An insight into Middlemore Hospital’s experience with the Roche

C8100 Track System

1. The C8100 Front End

2. C8100 Track

3. C8000 - Line 1 and Line 2

4. Haematology XN Line

5. Coagulation Stago

6. P701 Fridge

CENTRIFUGEX2

INPUT BUFFER

DESTOPPER

OUTPUT BUFFER

ADD ON BUFFER

RESTOPPER

SAMPLE CHECK MODULE

BARCODE LABELLER

ALIQUOT MODULE

Connects all the analytical instruments from chemistry and haematology to the c8100.

Transport Junction Lines (TLJ) - The transport junction lines are responsible for carrying the single tube holders along this belt system.

Reformatter - Transfers racks of samples off the C8100 onto an analytical instrument.

ISE – C702 – C502 –E602 – E602

Two duplicate lines.

Connected to the c8100 track via a corresponding reformatter.

ISE MODULE CHEMISTRY

C702 +C502

IMMUNOASSAY E602 X2

Full blood Counts!

XN1,XN2, XN3SLIDE MAKERS

REFORMATTER

Completed primary samples are sent here for a seven day storage.

Test adds are also retrieved from here using a remote test add system.

1. Doctor requests an electronic order.

2. Order is created with a lab number.

3. Prints lab form with tube labels.

4. Blood collected and labelled.

5. Form barcode scanned – tests loaded.

6. Samples go on c8100 Input Buffer.

ACU –Centrifuge

SCM – Check volume and take picture

DSP – Remove the cap

TLJ –Transport line junction

BRF – Bi directional reformatter

C8000

E602 – Sample for TNT

ISE – Sample for Potassium

C702 – Sample for the serum

indices

Results go to IT3000.

Non-critical results means it will auto

validate.

Critical results will be checked by a validator.

RSF – New cap on.

AOB – Stored for 2 hours at

room temperature.

Fridge –Storage for disposal or waiting for next task.

1. Our TAT’s had taken a slight decline.

2. Belt breakage’s

3. Presenting or re-presenting samples back onto the

system post breakdown – would cause more breakdowns.

4. Labels on primary tubes not adhering adequately, which

would lead to sample spillages.

5. Separating sample types when loading into the IPB tray –

eg. Heparin Gels and EDTA tubes had to be put in a

different IPB tray – which decreases efficiency.

6. Urgent aliquots not being frozen.

84

86

88

90

92

94

96

98

100

Old Lab - May 2016 New Lab - Nov 2016 New Lab - Sep 2018

Month

Percentage of TNT tests completed within 60

minutes vs Month

Perc

enta

ge

84

86

88

90

92

94

96

98

100

Old Lab - May 2016 New Lab - Nov 2016 New Lab - Sep 2018

Month

Percentage of Potassium Tests Completed with

60 Minutes vs Month

Perc

enta

ge

SODIUMSODIUM

POTASSIUM

CHLORIDE

IT3000

(Middleware)

CHLORIDE

POTASSIUM

CLINICAL PORTAL FOR THE

CLINICIAN

Before

Normal

10 minutes

After

STAT

3 minutes

18

Minute

Assay

9

Minute

Assay

No separate aliquots

No carry over issue

Release result as G10000

MANUAL CENTRIFUGATION MANUAL FRONT LOADING

Secondary workflow configuration which isolates the

c8100 front end to continue performing its pre-

analytical tasks.

As long as nothing is broken on the c8100 front end we

can implement this configuration.

Spun, picture taken, volume checked.

Aliquots still made and sent to the output buffer

Samples are tracked.

Loading the completed samples directly into the fridge comes with a few minor issues.

Test adds will not always go directly to the analytical instrument.

Higher probability the fridge may crash. This means stopping, starting and troubleshooting.

A sample maybe loaded into the fridge which requires an aliquot, which have to be retrieved manually and actioned.

Add On Buffer overload.

• In this tray we can load any sample and it will go directly to the fridge.

• Any outstanding tests will be completed on the way.

• Any aliquots will be made if missed.

• Load with caps on or off.

• No AOB overload causing a back log of samples.

Aliquot’s to be urgently

frozen - the software

will play a tune to alert

staff.

All hardware issues are

logged, continually

monitored and

communicated. Increases

understanding of

hardware knowledge and

reduces breakdown time.

Fully customised our

fridge retrieval workflow

to ensure all our test

adds smoothly come out

of the fridge including

aliquots.

Investigated which

labels adhere the

best to prevent

breakdowns.

Created rules in IT3000

to deliver samples to the

Output Buffer which

have critical results to

be double checked.

The End.