ABL77
Cases

1. Why chose a Radiometer POC solution?
Cheryl Cook, Point-of-Care Manager at the Ohio-based Riverside Methodist Hospital and Grant Medical Center in the US, explains why she chose a Radiometer POC solution. Read more. (pdf file 194 kb).

2. Critical care testing and compliance made easy
CMC Scranton streamlines workflow with Radiometer instrumentation

It was time for a change. That was the decision of the respiratory staff at the Community Medical Center (CMC) of Scranton, Pennsylvania, regarding their blood gas instrumentation. After more than 33 years with the same vendor, CMC replaced its blood gas analyzers with Radiometer instrumentation to keep up with the rigorous demands of today’s clinical and regulatory environments.

Community Medical Center of Scranton
CMC is a 319-bed hospital with admissions of nearly 13,500 annually. The hospital spotlights a trauma center/emergency department, an open-heart program, a 16-bed ICU (four beds are dedicated to cardiac patients), a NICU and a five-bed sleep center. In recent years, growth in these specialty areas has driven the hospital’s need to update its blood gas testing equipment and data management capabilities.

Blood gas analysis is performed in the hospital’s Blood Gas Lab, located adjacent to the ICUs, and in the CVOR. CMC’s Respiratory Department maintains the CLIA license for analyzers in the Blood Gas Lab and processes between 15 and 20 tests per day. The Perfusion Services Department maintains the CLIA license for the CVOR, which runs approximately 10 blood gas tests per day.

Instruments and data management system lacked integration
Aside from being more than 10 years old, CMC’s blood gas analyzers measured blood gases only. As a result, three separate instruments were utilized in the Blood Gas Lab to measure blood gases and CO-oximetry. An additional concern was that CMC’s data management system was not sufficient for regulatory documentation, nor could it be interfaced to the hospital information system.

In the CVOR, two point-of-care (POC) analyzers were used to measure blood gases, electrolytes and hematocrit. These instruments were in excess of 10 years old and would likely be replaced in CMC’s effort to standardize blood gas testing throughout the hospital.

The driving force behind CMC’s decision to standardize was a desire to ensure regulatory compliance, and using a single vendor for blood gas testing increased that likelihood. The hospital chose Radiometer as the vendor who could best satisfy a variety of requirements: the broadest parameter profiles, ease of use, minimal maintenance, automated quality control and sophisticated data management.

Radiometer solution streamlines workflow and data management
Early in 2001, CMC replaced the three instruments in the Blood Gas Lab (two blood gas analyzers and one CO-oximeter) with two Radiometer ABL720 analyzers and acquired Radiometer’s RADIANCE STAT Analyzer Management System. Later that year, CMC purchased two ABL77 analyzers from Radiometer to facilitate POC blood gas testing in their open-heart program.

Standardizing blood gas testing with Radiometer analyzers and software has optimized workflow, contained costs and improved regulatory compliance, according to Audrey Angelella, manager of CMC’s Respiratory Care Department and an employee with CMC for 28 years. RADIANCE plays a central role in delivering these benefits, she pointed out.

Ms Angelella maintains a RADIANCE workstation in her office. “From my desk, I can oversee and access five ABG machines, patient data, maintenance requirements and QC status,” she said.

In addition to simplifying testing, standardization has reduced the complexity and expense of blood gas support needs. The need to stock consumables for multiple vendors is eliminated, and technician time and training is also minimized, along with the related costs. One common quality assurance program, Radiometer’s Worldwide DATACHECK, is used for all the blood gas analyzers and provides QC statistics and peer group information.

While standardization by itself has streamlined blood gas testing, CMC is also enjoying the features and benefits of the newer instruments. The ABL77 and ABL720 are easy to use, highly accurate and require minimal maintenance, according to CMC respiratory staff.

“With only two consumables, the ABL77 is easy to maintain, which means high analyzer uptime and better patient care,” said Chief Perfusionist Carmen Sciandra. “I was very impressed with the speed and turnaround time offered by the ABL77.”

In particular, perfusion and respiratory staff have realized a significant time savings in POC analyzer start-up time. CMC’s previous POC analyzer remained in “hold” mode for approximately 45 minutes following cartridge installation. With the ABL77, the wait is two to three minutes before the analyzer is ready for patient testing.

Additionally, time conservation is facilitated through the internal software on the analyzers.  “Setup programs on both the ABL720 and ABL77 allow for customizable, flexible options for patient reporting and data management,” said Harry Werts, a respiratory therapist who oversees the analyzers and RADIANCE. For example, QC Lockout and Technician Competency programs are designed to support on-board regulatory compliance.

“Paperless” documentation saves time for both staff and inspectors
In addition to updated instrument capabilities and features, the CMC respiratory and lab staff are enjoying better integration of information systems and instrumentation through RADIANCE. The analyzer management system has streamlined regulatory reporting and compliance by storing QC documentation, corrective action and maintenance records in one convenient repository.

CMC’s goal is to undertake a “paperless” inspection, which would save time for both staff and regulatory inspectors. RADIANCE makes this possible by electronically filing all relevant regulatory data and eliminating the time and trouble involved with printing and filing paper documents.

“I consider it a benefit that we don’t have to download all this information and print out five, three-inch binders of material for inspectors to look through,” said Ms Angelella. “It’s much more expedient and convenient for them to go into the RADIANCE Data Management module and look for specific information during inspections.”

Ms Angelella recently underwent a JCAHO inspection (October 2003) and commented, “The surveyor was pleased with the ABL720s, ABL77s, the RADIANCE system. Worldwide DATACHECK was a large part of the inspection and gave a great review of QC over the past two years.” Ms Angelella suggested downloading some QC data each month, just in case a surveyor prefers reviewing paper versus electronic documentation. “We are very satisfied with Radiometer’s equipment and staff, who are wonderful to work with,” she said. “The switch to Radiometer has been a great experience!”