Echo Lumena® Implementation from Manual Gel
University of Maryland Capital Region Health Medical Center (former Prince George's Hospital) is located in Upper Marlboro, Maryland, USA. It is a nonprofit acute care teaching hospital and regional referral centre. The hospital is a Level II trauma centre, the second busiest Trauma Centre in Maryland, specialising in Acute/ Trauma care, Cardiac, Women and infant care and paediatric services. Capital Region Health Medical Center treats nearly 4,000 trauma patients each year. Transfusion Services perform 11,000 blood type and antibody screens annually. About 85% of blood type and screens are STATs from the Trauma and Emergency Room Departments, with about 8,000 units of blood products being transfused annually.
Three dedicated blood bankers staff during the day shift and two more in the evening and night shifts using manual gel testing with two ID MTS Gel stations found it hard to meet the 60-minutes turnaround time for blood type and screens for STAT orders. As a consequence, the rest of the hospital experienced delays in blood availability for patients. Most cases for antibody identification workups were sent to a reference laboratory due to the workload. The laboratory decided to automate blood bank testing.
The requirements were a user-friendly analyser with a fast turnaround time, a large test menu, the ability to run paediatric & cord blood samples and strong support and service with remote networking.
To address the staff shortages and manage the workload, the laboratory chose the Echo Lumena®, with a fast turn-aroundtime for type and screen and the smallest instrument footprint, allowing redundancy. The dynamic scheduling of the Echo Lumena allows ordering different tests and not affecting STAT samples’ turnaround time (TAT). Capital Region Health Medical Center automated up to 95% of its testing with the Echo Lumena's extensive test menu, including Type and Screen, antibody identification panels, Panels, Weak D, DAT, Crossmatching, Antigen typing, Donor Unit Confirmations, and Pediatric and Neonatal testing. Additionally, ImmuLINK® offered remote review capabilities and centralised data management with a single user interface for all Immucor instruments. Units are interfaced now with a regular interface but they are considering implementing ImmuLINK as the facility plans to purchase a free-standing NEO Iris® analyser. All samples for validation were implemented in the routine blood bank workflow, and all discrepancies were compared and resolved using secondary methodologies – gel and tube. In summary, automating with the Echo Lumena resulted in meeting turnaround time requirements. All STAT TAT for Type and Screen were reported at 95-97% within 60 min. The facility extensively uses Donor Antigen typing keeping 10 E-K- PRBCs in inventory at all times to support patients with the most common antibodies anti-E and anti-K based on Capital Region Health Medical Center patient population studies.
Article written in partnership with
Svetlana Zmanovskaia, MS MT(ASCP), CLS
System Manager, Transfusion Services
University of Maryland Prince George's Hospital Center, Laurel Regional Hospital, and Bowie Medical Center , USA