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Case Base Versus Single Piece IHC Workflows Evaluated in a Large Reference Laboratory

The Leica Biosystems Process and Solutions Optimization team has partnered with a high-volume reference laboratory to evaluate the potential impact of a case based IHC workflow versus an individual slide workflow.

The Leica Biosystems team observed current IHC protocols, staining instrument utilization, and case completion process. This reference laboratory performed 122,733 IHC stains utilizing 2 different staining systems. System 1 included 7 IHC stainers with random access slide capability and System 2 contained 3 stainers with 3, 10-slide racks. Currently, 22 steps, including 2 manual processes are required to complete the IHC staining procedure in System 1. By completing a time and motion study, the Leica Biosystems Process & Solutions Optimization team determined signifi cant LEAN laboratory savings of time, overproduction, and talent.

By evaluating both instrument workfl ows, significant manual sorting times were observed, and data analysis identified the following:

  • Total sorting times for fi lling both instruments averaged 4 minutes, 24 seconds for System 1 and 1 minute, 32 seconds for System 2. Total of 5 minutes, 56 seconds combined per run.

Fig 1(Above) : Current Average Sort Time


Time studies further revealed a manual slide rinse and counterstain process specifi c to System 1. By eliminating manual sorting, counterstaining, and slide rinsing with System 2’s case-based approach, appropriate instrumentation utilization can yield substantial improvements in time savings, hand-on time, and touchpoints.

Current hands-on time for System 1:

  • Individual slide staining process totals 89.8 seconds per slide, totaling 3059 hours per year.

Fig 2(Above) : Hands On Time Comparison

Proposed hands-on time for System 2:

  • Case base model reduces total hands on time to 28.2 seconds per slide, totaling 961 total hours per year a 69% difference between current and proposed staining processes.
Fig 3(Above) : 69% reduction in hands-on time

Projections and Realized Results are specific to the institution where they were obtained and may not reflect the results achievable at other institutions.

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