Pr Thomas Bourlet : We thus wanted to both increase the activity of the Biology Pathology center and respond to competition from the private sector. However, this requires better visibility among patients, whether they are seen by our internal consultations or coming from the city. The Saint-Étienne University Hospital has several sampling centers open to the public. Formerly scattered, these have gradually been grouped together on a few sites, sometimes close to healthcare services. For the new “medical biology laboratory”, we have also prioritized accessibility: located on the roundabout serving the main entrance to the Nord Hospital, in Saint-Priest-en-Jarez, it is much more visible and therefore more easily identifiable by the general public, which will strengthen our hospital activity in medical biology, while consolidating the other missions of the Cluster, in terms of research, teaching and training.
Could you come back to the genesis of the project?
Corinne Lebail : This has been under consideration for at least eight years. The Biology Pathology center has therefore wanted to create a better located and identifiable sampling center for a long time, but the main obstacle was land. The hospital management, and in particular the general director Olivier Bossard, finally had the opportunity to rent the premises of a former dental center, located on the roundabout in the immediate vicinity of the main entrance to the Hospital. North. They were able to use it to install both this new “laboratory” and some administrative premises. In total, no less than 120 square meters are allocated to the new sampling center which, after development work, now has four boxes, one of which is specifically reserved for Covid samples.
Where are the samples taken in this center analyzed?
Pr Thomas Bourlet : We favor the short circuit and “homemade” biology! More than 95% of analyzes are carried out within our laboratory, which is not the case with other sampling centers which, very often, subcontract their examinations or transfer them to technical platforms located in other locations. ‘other cities. Being able to carry out almost all the analyzes within our Biology Pathology center is therefore a certain “pride” for us, with activity 24 hours a day. This makes it possible to reduce the time taken to transport samples and that of rendering results, allowing faster patient care.
Corinne Lebail : All samples taken from the various CHU sampling centers are in fact transported to the hospital’s biology platform, also located at the North Hospital of Saint-Priest-en-Jarez. Scheduled shuttles run every day of the week according to a defined load plan. That said, beyond its proximity to the technical platform, the new sampling center offers other advantages. It is therefore open 7 days a week, weekdays from 7 a.m. to 6:15 p.m., Saturdays from 7:15 a.m. to 2:30 p.m. and Sundays from 8:15 a.m. to 11:30 a.m. However, private laboratories are often closed from Saturday midday to Monday morning. This Sunday opening therefore responds to a real need of the population. Moreover, attendance in this niche is one of the highest.
Several collection centers at Saint-Étienne University Hospital are recruiting agents from the job retention unit. Is this also the case for the new center?
Corinne Lebail : Yes, and in my opinion this is an important characteristic. As you mentioned, the historic collection centers have already employed professionals from the job retention unit for several years, that is to say caregivers who, often due to medical restrictions, can no longer work. in care service. However, they can still welcome patients, or take blood or urine samples, or electrocardiograms. It is also these agents who, during the health crisis, ran the Covid sampling center. Many had been called in as reinforcements and, now that this crisis is over, they have been able to find stable professional activity by integrating the new medical biology laboratory.
Have you adapted the patient pathways to take into account the center’s opening to community care?
Corinne Lebail : The building in question being external to the University Hospital, it was indeed necessary to think about the patient journey in a more “practical” way. Requiring users to first go through the University Hospital Entrance Office, and then return to take a sample at the laboratory, went completely against our desire for openness and simplification. This subject has also been the subject of extensive reflection. We have, in fine, chose to install a remote entry office within our premises. The patient can thus be welcomed as in a private laboratory in town, by presenting their identity card, vital card and mutual insurance card at the entrance. Administrative reception is therefore done directly on site.
Was this simplification of the process, in your opinion, a prerequisite for competing with private laboratories?
Corinne Lebail : Quite. It seemed essential to us to simplify the procedures to facilitate access to the laboratory for everyone. Beyond the name “Medical Biology Laboratory”, the logo created for the occasion bears witness to this: the microscope and the drop of blood take up images evocative of a symbolism that we also find in the LBM of city. It was also an important step in defining the project: a major consultation was carried out between general management, the communications department and the division’s teams, to develop an identity that speaks to as many people as possible.
Pr Thomas Bourlet : We were also accompanied here by the Auvergne-Rhône-Alpes Regional Health Agency, which was obviously consulted before the opening of the new sampling center. Another point that we have not yet mentioned, and which represents a real asset: this place not only makes it possible to expand the healthcare offering for the Saint-Etienne population; it also allows a patient’s results to be directly integrated into their hospital medical record. Indeed, although it was designed as an external structure with simplified access, the sampling center is an integral part of the University Hospital and therefore benefits from all the associated services.
After more than six months of opening, do you already have some figures in terms of activity?
Corinne Lebail : For the moment, around thirty samples are taken each day, and around twenty during the weekends, that is to say the day of Saturday and the morning of Sunday. These numbers may seem low, but they are steadily increasing. We have also launched a major communication campaign, on the internet and in the local media, to raise awareness of the center which should, ultimately, exceed fifty samples per day. Several other projects are also being implemented to revitalize the place. For example, CHU patients hospitalized at home could be redirected to the collection center to carry out their assessments. Here again, the fact that the results are directly entered into the patient file is a real advantage for healthcare professionals, and more broadly for the continuity of pathways because these patients are generally followed over the long term.
What about the Biology and Pathology center at the University Hospital? Could you introduce it to us?
Pr Thomas Bourlet : Each year, the center processes 5,400,000 documents, or a little more than 3,000 files per day. All of this activity is carried out by 258 full-time equivalents (FTEs) of non-medical staff, and around fifty FTEs of biologists. The Center has a common pre-analytical sector allowing the distribution of samples according to the disciplines concerned – and there are many of them: biochemistry, pharmacology, bacteriology, virology, hygiene, parasitology, mycology, molecular biology, cytogenetics, hematology, anatomo-pathology , renal histology, cytology and immunology. A robotic chain takes care of the routing to biochemistry and hematology machines for carrying out ionograms and blood counts in particular. Other sectors benefit from automated or manual techniques to carry out more specialized analyses.
What projects are currently underway within the cluster?
Pr Thomas Bourlet : Several projects coexist at the moment, but one of the most demanding is certainly the change of our information system, to evolve towards a more recent version and thus have a real connected prescription. This is not yet the case today, and this highly anticipated functionality will also benefit the new sampling center. Its advantages will also be reflected on all floors of the CHU, with faster recording of data in patient files. This new information system will also offer more possibilities for exchanges between the establishments of the Territorial Hospital Group (GHT), which allows it to be part of the strategy of convergence of information systems at the scale of the GHT.
A word, perhaps, about your research activities?
Pr Thomas Bourlet : The research activity of the Biology and Pathology center represents approximately a fifth of the total research carried out at the Saint-Étienne University Hospital. We are often associated with clinical research projects carried out by different healthcare services, for example for infectious diseases or nephrology. But our center also carries out its own research activities, in conjunction with the Faculty of Medicine of Jean Monnet University. Here we rely a lot on the Biological Resources Center (CRB), which is an integral part of the Biology Pathology center and brings together several series of samples intended precisely for research projects. These samples can also be taken internally, including by the new sampling center which thus indirectly participates in the CHU’s research work.
Finally, what are the prospects for this new sampling center?
Corinne Lebail : Our primary objective is to boost its activity and develop partnerships. But we also plan to extend its scope to vaccination. Our historical sampling centers had already been able to carry out Covid vaccination of healthcare professionals. We now wish to open this activity to the outside world, and are now working with the infectious diseases department to offer vaccination against all recommended diseases. We would like to take the plunge in the coming months, and thus offer an additional service to the population of Saint-Etienne.
> Article published in Hospitalia #65, May 2024 edition, read here
