Full presentation by Dr. Virginia (Jennie) Thurston delivered to healthcare and laboratory medicine leaders at the Roche Efficiency Days (RED) 2018: REDefining perspectives in Guangzhou, China.

Esoteric laboratory testing, including molecular pathology and cytogenetics, is a frequently overlooked area for continuous process improvement as it is viewed as a relatively low volume, highly complex field in comparison to other laboratory specialties. In particular, cytogenetics (the study of the morphology of chromosomes and their impact on disease) is perceived as a very labor-intensive process with high costs due to the need for many highly-trained technologists and the lack of automation.

As many in the healthcare field have little knowledge of cytogenetics, its role in contributing to the diagnosis, prognosis, and treatment of disease (particularly in oncology) is often disregarded. However, when viewed through the lens of continuous quality improvement, many processes can be implemented to lower costs and to enhance efficiency by focusing on workflow, cross training and automation of certain steps in the processing of chromosomes. This presentation will describe the current state of the field and focus on our experience in building a new core laboratory allowing for the consolidation of esoteric testing under one roof and the gains achieved using continuous process improvement.