Landmark Installation, Impressive Results
Lake Forest Hospital Becomes the First U.S. Placement of the UniCel DxH 800 Coulter Cellular Analysis System

Labs switch instruments (and vendors) for different reasons. Sometimes it's because of poor instrument performance. Other times, it's costly maintenance or a lack of quality service and support.

In the case of Lake Forest Hospital in Lake Forest, Illinois (USA), it was none of these. In early 2008, this 120-bed community hospital simply had an expiring contract on its primary hematology system—the COULTER LH 750.

The replacement search soon led to a landmark installation—Beckman Coulter's first U.S. placement of its newest hematology system, the UniCel DxH 800 Coulter Cellular Analysis System.

Finding the Right System
Facing the need to change, the laboratory began to consider its instrument options.

"We did look at other vendors, and up until the time we saw the DxH 800, I was somewhat concerned with Beckman Coulter because we hadn't seen any technology changes in awhile," says Elizabeth Cichon, laboratory team leader and technical specialist for Hematology, Coagulation and Urinalysis. "But when I heard the company was unveiling the new UniCel DxH 800 at the Clinical Lab Expo in July, I flew to Washington, D.C. to see it. Later, my boss and I took a VIP tour in Miami, where the company went through great detail about all the new technology changes. We were really impressed with what we saw from Beckman Coulter, and that really sold us."

"We definitely didn't make this change because we were unhappy with the LH 750—or with Beckman Coulter. In fact, just the opposite," she says. "Our experience with Beckman Coulter over the past five years had always been very good. We saw our sales reps often, and the service was always good and timely."

Not One, But Two
Once the lab selected the UniCel DxH 800, it quickly decided that one was not enough for its annual throughput of 70,000 hematology tests.

"We needed a backup system to replace our aging COULTER HmX, and we really liked the idea of a same-system backup," says Cichon. "Previously, we used our LH 750 as our primary system during our day shifts and the HmX for the night shift. Thus, the night techs were very experienced with the HmX, but whenever the daytime techs had to use it, many weren't as comfortable because they didn't use it often enough."

Going forward, the lab decided that having the same system for backup seemed to make more sense. It also provided better reliability and result comparison between systems; and consistency between reagents, calibrators and controls.

A Fast and Efficient Installation
The DxH 800 installation was a smooth, quick and seamless process. Both systems were installed in just a few days while two lab members were in Florida for instrument training. Coincidentally, these clinical laboratory technicians were attending the very first DxH 800 class at Beckman Coulter's new Customer Training Center at the main cellular analysis facility in Kendall, Florida (USA).

"It was great. The service team actually emailed us photos during the installation, just to keep us up-to-date and help us follow the progression," says Cichon. "It took less than a week for installation, and both instruments were ready for us when we returned."

Reaping the Rewards
Once the lab technicians started using the new systems, they were highly impressed. First off, the team performed manual differentials and compared the results to those from both the LH 750 and the new DxH 800. They wanted to make sure immature cells that were visible on a manual slide also were picked up by the analyzers (and vice versa)—basically double-checking for false positives/negatives, as well as true positives/negatives.

"What we found were improvements in every category," says Cichon. "Based on that information, we were able to adjust our review rates, which has enabled us to reduce our manual differentials by about 20 percent.

"With the LH 750, we were at the 23-25 percent manual diff rate and we're now about 18-20 percent with the new equipment," she says. "This means fewer manual processes and frees techs to focus on the really abnormal samples—or to handle other lab responsibilities.

"Plus, the lower linearity levels we've been able to achieve have helped us report out body fluids at a lower level without doing a manual count," she adds. "Previously on the LH 750, we had a 200 cell limit on the white blood count (WBC) and the lower linearities on the new system have helped us drop our WBC. Our in-house studies have validated Beckman Coulter's claim that a lower reportable limit of 20 cells is achievable, and we typically see total nucleated cell count (TNC) background counts of less than five cells."

Running two DxH 800 systems boosts efficiency in other ways, too. For instance, if one system runs out of reagent, the lab technician simply moves the sample to the other system and runs it there. The lab doesn't lose any time and doesn't miss a beat.

Best yet, the DxH 800 is much smaller than the LH 750. In fact, both DxH 800 systems fit in the same space as the one LH 750 system, which means the lab gained a valuable commodity: counter space. Space efficiency was further improved with the help of the floor cart, which neatly contains all the system reagent boxes and compressor.

New Hardware Improvements
Compared to the LH 750, the DxH 800 has far fewer parts—70 percent less tubing and no pinch valves. And for Cichon, fewer parts means fewer things that can go wrong.

The hardware improvements continue. The system reagents were updated, color-coded and optimized—including smaller-sized (and lighter weight) diluent cubes. The Latron control is now cap pierceable and doesn't require priming; body fluid QC was added; mode-to-mode QC was eliminated; and the QC lots are now downloaded via barcode reader. Plus, the lab now enjoys more advanced data plots and histograms and less sample handling with microsamples.

"The new auto-correction feature provides the added benefit of less sample handling and manipulation overall," she adds. "We rarely ever have to perform a plasma replacement procedure."

Another enhancement is the updated software interface, which now more closely resembles that of the UniCel DxI and Access 2 software.

"This is great because we have generalists that rotate between chemistry and hematology—and similar software screens make it easier for them to go from one department to the other and run an instrument," says Cichon.

"Overall, we're very happy with our UniCel DxH systems," she says. "I felt that Beckman Coulter had really been listening to the customer voice—and provided what today's labs want."

Beckman Coulter, the stylized logo, UniCel, COULTER and Access are registered trademarks of Beckman Coulter, Inc. DxH and Latron are trademarks of Beckman Coulter, Inc.