Urine sediment analysis, or urine microscopy, focuses on the measurement and description of the formed elements of urine. In the traditional method (manual microscopy), urine is spun and the sediment is observed manually through a microscope.²

This approach, while effective, is labor-intensive and prone to subjectivity. Not surprisingly, laboratories not employing automated alternatives have developed rules from clinical parameters or urinalysis results to limit the number of these examinations.²

The Need For Laboratory Automation

Previously, the methodology that Broadlawns Medical Center laboratory was using proved costly – not only because of the excessive use of the technologist’s time but also in terms of the supplies needed.

With the combined urinalysis, hematology and coagulation departments, priority runs were generally given to STAT hematology testing. This occasionally caused a decreased turnaround time in the manual urinalysis review. To further delay matters, the reflex protocol resulted in a recorded average of 66.5% of routine urine samples being reflexed for microscopy exam.

Automation Drives Results for Broadlawns Medical Center

In the fall of 2018, Broadlawns Medical Center implemented the use of the iQ Workcell urinalysis solution pairing iQ200 urine microscopy and Arkray AUTION MAX™ AX-4030 fully automated urine chemistry analyzer in their laboratory.

Before implementing this automated solution, each manual microscopy took approximately 14 minutes — including spinning, reading, manual review, and entering results. Post-implementation turnaround time was reduced to 5 minutes, allowing technologists to utilize the 9-minute difference on critical areas of the laboratory.

Improving Productivity and Reducing TAT by Automating Urinalysis

While the significance and details obtained from microscopic analysis far exceed those gained from the chemistry side, laboratories must be mindful of redundant testing that may result in budget depletion. A proper balance between diagnostic precision and cost efficiency is key. Automated urinalysis allows for standardization of results as well as, reduced subjectivity and variability, resulting in quantifiable savings to the laboratory. The iQ Workcell automatically identifies 12 particle classifications and 27 sub-classifications with >90% confidence and has the proprietary Digital Flow Morphology and Auto-particle Recognition (APR).

The results are then shown on the computer screen and auto-released using the Edit-free Release software for auto-verification. Immediately after the implementation, Broadlawns Medical Center was able to reduce manual microscopic review rates from an average 66.5% to 4%*.

"At first the techs were hesitant of making the dilutions for turbid urines as they thought it would be more time-consuming. However, they soon realized that dilutions are very simple and far easier than using the scope," shared Casey.

As expected with time and as the technologists grew more comfortable with the iQ200 technology, the manual microscopic review rate continued to drop to an average of 4%*.

Highlights of Broadlawns Medical Center Workflow Enhancements with Workcell Implementation