We are in the beginning stages of moving towards automation. I have requested from Ortho, Immucor and Bio-Test/Bio-Rad to bring their insturments in at the same time so that I can do a parrallel comparison. We currently use LISS tube methodology with a serum specimen and have been freezing serum specimens with identified antibodies. While I have a good idea on how I want to do the comparisons, I am askign for opinions on what evaluation protocols could/should be used. If anyone here could suggest protocols, even to the point of sending me any that you have used or recommend I would appreciate it. We are looking at July to start the evaluation. Also, if you could identify any pitfalls that may occur, in your experience, I would appreciate it.

I know that one of the pitfalls that might occur is our serum samples instead of plasma samples. How much of a problem will this be and what have others done to rectify this. As a former mentor told me the first day I met her, there are no stupid questions, only stupid answers. :-)

I'll take the easy part.....Before our automation, we used PeG/Tube technique (and it currently serves as our backup method.) We switched to EDTA plasma before we started automation, so that took that factor out of the running when you go to do your sutomation comparison/evaluations study. (I think you should consider making that change before you start your automation studies in July.) (NOTE: Make sure the EDTA vacutainer tube that you use to draw your patient samples has been approved by the FDA for use in Blood Bank testing.)

:confused:I would be interested to known if the 3 companies agreed to bring their instruments in at the same time.

That's a good question, Mary**. (I haven't heard of that level of cooperation.) Let us know, conwaysbb, OK?

I believe all of the automation manufacturers require plasma samples rather than serum samples, so that could be a critical issue for you if you cannot switch.

One unexpected thing we ran into when we made the switch is that people all of a sudden expected us to share tubes with Hematology. This caused major delays for us and recollects for them (if we got the sample first and spun it down and removed parts it kinda messes with the CBC). We ended up solving the problem by moving to pink top tubes instead of lavendar top tubes. The only other lab test using pink tops is the BNP. Apparently no one thinks that blood bank and chemistry should have to share tubes...

Edited May 25, 201015 yr by adiescast
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We did the same thing, adiescast - use pink-top tubes for BB (instead of the lavender-top tubes that Hematology has used for eons.) For a long time we never told the phlebotomists and nurses who collect samples that there's really no difference between the pink-top and lavender-top tubes, so everybody got off to a good start of automatically drawing only pink-top tubes for Blood Bank (and not requesting that we share a tube with Hematology.)

We are ProVue users and you can't run serum samples on it. L106 is right, switch to EDTA before looking at automation, it will make your life easier.

Remember that each of the 3 vendors all have pluses and minuses. No one system will probably fit every requirment you may have and don't be fooled by a slick sales presentation, ask to talk to current users of each system, preferrably in places about the same size and pt population as you have.

I have a Galileo Echo, while it can run serum if you pull it off the primary tube, we made the switch to EDTA pink top tubes because I felt that pulling off was an area of possible error that was not necessary. Now leave all specimens intact in the primary tube. If a patient has an antibody we will then drawn a serum tube to freeze and aliqot. I did not have any issues with switching to EDTA from serum, I did a 30 sample comparison and had the pathologist sign off on it.

As for the ECHO, we are a small sized hospital with a large prenatal volume, the ECHO works great for batching routine samples, it will perform 4 TYSC's every 26 minutes and maintenace is minimal. It has a few issues, every analyzer seems to. The data station is a little underpowered, it tends to crash if you try to do multiple tasks to quickly. But for the most part it is a huge convienience and it was the analyzer that meshed the best with using the tube method as our backup.

Good advice from all. Seeing them in use with users who are comfortable with them is an ideal way to see what the workflow is and to see what you might have to do to your process to make them work well for you. I would also recommend switching to the pink tops ahead of time.

You may see some non-specific nasties trying to use frozen serum with Echo and gel, as compared to the original tube test Any fibrin in the sample will goof your gel and solid phase tests up and freezing seems to cause it's own weird problems, though not in all samples - false positives and false negatives are possible, including with tube testing. I have no experience with Bio-Test, so I can't offer an opinion there.

You may see some non-specific nasties trying to use frozen serum with Echo and gel, as compared to the original tube test Any fibrin in the sample will goof your gel and solid phase tests up and freezing seems to cause it's own weird problems, though not in all samples - false positives and false negatives are possible, including with tube testing.QUOTE]

Too true!!!!!!!!!!!!!!!!!!!!!!

:):)

I agree with everyone...by using serum you are going to waste your time and resources. Frozen serum sepcimen will give you problem with gel(I am a gel user so I only know about gel).

I am also surprised that all three companies agree to bring their isntrument same time??? I know your volume is large. ..Our back up is PEG.

Are you going to run panels on ProVue or by manual Gel???

Thanks for all the replies. So far two of the vendors have agreed and we will be sending them to official training. One vendor needs more information before agreeing, so I need to get my protocol in place. While all three of the vendors recommend plasma samples, all three also can use serum samples for antibody screens and panels. In fact, since I am still using serum, we have been used as a source for serum samples by one of the vendors for validation purposes of their methodology, and these samples used were frozen prior to sending them for testing. However, for ABO/Rh they all require plasma samples so we will be using EDTA samples most likely from CBC samples sent. I am probably going to also look at the CBC specimens for plasma samples to store for patient's identified to have antibodies from our serum samples, plus my other smaller hospital uses manual gel and is collecting specimens in a pink top, so they too are freezing samples.

I have informed my vendors that if they don't want to participate, they will not be considered when choosing vendor for automation. This is similiar to what I did when I sent an RFI for our blood bank systems. Makes a good incentive for participation, especially since I will be makiing the decision for a multi-hospital system.

I am still looking for any protocols for evaluation if anyone has one.

Thanks for all the replies so far and I will keep everyone updated. I just have had a spate of inspections recently including the FDA, AABB and now the State Dept of Health.