By A
LIS Downtime for Cytogenetics and FISH
Stabilize samples, name the exceptions, reconcile cleanly with SoftGenomics (SCC). Staggered rollout: Phase 0 paper, Phase 1 accessioning station, Phase 2 department stations.
Downtime replaces the tile, not the bench
Stays the same
Every bench step follows standard SoftGenomics SOPs Same reagents, instruments, QC and timing No downtime-only bench methods
Moves to paper
Only what a tile would document Recorded on the Case Traveler Entered back into SCC when it returns
Four stages, each one usable on its own
Phase 0 (now)
Paper only: handwritten DT IDs, scannable travelers, event log, req copies
Phase 1
ACC / CLC accession station: scan req, print labels and travelers
Phase 2
Cyto and Cyto-FISH stations print labels; Flow and Mol TBD
Later
SCC downtime mode on our own CPUs, offline fallback CPU
Phase 0 works with no computers at all. Each later phase falls back to the one before it.
Phase 0: Paper Only
Handwritten IDs, scannable travelers and a single event log, with no computers needed.
Three identifiers on everything
Patient name
Full patient name on every tube, aliquot, slide, traveler and log line.
Date of birth
DOB is the second identifier and always travels with the name.
DT ID, the third
Format DT-26-0000123. The handwritten short form is DT-26-123.
Phase 0: handwritten
Written with a VWR marker and covered with clear tape so it stays legible.
Phase 1+: printed
Printed labels carry a DataMatrix that encodes exactly the printed ID, nothing more.
Every child is parent plus next unused .n
A FISH slide off a cyto pellet continues the series (L3). Numbers are never reused.
Three safe points where a case can wait
The only times written on the traveler: when a case is held at A, B or C, and when it restarts.
No FISH case waits for the LIS
Received before 1:30 PM
Direct harvested the same day Taken to a fixed pellet (point A) Held at -20 °C until restart
Received after 1:30 PM
Direct harvested the next day Normal 1:30 PM cutoff applies Same fixed pellet at point A
STAT and Pediatric
Processed the same day, even after 1:30 PM Keep going through slides, hyb and post-wash??? Hold times recorded on the traveler
Five things that never wait
Priority cases
STAT, Pediatric and Rush/Acute cases keep moving through every bench step.???
MM CD138+ enrichment
Done on the fresh specimen. The traveler asks for the RoboSep run report or the Manual sep log.
ThermoBrite slides
Slides already on the ThermoBrite are post-washed within the 12-36 h window.
Cyto cultures
Cultures are harvested on schedule, whatever the LIS status.
Director decisions
Add-ons, probe changes, merges and culture flips need a director decision written on the traveler.
Three documents carry the whole case
Case Traveler
One scannable sheet per case: bubbles, comb boxes, A/B/C hold rows and QC rows. Rows that don't apply are greyed out.
QC by initials
Initials on QC rows confirm QC against the TRAVELER REQ copy. Example of greying out: enrichment on a non-MM FISH case.
Downtime Event Log
One line per case per department, each with a NOTE line. The back page holds notes and the internal note.
TRAVELER REQ copy
A copy of the requisition for every department: TRAVELER REQ at top, department top right, date/time bottom right.
Phase 1: ACC / CLC Accession Station
Scan the req, confirm it, then print labels, REQ copies and pre-filled travelers.
Sign in, pick your station
Initials first
Every user enters their initials before anything else on the station.
Pick your station
Choose ACC, Cyto, Cyto-FISH, Flow (TBD) or Mol (TBD).
Logged under you
Everything you do is recorded under your initials for that session.
The virtual req, built on PDF Forge
1 Scan the req
Scanner, scan folder or upload
2 OCR reads
Check marks and handwriting areas
3 Side by side
Scan beside the virtual req, or underneath
4 Colour key
Yellow OCR, green CLC added, red x removed
5 CLC completes
Types anything OCR missed
The review panel flags gaps before printing
Errors
Missing patient name, DOB or specimen type Missing tests or collection date Missing physician signature or ICD10 Missing submitting institution
Warnings
More than one specimen type Faint marks or untyped handwriting Pediatric age Received after the 1:30 PM cutoff
Acknowledging
Errors can be acknowledged with initials Acknowledged errors print on the traveler notes The bench follows up from the traveler
Five steps from req to department
1 Req
Scan and confirm the req; DT ID assigned
2 Tube labels
Check labels: Zebra ZD621, 2 x 0.5 in, DataMatrix
3 Documents
Check TRAVELER REQ copies and pre-filled travelers
4 Yes, proceed
Only now do labels and documents print
5 Dispatch
Each department gets its traveler and REQ copy
Every action is logged
Sign in and scans
Every sign-in and every scan is recorded with time and initials.
OCR corrections
Each correction keeps what OCR read and what the CLC changed it to.
Acknowledgements
Acknowledged errors and every confirmation are logged with initials.
Prints and dispatch
Every print and every dispatch per department is logged with time and initials.
One log per day
A single audit log per day, viewable on every station.
Phase 2: Department Stations
Each department prints its own aliquot and slide labels on demand.
Cyto-FISH slide labels in eight steps
Cyto next; Flow and Mol designed with teams
Cyto station
Prints culture slide labels H1, H2, with a backup star.
Flow and Molecular
Placeholders today that show the dispatched case list. We design each station with the team.
Aliquot labels at ACC
Already print in Phase 1 when we know another department needs one: parent plus next unused .n.
Aliquot labels follow the DT ID family tree rule in every phase.
Later
Automatic reconciliation and SCC downtime mode on our own lab CPUs.
Less re-entry, no single point of failure
Automatic reconciliation
Scanned travelers reconcile automatically against SCC and write the downtime internal note.
Shared case list
Every station sees the same case list, so hand-offs show up everywhere at once.
SCC downtime mode
Runs on our own lab CPUs and network, independent of the main LIS.
Offline fallback CPU
A dedicated CPU keeps working with no network, then syncs back to SCC.
Reconcile oldest first, then audit
Accession
CLC accessions each DT case and gets an HLID
Enter tiles
Techs push travelers through the tiles, oldest first
Relabel
HLID labels applied
Retire DT ID
Traveler records the step the DT ID retired after
Document
Internal note plus scanned traveler on the case
Audit
Supervisor audits the event log
Later: scanned travelers reconcile automatically against SCC and write the downtime internal note.
What we need from each group
Directors
Approve hold limits, the same-letter culture rule and the STAT Metafer exception.
CLC / ACC
Own the DT number log and label stock, and test the Phase 1 station.
IT / SCC superuser
Set up the Zebra ZD621, document scanner and regular printer on the ACC PC. Define how scanned travelers attach in SCC.
QM
Map CAP checklist items, set record retention and schedule the annual downtime drill.
Send owner names and sign-off for your group's items, then we book a Phase 1 station test and the first downtime drill.