Hematology Customer Profile - Pomona Valley Hospital Medical Center

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Pomona Valley Hospital Medical Center in Pomona, CA is a nationally recognized community hospital serving residents in eastern Los Angeles and western San Bernadino counties. This 427-bed medical center has a 72-bed emergency/ trauma department and has one of the highest-volume labor and delivery departments in California. In addition to the inpatient orders, the laboratory processes samples from their many outpatient clinics and outreach sites and performs approximately 450 CBCs each day.

In March 2023, PVHMC went live on the Sysmex XN-3100™ Automated Hematology Analyzer with an integrated DI-60™ Digital Imaging Analyzer and Caresphere™ Workflow Solution (WS). The XN-3100 configuration includes two XN-10 hematology modules and an SP-50™ Automated Hematology Slide Preparation Unit. Integrating the XN conveyor with the DI- 60 allows automated, hands-free CBC analysis, slide processing and digital imaging with reflex and repeat testing being driven by Caresphere WS. The lab’s previous hematology analyzer was an integrated CBC analyzer and slidemaker/stainer, but slides needed to be moved manually to the standalone digital imaging unit.

When evaluating hematology platforms, PVHMC was looking for a solution that made their operations more efficient. Sysmex’s RU- 20™ Concentrated Reagent Delivery System “was a big selling point,” according to hematology supervisor David Burt. The RU-20 provides diluent to both XN-10 modules by diluting a concentrated reagent with the laboratory water system. This technology allows the PVHMC lab to change diluent cubes only once per month based on a daily volume of 450 CBCs per day. Virtually eliminating this once-daily task minimizes disruption to their workflow and saves the lab staff from frequently moving heavy reagent cubes.

The co-primary analyzer configuration of the XN-3100, which intelligently load-balances the specimens between the two analysis modules, has also been an advantage for PVHMC. The XN can also automatically repeat testing on a sample based on lab-defined rules, and can reflex additional testing such as the fluorescent platelet count. “Reducing the operator touch points allows the system to operate more efficiently and frees up staff to complete important tasks such as other necessary testing and ensuring the lab is properly maintained,” according to Burt.

By automating or reducing many of the processes that required manual intervention on their previous hematology system, PVHMC is realizing measurable improvements in turnaround times. Previously, the laboratory had a received-to-result goal of 45 minutes, which they were able to meet 94-95% of the time. With the XN-3100, not only were they able to meet that goal as well, but performance tracking shows they are able to reduce that goal to 30 minutes with the same high outcomes!

Burt also cited the benefits of the XN’s unique fluorescent platelet parameter, PLT-F, as a reason PVHMC chose the Sysmex hematology platform. With the specific staining of the PLT-F reagent, Fluorocell™ PLT, a secondary platelet count can be automatically analyzed by the XN which is free from interference from fragmented WBCs and RBCs. As an added benefit, the PLT-F parameter helps reduce manual smear reviews for platelet clump flags, making better use of the PVHMC techs’ time.

The advanced flow cell technology on the XN and integration of digital imaging have also been time-savers for the lab. Due to the high acuity of PVHMC’s patient population, approximately 50% of CBC samples required a smear review on their previous platform, however, that workload has been cut in half with implementation of the XN-3100. Additionally, the previous system was able to meet their 90-minute manual differential receive-to-result goal only 75% of the time, but the combination of the XN-3100 and DI- 60 allows them to meet that goal 95% of the time, and they are currently meeting a 60-minute turnaround time 83% of the time.

Burt attributes PVHMC’s improved turnaround times to the DI-60’s advanced and user-friendly software functions. According to Burt, the streamlined processes and CellaVision’s Remote Review Software contribute to consistency and standardization of results. Features such as an on-board reference cell library assist with competency of the staff, and allowing techs and pathologists to access the digital imaging results from anywhere, makes it easier for the hematology staff to assist with smear reviews, even when working at other benches.

Automating body fluid analysis can be a benefit for busy labs as it offers speed and standardization for a manual test that requires considerable expertise. PVHMC’s previous urinalysis analyzer performed total nucleated cell and red blood cell counts on a variety of body fluids, but the clinical staff often wanted a WBC count reported as well. This required the lab to perform a manual differential, then calculate the WBC count—a process that’s very time-consuming for most labs. The XN-Series analyzer’s dedicated Body Fluid Mode offers WBC, RBC and total nucleated cell counts as well as an FDA-cleared two-part (mononuclear vs. polymorphonuclear) differential. Burt stated that, for their mix of ascites, pleural and synovial fluids, the PVHMC lab “appreciates being able to report the WBC count and use the two-part differential during slide reviews” and that reporting the body fluid WBC count has increased physician satisfaction.

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