance of the Health Check.

With Siemens as your business partner, customer care isn’t limited to ongoing annual health checks and consulting services designed to improve system utilization. Siemens Customer Care draws on a wealth of experience and knowledge to provide a variety of innovative services you need to optimize performance, get more from your investment, and improve patient care—and ultimately deliver sustainable healthcare.

Making sure you stay up and running takes more than simply replacing parts. Our System Services proactively ensure that your systems are always technically up to date and optimized for enhanced uptime. Personalized training unlocks your staff’s potential to improve efficiency and keep your organization at the forefront of clinical diagnostics. Professional IT services are designed to maintain system productivity, performance, and security. Siemens Remote Service (SRS) provides a secure data link for monitoring that enables fast error identification, remote repair, application support, and preventive maintenance to track down problems before they have a major impact on your operation. Collaboration services are designed to support you—anytime and anywhere—concerning questions about usage. And our comprehensive online teamplay Fleet portal provides an overview of all service-related activities, documents, and reports—enabling you to communicate, follow, monitor, plan, interact, and shop.

We stay close to you, so you can stay closer to your business.

Siemens Healthineers customers consistently get the results they expect—and more—from our total laboratory automation solutions. We’re the global leader** with the most track-based automation customers** because every project we are entrusted with is planned, designed, installed, and supported to satisfy the unique needs of an individual customer’s laboratory. Siemens Healthineers turns challenges into achievements.

Improving workflows, laboratory management, and clinical quality with track-based solutions is not the only way Siemens helps customers achieve their goals. Where total automation is not feasible or doesn’t provide a complete laboratory management solution, Siemens offers a broad portfolio to resolve customer problems.

Operational manager at South Tees NHS Trust talks about VersaCell^® System footprint, sorting capabilities, and simple software

With strong project management and practiced coordination, there is a large team of Siemens Healthineers experts working behind the scenes for our customers. Gain insight from the Lean experts, sales consultants, workload analysts, design engineers, and technical applications and field support specialists who contributed to our more than 1600* total laboratory automation projects. Siemens Healthineers turns collective experience into individualized guidance.

In my experience, the phase between the initial installation and the final handover to routine operation can last 3–6 months and sometimes longer. More specifically, the stabilization and optimization activities that take place between a defined training period and a discrete handover deadline are typically the most difficult to predict. During this period, new processes and operating procedures start to take hold, as previously independent diagnostic empires begin to function as a holistic team leveraging a common transport and centralized data-management system. Siemens field service personnel and technical application specialists, who will support the site going forward, join the team. In addition to implementing fairly straightforward technical refinements to improve performance of the automation system, we frequently see human and process issues that were not visible when the automated laboratory was still theoretical. When this happens, the Siemens Healthcare Consulting Services team will help the customer organize rapid-improvement events and employ other Lean process strategies to better optimize overall laboratory operations. Although it can take time and be a bit unpredictable, the laboratory director and staff improve their change-management skills and are better equipped to drive for continuous improvements in their operation long after this discrete automation project has been completed.

—Stan B., Senior Manager, HCS, ~12 years at Siemens

Both have challenges, but they tend to be different. For instance, during the implementation phase, a second- or third-generation project tends to require more planning and training to enable staff to temporarily adopt manual, stand-alone lab operations while the old track is dismantled and the new system is installed. This can be especially challenging when a site has been automated for a long time and the staff has limited experience in a nonautomated environment. Once the new track is up and running, however, adapting to a different automation and IT system tends to be comparatively fast. In contrast, laboratories automating for the first time do not experience the same degree of operational disruption when the new system is being installed and tested. However, more time and training may be needed during the post-implementation phase as the staff learns brand-new operating procedures and gets familiar with centralized data-management tools.

—Margaret P., Senior Manager HCS Training and Quality, ~15 years at Siemens

The environment must support the operating range specified for the most sensitive analyzer in the laboratory—not just temperature, but relative humidity, electrical draw, etc. And noise and light are equally important considerations in the working conditions for laboratory staff. Ensuring that the room stays within all ideal ranges is part of the design challenge. Effective planning and design considers the location of heating and air conditioning units and overhead lighting, thermal output of all the connected systems, year-round changes in seasonal temperatures and natural sunlight in rooms with windows, and more. The need to understand and address these factors often requires the support of the engineering and IT staff at the customer organization.

—Jack M., Senior Director Customer Service, ~34 years at Siemens

Not necessarily. Laboratories should independently examine overall operations to understand all the opportunities for improvement before thinking about automating. With no other changes, automation simply mechanizes a portion of the overall process and is unlikely to yield the significant productivity and cost improvements desired. For this reason, Siemens performs a Lean process review of key workflows, both inside and outside the laboratory, as part of any pre-sales engagement. As all pre- and post-analytical processes are evaluated and optimized, it can become easier to improve the design and ROI for the total end-to-end solution. For example, if a laboratory can reduce the number of aliquots through process changes, there is no benefit in taking up valuable space, time, and money to buy and maintain an automated aliquot module on the track.

—Sue Y., Senior Manager, HCS, ~10 years at Siemens

We have found quite the contrary to be true. Our customers have reported that the opposite happens. By its very nature, automation mechanizes many of the low-skill, non-value-added tasks, such as tube decapping, aliquotting, sorting and individual tube loading, locating and retrieving patient samples, capping and storing tubes for future testing, disposing of expired samples, manually checking reagent levels, and so on. Automating these tasks gives everyone more time to perform more-valuable activities.

Consider the impact of employing autoverification rules to release results: Laboratory staff needs only to consider the typically small number of results that have been held for manual review. This removes a great deal of pressure created by the sheer volume of results and encourages more thoughtful and considered decisions for the results that actually require attention. When the flagged results are accompanied by information about why the sample was held for review (outside acceptable range, QC rule exception, delta check, or an instrument or sample flag), staff can make an informed decision to release or retest, thereby avoiding unnecessary testing and the associated low-value tasks standing in the way of addressing the clinical issues that matter most.

For senior staff, this extra time can offer the opportunity to explore new testing protocols and further the patient-care mission of the lab. For all staff, free time can be used for enhanced training and development work to “up-skill” personnel. When released from the crushing volume of work, even nontechnical personnel can focus on further enhancing processes in ways that increase turnaround times to speed diagnosis and improve patient outcomes.

—Jeff A., Head of HCS Northwest Europe, ~9 years at Siemens

Lean processes and analysis tools are used throughout all phases of a Siemens automation project, and the many of the experts on our Healthcare Consulting Services staff are Lean Healthcare-accredited by the University of Michigan. During process definition and project validation phase, we share best practices and use value stream mapping to reduce non-value-added activities for overall laboratory operations, not just the automated track. During the installation and stabilization phase, we may organize rapid-improvement events to optimize the period of stand-alone operation and set the stage for new processes to be adopted in the automated environment. Finally, the post-implementation and health check phase of a project may uncover new opportunities to streamline processes both on and off the track. For example, an analysis of error messages may highlight patterns in sample handling across three shifts. Likewise, with the automation and centralized data-management systems operating smoothly, it becomes easier to identify bottlenecks that delay reporting of results to physicians. In each case, new processes will be implemented, measured, and refined following the Plan-Do-Check-Act steps of traditional continuous improvement

—Denise O., Senior Manager, HCS, ~13 years at Siemens

This is a valid question almost always asked by customers. When a design that includes only Siemens systems is agreed upon, it is possible to estimate track throughput with a high degree of accuracy using simulation tools. Projections are more difficult for open solutions that utilize diagnostic systems from other manufacturers. Interestingly, based on the volume of data that Siemens has collected in the development of its diagnostic analyzers as well as its automation projects, a variable that has a tremendous influence on throughput—the number of tests needed per tube—actually tends to be quite constant by region. The simulation uses the actual data stream from a heavy testing day for that specific site rather than estimating peak loads. Using real customer data, the actual time that samples arrived in the lab and the actual tests ordered are factored into the equation, along with the number and type of pre- and post-analytical modules and diagnostic systems that will populate the track. To improve the accuracy of the projection, Siemens methodologies utilize discrete event simulation so the testing path for one tube directly affects the testing path for the next tube, and so on. No estimate can overcome “people factors” that come into play when the actual system comes online, such as a random decision to start directly front-loading analyzers on the track. However, the calculation is done with a level of precision that has been successfully used to set performance benchmarks for final installations.

—Marc M., Automation & HCS Manager, ~9 years at Siemens

When customers come from an environment where pre-analytic workflow can be improved—for example, if batching has been creating constraints—the first impulse may be to request the largest-capacity and fastest systems in the belief this will solve workflow concerns. This can easily lead to underutilized diagnostic capacity that requires calibrations, controls, maintenance, and extra staffing. However, when we are able to show these laboratories how to smooth out pre-analytical processes to deliver smaller batches on a more-timely basis, they see how easy it is to get by—and even grow—with fewer and/or smaller instruments.

For example, dedicating three staff members to pre-analytics when only one person is responsible for demographic entry can create an imbalance that delays samples from moving to the track. Reassigning personnel with an eye toward establishing a similar pace or TAKT time for both processes can reduce or eliminate artificial peaks in workload. It’s also important to understand how phlebotomy procedures, courier routes, and other factors outside the laboratory contribute to batching.

The pre-analytical process needs to be as smooth as possible to support more-accurate and appropriate planning of diagnostics. In addition, the use of highly integrated, “smart” middleware on the track for intelligent routing and post-analytical processing can also prevent overinvestment in diagnostic systems.

—Alistair J., Regional Sales Manager, ~19 years at Siemens

Both have challenges, but they tend to be different. For instance, during the implementation phase, a second- or third-generation project tends to require more planning and training to enable staff to temporarily adopt manual, stand-alone lab operations while the old track is dismantled and the new system is installed. This can be especially challenging when a site has been automated for a long time and the staff has limited experience in a nonautomated environment. Once the new track is up and running, however, adapting to a different automation and IT system tends to be comparatively fast. In contrast, laboratories automating for the first time do not experience the same degree of operational disruption when the new system is being installed and tested. However, more time and training may be needed during the post-implementation phase as the staff learns brand-new operating procedures and gets familiar with centralized data-management tools.

—Margaret P., Senior Manager HCS Training and Quality, ~15 years at Siemens

The timing and frequency of system health checks depend on the complexity of the project and the needs of the customer. After the implementation and initial optimization period, a first pulse takes place within 3 months of the go-live hand-off from the Siemens healthcare project manager to the Siemens field service engineer. If operations are smooth and performance (i.e., system utilization, turnaround times) is acceptable, ongoing health checks may only need to be scheduled annually. However, if performance is not what was expected, immediate action is taken to fine-tune systems, do more training, or hold a rapid-improvement event to further streamline processes, etc. Changes are implemented, measured, and refined as necessary and the health check repeated to ensure that improvements are realized. Learn more in this short article: Automation and Optimization: the Importance of the Health Check 

—Dr. Alistair G., Senior Director HCS, ~18 years at Siemens

Check back periodically for new topics.

For more in-depth explanations about issues surrounding laboratory automation, we invite you to listen to the following on-demand webinars:

At Siemens Healthineers, we understand that there are a lot of differences from one lab to the next. Differences in test volumes, diagnostic systems, assay menus, staffing levels, pre- and post-analytical needs, and budgets combine to make every laboratory unique. And don’t forget about variations in workflow processes that take place before the samples arrive at the laboratory.

Fortunately, Siemens Healthineers offers a broad portfolio of products and the depth of service needed to help ensure that an automation system is designed and maintained to meet each laboratory’s needs. Furthermore, we support best-in-breed strategies that provide our customers rapid access to innovations in diagnostics and automation to meet future needs. Siemens Healthineers turns a portfolio of choices*** into lab-specific solutions.

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To help you fully leverage the capabilities of Siemens automation solutions, we've packaged key lessons in easy-to-read communications called CentraBytes. Explore each topic at your own pace to improve laboratory management in centralized settings. Siemens turns a commitment to training into improvements in productivity.

CentraByte Tutorials: Tips for better automated workflows in your laboratory

Additional courses are available as part of the Siemens Personalized Education Plan (PEP).**** Register for a PEP account to learn about Lean concepts such as process mapping, value stream mapping, spaghetti mapping, and more.