Tekirdag Namik Kemal University Hospital. The Tekirdag University Hospital and Roche: A partnership built for success. Dr Savas, Laboratory Director

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1 Tekirdag Namik Kemal University Hospital Turkey Dr Savas, Laboratory Director COBAS, COBAS C, COBAS E and LIFE NEEDS ANSWERS are trademarks of Roche. All other trademarks are property of their respective owners Roche 0710 Roche Diagnostics Ltd. CH-6343 Rotkreuz Switzerland The Tekirdag University Hospital and Roche: A partnership built for success

2 Tekirdag Namik Kemal University Hospital, Turkey University hospital laboratory 120 beds 165,000 Clinical Chemistry results per year 25,000 Immunochemistry results per year Turkey is a country undergoing rapid transformation as the sophistication of its public services increases. A major focus is placed on building Centers of Excellence such as Tekirdag University Hospital where Dr Savas and his team are aware of the need to live up to their reputation. As the new laboratory has grown they have placed a very high emphasis on generating confidence in their results. Their success can be measured by their ability to manage an ever-increasing workload while maintaining excellent standards.

3 Sharing success, year after year The foundation and development of University Hospitals like this one is an important part of our country s continuous drive to expand healthcare provision Turkey is undergoing rapid changes as the government aims to build a network of core healthcare centers around which Turkey s healthcare infrastructure can further develop. Under these circumstances the trend for tighter regulation is understandable and this extends to the provision of laboratory services, which have to undergo an exhaustive process of annual tendering. Dr Savas, Laboratory Director, experiences at first hand the workload and pressure that come with this drive for excellence. The foundation and development of University Hospitals like this one is an important part of our country s continuous drive to expand healthcare provision, but every year, repeating the tendering process for services puts a lot of pressure on the smooth functioning of laboratories like ours.

4 Attention to detail: essential for excellence...the lab requires technological innovation, a comprehensive offering, attention to detail and spirit of service. This rigorous environment means that Dr Savas needs a partner he can rely on: one that will share in the vision of a Center of Excellence by providing the very best in service, support and results. The very best in every discipline is what defines a Center of Excellence and includes specialist physicians and staff who have an almost entrepreneurial spirit: eager to tackle and solve non-routine issues and able to deal with complex symptoms and procedures. To meet the demands of their clinical colleagues the lab requires technological innovation with a comprehensive offering and absolute attention to detail. It s this attention to detail that makes cobas 4000 analyzer series stand out from its competitors. For example, the following features are just some of the many that help to ensure reliability of results: Ultrasonic mixing without the need for exogenous physical interference, which means that the chance of a carryover error between samples is greatly reduced. It also reduces water consumption used in washing an important asset to take into consideration in Turkey. Intelligent Clot Detection: the cobas c 311 analyzer does not stop the test run automatically when it discovers a clot, but instead it tries three times to expel the clot from the system. Disposable tips and cups for the cobas e 411 analyzer for virtually no carryover risk Dr Dumrul Gülen, Microbiology Laboratory Director, knows that working with cobas 4000 analyzers delivers results with assurance and speed, which are benefits he is keen to emphasize. If a clinician is not confident about the results, the lab will be challenged. Thanks to cobas systems and its attention to detail, I feel confident that I can always meet those challenges head on.

5 Sample quality is a crucial element for peace of mind We simply cannot afford the delays and re-tests that occur when sample integrity is compromised. Dr Savas envisions a virtuous circle whereby reliable quality control elements lead to confidence in results and hence cost effectiveness due to the low level of re-tests. This in turn leads to peace of mind for him and his team, which can only have a positive influence on the way his staff perform their duties and hence improve still further the quality. He has experience running laboratories of all sizes and he is very familiar with the waste that can occur, in both time and money, when non-consolidated analyzers are used and when sample preparation is not optimized. The ability to detect potential interfering substances before the test is run can dictate the validity of the final result. Dr Savas simply cannot afford the delays and re-tests that occur when sample integrity is compromised. So what does the cobas 4000 analyzer series have to offer him in this regard? The answer is test-specific serum indices performed on the cobas c 311 analyzer that provide a semi-quantitative representation of levels of hemolysis, icterus (bilirubin) or lipemia (turbidity) present in patient samples. Interfering agents barely affect enzyme results but tests such as creatinine, triglycerides, cholesterol, total protein and bilirubin may be very sensitive to them. For me the great benefit of the serum indices provided by the cobas c 311 analyzer is not so much that they tell me which sample has interference, but that they tell me if that particular interference affects the accuracy or the clinical relevance of a given test result.

6 Long on-board stabilities are vital The annual tendering process inevitably puts great emphasis on cost efficiency. For a small laboratory with a limited throughput of samples, it can sometimes be difficult to offer a broad menu cost effectively. The clinical chemistry workload of the lab is around 85 samples per day, routinely performing HbA1C whole blood for example. But tests such as cortisol, IgG and IgM are much less frequently requested which means that reagents for them must remain stable for a prolonged period. We only conducted 6 cortisol tests during January, but today (February 25 th ) the reagent is still on the system and with good QCs well in range. Comparison of on-board stabilities On-board stabilities (days) Roche cobas 4000 analyzer series Beckman UniCel Abbott ARCHITECT Johnson & Johnson VITROS Siemens Vista IgG n.a. IgM n.a. Cortisol n.a. 10 Data from product package inserts Siemens Centaur Dr Savas knows that he has to tender yet again this year for all his laboratory services, however, cobas 4000 analyzer series and Roche will no doubt be frontrunners thanks to the sheer quality of the system and the performance benefits that it brings. The specification for the tendering process will be tough, but it s one that he knows is fair. Some suppliers may not be able to deliver on all of the requirements, but these specifications are the very things that make his laboratory work efficiently to the standards expected of a Center of Excellence. We are a relatively new, small, but growing laboratory and the problem we found in the tendering process was that many of the bigger solution providers were not prepared to bid due to the small volumes that we used. Roche, on the other hand, could not only see our vision for a rapidly growing, high class laboratory but they were prepared to share in that vision by investing in us. However that alone would not be enough to protect their position when re-tendering. Thankfully, there is so much quality in what Roche has to offer that I m not at all worried about their chances of success at the next tender. Roche could not only see our vision for a rapidly growing, high class laboratory but they were prepared to share in that vision partnering with us. What next for the laboratory? Tekirdag Namik Kemal University Hospital Turkey From very small beginnings, Tekirdag Namik Kemal University Hospital is growing rapidly and soon the laboratory will have to meet the demands of an ever-expanding and complex group of doctors and patients. For example, the hospital is about to open a new 100 in-patient facility, 3 new operating rooms, a critical care unit and 2 delivery suites. The 5 year plan is to grow this to a 600 patient facility. That s why getting things right from the start was so important and also why the laboratory chose Roche analyzers family which offers them great flexibility and can grow with their needs.