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RI Witness as a Laboratory    Management Tool       Dr Alan Thornhill  The London Bridge Fertility,Gynaecology and Genetic...
Background• Established 1988• 1,500 IVF/ICSI cycles p.a. (capacity 2000 +) ; 600 IUI cycles p.a.• IVF, ICSI, PGD/PGS, Egg ...
How often do you make mistakes?               Mistakes               We neverit                The last                   ...
How often do you make mistakes?               Mistakes               We never                The last               are ve...
How often do you make mistakes?               Mistakes               We never               are very               make   ...
Maybe mistakes aren’t that rare•   Validation 12/2010-3/2011.•   420 cycles•   3694 witness steps•   48 (1.39%) tag alloca...
Total Work – 1507 yellow buttons1600                                                               Total140012001000 800 6...
Others?Frz Hb Sperm Step 1      Egg Freeze    Egg DonationSperm Prep Step 1        TE Biopsy     Frz D Sperm Step 1Sperm P...
Total Work Load4035302520151050     1      2          3         4           5               6      7        8          9  ...
Assign sperm pots (including wit)3530252015                                                                           Assi...
TVOC252015                                                                               TVOC10 5 0     1   2   3   4   5 ...
ICSI strips141210 8                                                                             ICSI strips 6 4 2 0     1 ...
Insem (+Recipient)201816141210                                                                             Insem (+Recipie...
Post ICSI30252015                                                                                Post ICSI10 5 0     1   2...
Fert Check4035302520                                                                            Fert Check1510 5 0     1  ...
Transfers events (+FET)30252015                                                                              transfers eve...
Untagged/incorrect by practioner3.5 3              BC35321-              Dish III not2.5              tagged 2            ...
Summary• Detection and Prevention of errors• Risk management/continuous improvement• Traceability (Traceability Element fo...
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Eshre 2011 Alan Thornhill RI Witness as Lab Management Tool Presentation

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Dr Alan Thornhill, London Bridge Fertility, Gynaecology and Genetics Centre talks about the use of RI WItness as a resource management tool indicating training requirements, stress points, procedure requirements, and assisting transparency. Presentation given at ESHRE, Stockholm, July 2012

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Transcript of "Eshre 2011 Alan Thornhill RI Witness as Lab Management Tool Presentation"

  1. 1. RI Witness as a Laboratory Management Tool Dr Alan Thornhill The London Bridge Fertility,Gynaecology and Genetics Centre
  2. 2. Background• Established 1988• 1,500 IVF/ICSI cycles p.a. (capacity 2000 +) ; 600 IUI cycles p.a.• IVF, ICSI, PGD/PGS, Egg freezing, Gamete/Embryo Cryopreservation• 60% Private : 40% NHS• Full 7-day a week service• Proven track record, large experience working with satellite (7) and transport (4) partners – QMH since 1994• ISO 9001;2000 certified, HFEA/CQC licensed, EUTD compliant• 3 full-time sub-specialty trained consultants + Male Fertility specialist• Experienced Laboratory Team (12 Full-time)• World leaders in Reproductive Genetics• Full-time Board-Certified Genetic Counsellor
  3. 3. How often do you make mistakes? Mistakes We neverit The last think is low...but are very make was mistake we 1989... rare in our mistakes in in don’t know lab... our lab!
  4. 4. How often do you make mistakes? Mistakes We never The last are very make was mistake rare in our mistakes in in 1989... lab... our lab!
  5. 5. How often do you make mistakes? Mistakes We never are very make rare in our mistakes in lab... our lab!
  6. 6. Maybe mistakes aren’t that rare• Validation 12/2010-3/2011.• 420 cycles• 3694 witness steps• 48 (1.39%) tag allocation • 17 practitioner error, 19 power related, 12 flow-chart• Mismatches – 16/3694 (0.43%) – mainly flow chart/tag outside – TRUE mismatch 4/3694 (0.11%)
  7. 7. Total Work – 1507 yellow buttons1600 Total140012001000 800 600 400 Total 200 0 Procedures Assign transfers Fert Check TVOC ICSI strips Post ICSI Insem Furthure Embryo set- Other 28/3-28/4 sperm pots events (+Recipient) cultures ups (including (+FET) wit) Assign Sperm Pot Fert Check ICSI Strip Post ICSI Recipient Egg Insemination Embryo Transfer Transport Egg Collection Insemination Further Culture Further Culture
  8. 8. Others?Frz Hb Sperm Step 1 Egg Freeze Egg DonationSperm Prep Step 1 TE Biopsy Frz D Sperm Step 1Sperm Prep Step 2 D3 Biopsy IUI D Step 1Pre ICSI/Sperm Fishing PN Thaw Embryo Surrogate Set-upAssign IUI sperm pot Post BiopsyIUI Hb Step 1 PN ThawIUI Sperm Prep step 2 ICSIEmbryo Thaw PB BoipsyICSI Holding
  9. 9. Total Work Load4035302520151050 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Assign sperm pots (including wit) transfers events (+FET) Fert Check TVOC ICSI strips Post ICSI Insem (+Recipient) Furthure cultures Embryo set-ups untagged/incorrect by practioner
  10. 10. Assign sperm pots (including wit)3530252015 Assign sperm pots (including wit)10 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
  11. 11. TVOC252015 TVOC10 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
  12. 12. ICSI strips141210 8 ICSI strips 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
  13. 13. Insem (+Recipient)201816141210 Insem (+Recipient) 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
  14. 14. Post ICSI30252015 Post ICSI10 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
  15. 15. Fert Check4035302520 Fert Check1510 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
  16. 16. Transfers events (+FET)30252015 transfers events (+FET)10 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
  17. 17. Untagged/incorrect by practioner3.5 3 BC35321- Dish III not2.5 tagged 2 BC27826- ET dish untagged/incorrect by practioner1.5 incorrectly assigned 1 BC36077 BC35572- BC34371- BC23554- - Egg Dish II not swim-up Step 2 sperm0.5 tubes as assigned tube not not assigned thaw assigned dishes 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
  18. 18. Summary• Detection and Prevention of errors• Risk management/continuous improvement• Traceability (Traceability Element formerly tracker software)• Competency assessment• Productivity• Identify training needs• Etc, etc......

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