Interview conducted with Sibel Ergünes and Histotechnician Camilla Grandal, at Odense University Hospital in Denmark.

Moving  to  the  latest  technology platform,  the  Tissue-Tek AutoTEC^® a120

Odense University Hospital (OUH) in Denmark is the largest hospital in the region of South Denmark. It has 1,045 beds spread over all medical specialties and the staff includes approximately 11,000 employees.

Sakura^®  spoke  with  Sibel  Ergünes  and  Camilla  Grandal,  both super users from the Pathology Department, to learn from  their  experiences  with  the  new  Tissue-Tek  AutoTEC  a120. 

Why did you invest in a Tissue-Tek AutoTEC a120?

Ergünes explains that during the past 5-7 years they have had   an   increasing   workload,   where   the   contributing   factors  were  the  rising  incidence  of  cancer  within  the  aging  population,  both  resulting  in  increased  tests  to  be  performed.  

We  also  wanted  to  change  the  workflow  in  the  lab  to prepare for the future and realised that our current Tissue-Tek  AutoTEC® was not able to fulfil our needs. Therefore management  made  a  decision  to  purchase  an  additional  automated embedding machine. 

Grandal  adds  that  automation  made  it  possible  to  free  up  labour for other purposes.

What is important to you, in regard to the performance of the Tissue-Tek AutoTEC a120?

The  most  important  thing  is  of  course  the  quality  of  the  blocks. They have to be as high in standard as with the old Tissue-Tek AutoTEC. Other parameters include the ease of use, the maintenance we have to carry out and the reliability. Let me try to explain it in more depth.

Time saving

One of the main reasons of going from manual to automated embedding, was the time saved. Before  the  Tissue-Tek  AutoTEC  arrived  back  in  2010,  we  had four to five people occupied at embedding stations from the morning up until lunch. Now we have one to two people embedding for 1-2 hours, so we have gained resources to be used elsewhere in the lab. 

All the routine work has been automated and we can spend time on more challenging things, which require our histology skills.  Compared  to  Tissue-Tek  AutoTEC,  the  Tissue-Tek  AutoTEC a120 has a variable warm-up time, which is really appreciated. We can start almost directly without waiting 15 minutes for the instrument to get ready. 

Ease of use

One thing that is really important for us as histotechnicians is that our instruments are easy to use. 

Remember we have a lot of different instruments in our labs, so the more intuitive the graphic user interface is, the easier it  is  for  us  to  do  the  operations.  You  can  almost  compare  the  Tissue-Tek  AutoTEC  a120  with  an  iPhone,  the  screen  tells  you  exactly  what  to  do  and  as  the  size  of  the  screen  increases it becomes even easier.   

The  fact  of  being  able  to  see  the  recovery  zone  of  the  rejected blocks is an advantage. In effect, this eliminates the risk of forgetting these cassettes. The arrival time of the embedded blocks is also indicated, making the workflow easier. 

Ergonomics

One   of   the   major   improvements   with   the   Tissue-Tek   AutoTEC a120  is  that  you  can  access  all  necessarily  functions from the front, meaning it can be placed directly against the wall and not in the middle of the lab. The refilling of paraffin takes place at an elbow level and not top filled as with the Tissue-Tek AutoTEC predecessor. The magazines slide  in  easily  and  the  opening  mechanism  is  so  much  quicker.  This  impacts  our  ergonomics  as  we  do  it  several  times  each  day.  The  maintenance  tools  have  a  location  of  their own in the system, meaning we avoid scattering and wasting  time  finding  them.  Stejlsted,  a  histotechnician highlights that, “It’s so intuitive and easy to operate - even without training”.

Maintenance

This is another important factor for us. With several different instruments at the lab, the time we spend on maintenance has to be as little as possible, without sacrificing the quality of the specimen. 

The  Tissue-Tek  AutoTEC  a120  really  has  made  improve-ments. Drip trays and checking paraffin level is what we do every day, the rest is on a monthly basis. 

Quality of blocks

Sakura was curious to the viewpoint of the pathologists on the  Tissue-Tek  AutoTEC  a120,  and  whether  we  would  get  the same high quality as before. A blind test was carried out and the result was, according to Bak Jylling (a pathologist), “Top quality – [with] absolutely no difference”.

Results: 

• Tissue-Tek AutoTEC a120 is faster than its predecessor.
• Blocks are ready earlier, allowing for workflow optimisation.
• Tissue-Tek AutoTEC a120 requires minimal maintenance.

End note

Grandal highlights that it’s very common in Scandinavia to name your equipment in the laboratory after famous movie stars, kings or queens, even popular pet names have been used and of course our new instrument had to have a name. The  old  Tissue-Tek  AutoTEC  is  named  Oscar  and  we  had  to decide whether or not Oscar should have a boyfriend or a girlfriend. So competition was arranged and the winning name  was  Hugo  (a  very  popular  cartoon  hero  for  smaller  children).

 “All  the  routine  work  has  been  automated  and we can spend time on more challenging things, which require our histology skills. ” (Sibel Ergünes and Camilla Grandal)

Department of pathology of Odense University Hospital in Denmark

In mid-2017, the Institute had a staff of approximately 145 people. This consisted of:

91 Histotechnicians

10 Secretaries

3 Molecular biologists

35 Doctors3 Professors

17 Senior physicians6 Department physicians

9 Residents

The  workload  has  steadily  increased  with  an  average  of  5%  each  year  since  2010.  Today,  the  total  number  of pathology reports is 84,130, where histology reports accounts  of  58,700.  The  yearly  production  of  glass  slides is 430,000, which includes IHC and SS as well. 

The department of clinical pathology at OUH, the first site in Europe equipped with a Tissue-Tek AutoTEC a120 as well as its predecessor, produces between 500-1200 blocks  a  day,  meaning  that  more  than  120,000  blocks  are embedded automatically each year.