Impact of total laboratory automation on workflow and specimen processing time for culture of urine specimens

Melanie L. Yarbrough, William Lainhart, Allison Rebecca McMullen, Neil W. Anderson, Carey Ann D. Burnham

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Total laboratory automation (TLA) has the potential to reduce specimen processing time, improve standardization of cultures, and decrease turnaround time (TAT). The objective of this study was to perform a detailed interrogation of the impact of TLA implementation in all aspects of the workflow for routine culture of urine specimens. Using a detailed motion capture study, the time required for major steps of processing and result reporting were prospectively assessed for urine samples prior to (n = 215) and after (n = 203) implementation of the BD Kiestra TLA system. Specimens were plated on all shifts, but cultures were read only during the day shift for both time periods. Significant increases were noted in the time from receipt to inoculation (23.0 min versus 32.0 min, p < 0.001) and total processing time (28.0 min versus 66.0 min, p < 0.0001) for urine specimens post-TLA. Rates of positive (18.6% versus 16.3%) and negative (71.2% versus 79.3%) urine cultures remained stable through the pre- and post-TLA time periods (p = 0.58). There were no changes in TAT for organism identification or susceptibility results. The time to final report was decreased from 43.8 h pre-TLA to 42.0 h post-TLA, which was attributed to significant decreases in TAT for negative cultures (42.0 h versus 37.5 h, p = 0.01). These findings demonstrate that changes in laboratory workflow are necessary to maximize efficiency of TLA and optimize TAT.

Original languageEnglish (US)
Pages (from-to)2405-2411
Number of pages7
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Issue number12
StatePublished - Dec 1 2018


  • Kiestra
  • Total laboratory automation
  • Turnaround time
  • Urine culture

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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