Designing a diagnostic total testing process as a base for supporting diagnostic stewardship

Cobbaert, C.; Albersen, A.; Zwiers, I.; Schippers, P.; Gillis, J. (2021)

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To more comprehensively support clinical management of patients in our hospital, we redesigned the diagnostic Total Testing Process (TTP) from request to report. To that end, clinical needs were identified and a vision on Total Laboratory Automation (TLA) of the TTP was developed. The Delft Systems Engineering Approach was used for mapping a desirable laboratory testing process. The desirable "To Be" diagnostic process was tendered and the translation of a functional design into a specific TLA-configuration - compliant with the vision and the predefined functional design - was accomplished using a competitive dialogue tender variant (based on art. 29 of the EU guideline 2014/24). Realization of this high-end TLA-solution enabled a high-quality testing process with numerous improvements such as clear and supportive digital request forms, specimen consolidation, track and trace and non-conformity registration at the specimen level, better blood management (similar to 40% less blood sampled), lean and in line processing with increased productivity (42% rise in test productivity per capita), and guaranteed total turn-around-times of medical tests (95% of TLA-rooted in line tests are reported <120 min). The approach taken for improving the brain-to-brain loop of medical testing, as fundament for better diagnostic stewardship, is explained.

• competitive dialogue variant
• Delft Systems Approach
• functional design
• Total Laboratory Automation
• Total Testing Process

• All authors: Cobbaert, C.; Albersen, A.; Zwiers, I.; Schippers, P.; Gillis, J.
• Date: 2021-03-01
• Title of host publication: Clinical Chemistry and Laboratory Medicine
• Volume: 59
• Issue: 3
• Pages: 473 - 489
• DOI: doi:10.1515/cclm-2020-1251
• Link: https://www.degruyter.com/document/doi/10.1515/cclm-2020-1251/html