At Mayo labs, it's a 24-hour work day
It’s 7:30 a.m., a time when most of Rochester is still rubbing the sleep from its eyes.
But here at Mayo Medical Laboratories, the methodical work of receiving and testing 30,000 test tube samples each day has shifted into high gear.
The samples come from thousands of hospitals and medical care centers from across the United States and more than 60 different countries. They are sent to Mayo Medical Laboratories, because many hospitals don’t have the staff or expertise or the equipment to conduct the kinds of "esoteric tests" that MML can.
What amazes is this: These thousands of samples representing patients from around the world will be conveyed to 58 specialty laboratories on the Mayo campus for testing within a matter of hours. And most of the tests will be conducted on the same day, the results fed electronically into patients’ medical records.
"If it’s a critical result, on some types of testing we’ll actually call back within 30 minutes, and that’s what our call center does," said Albert DalBello, operations administrator for Mayo Medical Laboratories.
Such speedy turnaround times are achieved partly because many of the tests are performed in the same building where the test tube samples are received and verified at the Superior Drive Support Center at 3050 Superior Drive Northwest.
But another factor is the degree to which engineering and automation have been harnessed on behalf of patients and hospitals to guarantee quick and timely transmission of test results.
Those tests number in the thousands and cover every conceivable category of testing that "hits the radar screen:" genetic testing, testing for HIV and hepatitis, metals testing, lung profile tests and many others.
Last year, Mayo Clinic performed more than a 20 million tests, half from Mayo’s own patients and the other half from its external clients. Annual double-digit growth has now become the norm at MML.
But it probably wouldn’t have happened, officials say, had MML been forced to remain at the Hilton building downtown, where limited space had strait-jacketed its ability to expand. Since moving in 2004 to its current location — a building that formerly housed the Celestica assembly plant before it closed — MML has had the space to innovate, improve and refine its procedures.
"This gave us the ability to expand — not just expand from space perspective, but also do some automation and really enhance our processes," Al said.
More than 95 percent of the orders for tests are sent to Mayo electronically, often the day before the orders come in. And that automation, integrated with Mayo’s lab-coated workforce, is on display from the moment the specimens arrive at the Superior Drive Support Center to be unloaded to the moment they undergo testing
The samples of blood, plasma, urine and stool samples arrive stored in Styrofoam containers, which come packaged in standard-sized boxes.
Once offloaded, the boxes move forward on a conveyor belt. One of its first stops is a electronic box cutter whose razor blades whip around the bottom edges of the box. A hydraulic machine then lifts the rest of the box off the Styrofoam container inside.
At another stage, a scanner reads the bar code on the container and a label is mechanically placed on its side.
The label serves two functions, DalBello said. It describes the samples inside the container and the hospital they came from.
That’s important, because in the process of receiving and verifying the test samples, Mayo uses a "pod" system in which lab technicians are paired with individual hospitals. The relationship helps Mayo technicians better understand the culture and needs of their clients. The labels thus direct the samples to the laboratory technicians assigned to serve that hospital.
"It goes to the same group every day, so that they have more familiar with that client," Al said.
When it reaches the pod, a technician will scan the order and pull up the electronic order to make sure everything is correct. Every sample will also be relabeled so it goes to the proper Mayo laboratory for testing.
Performance is continually monitored. Above the throng of white-coated technicians is an electronic scoreboard of sorts. On it are recorded the number of samples Mayo Medical Laboratories is expected to receive that day and how many have been received and verified.
Once a sample is processed, it is then ready for distribution to the different laboratories. Some are done manually and others go through an automated testing process.
Although Mayo Medical Laboratories serves an external customer base, the work done there benefits Mayo Clinic patients as well. Mayo is constantly developing new tests to offer its clients, and each year adds more than 100 new ones to its catalog.
Those tests are available to Mayo patients as well. And because of the volume of tests that keep MML lab operations running almost continually, Mayo patients are able to get the results of those tests back faster than if MML didn’t exist.
Once a test becomes more established, Mayo does something that some might consider unusual for a business. It works with its client hospitals and medical centers to set up and perform those tests in their own laboratories. Mayo officials say there is never any danger of driving themselves out of business, because the quantity of work and the number of tests is always growing.
"Mayo believes that community medicine is the best medicine, so we want them to bring it in-house and do it locally," said Andy Tolifon, communications consultant for the Department of Laboratory Medicine and Pathology.
Mayo officials says the innovations and improvements in its testing procedures have allowed it to process tests more rapidly without sacrificing accuracy.
"The accuracy and quality is more important, but the throughput is also important. We have patients waiting for results," DalBello said.