Expanding laboratory diagnostics across diverse operating environments

• Compact benchtop analyzers with broad test menus can expand access to high-quality testing in satellite and lower-volume laboratories
• Standardizing technology, reagents, and workflows across locations can improve result comparability, reduce downtime, and support service continuity
• Smaller reagent packs, simplified maintenance, and intuitive interfaces can reduce waste, streamline staff training, and improve operational efficiency

Smaller benchtop analyzers can help expand access to high-quality laboratory testing across satellite and lower-volume locations. Poliklinika Human operates a six-site laboratory network in Serbia, including sites where space, infrastructure, and access to technical support are often limited. In this interview, Aleksandra Krstic from Poliklinika Human explains how compact, robust analyzers with broad test menus support timely and comparable results. She also discusses how compatible reagents, intuitive workflows, and simplified maintenance can reduce waste, ease staff onboarding, and help maintain service continuity.

Poliklinika Human has been operating in Nis, in southeastern Serbia, for 19 years. Nis is home to our central laboratory and two smaller satellite clinics at different addresses, while medium-sized laboratories are located in three additional cities, up to 100 kilometers from the central site. Today, our professional team consists of 110 employees across six locations. At the central laboratory, we process between 300 and 500 samples per day, representing more than 3,000 tests.

Growing from the small laboratory we were in 2007 to the system we have today has been demanding, but also deliberate and carefully planned. In the early stages of development, when patient numbers were lower, key challenges included investing in high-quality equipment, ensuring reagent stability over a longer period of use after opening, and, above all, ensuring the reliability of results. For this reason, we consider the selection of high-performance equipment and reagents to be one of the most important strategic decisions a lab can make.

A major step forward for us in terms of quality came with the introduction of a laboratory information system (LIS) and the installation of high-quality analyzers based on sensitive and precise methods. This approach allowed us to standardize our work, improve service quality, and gradually expand our network.

When equipping our remote laboratories, it is important to identify in advance the constraints and risks that may affect the continuity of operations. The most common challenges that we encounter are available space, reliable water and electricity supply, and the distance of the location, which can make rapid service intervention more difficult.

For that reason, we choose robust equipment that is easy to maintain, resilient to environmental conditions, and as independent as possible from additional infrastructure. In our system, the principle of equipping satellite laboratories with analyzers from the same manufacturer as those in the central laboratory has proven particularly effective. These are usually small-throughput systems that use the same or compatible technology and reagents, with pack sizes adapted to lower testing volumes.

Regular maintenance, clearly defined step-by-step instructions, and high-quality technical documentation in visual and video formats are very important for reliable operation. We favor instruments that allow staff to perform part of the routine maintenance themselves and replace certain key components, which is especially valuable at locations where field service is not quickly available. The experience of colleagues in the central laboratory also provides important support to satellite teams in their day-to-day work.

It is very important to us that as many tests as possible can be performed at the location where the patient is seen, while maintaining the same level of quality as in the central laboratory. This shortens the time to results and reduces the need to transport samples, which is important for both patients and physicians.

This model accelerates clinical decision-making and allows appropriate next steps to be planned without unnecessary delay. We achieve this by selecting equipment that combines a broad menu of tests with high medical value and smaller reagent pack sizes adapted to the workload of satellite laboratories. In this way, we can maintain high reagent utilization while ensuring accurate and precise results.

Physical space is often limited in smaller laboratories, so a compact benchtop system is a very practical solution for us. In this setting, a small analyzer footprint is important, as is a sufficient number of reagent positions, in our case at least 30, so that daily work can be organized without frequent reagent changes.

An extensive test menu is equally important. A system that can perform more than 100 different tests gives a small laboratory significantly greater flexibility and allows routine and additional tests to be run in parallel, without unnecessary instrument stoppages. This directly simplifies workflow organization and contributes to faster sample processing.

Process standardization is one of the foundations of our system's development. We continuously analyze every step, from patient reception and biological sample collection, through the pre-analytical and analytical phases, to post-analytics—and improve our way of working based on risk assessment.

Maintaining comparability of results across locations is significantly easier when laboratories use equipment from the same manufacturer, the same or compatible testing technology, and aligned reagents. We adapt pack sizes to the capacity of each individual laboratory while retaining the same system and auxiliary reagents wherever possible. This allows experience gained in the central laboratory—including knowledge of reagent behavior and stability—to be transferred easily to colleagues in smaller laboratories.

This approach helps reduce the risk of failed calibrations and unacceptable internal quality control results. An additional advantage is stronger backup between locations: If one analyzer is temporarily out of operation due to maintenance or service, system compatibility helps maintain continuity of operations, reduces downtime, and supports the timely release of results to patients.

Reagent management is particularly challenging at locations with a lower daily sample volume and a wide variety of requested tests. When testing volume is lower, reagents are consumed more slowly and remain exposed for longer to various influences during use—temperature changes, repeated loading onto the instrument, mixing, pipetting, and contact with air. All of these factors can affect reagent stability and analytical performance.

For this reason, smaller pack sizes are important to us, as are reagents that have a longer shelf life and can be monitored directly on the instrument. This reduces the amount of unused reagent and allows better cost control.

Efficiency is further improved by analyzer design that reduces energy consumption and the use of system wash fluids. Radio-frequency identification (RFID)-identified reagents that require no additional preparation and provide extended onboard stability further simplify workflows and reduce waste. In addition to the financial impact, this approach also has a clear environmental benefit.

Staff turnover can be a challenge in our lab, which is always growing and developing. Good organization requires a balance between experienced professionals and newly hired employees who are still learning the work processes. New team members require training and supervision, which also places additional demands on experienced colleagues who must ensure the continuity of day-to-day operations.

For this reason, equipment that is simple and safe to use, with a clearly defined, intuitive interface is very valuable to us. With fewer manual steps to memorize, it shortens the training cycle and reduces the amount of time a mentor needs to spend with a new employee. In this way, new hires can quickly gain confidence to work independently, and we can also potentially rotate staff across different locations as needed if all the instruments have the same user interface. 

The end result is a more stable organization while preserving the quality and speed of service our patients and partners have come to expect. This allows the growth of the system to be matched by the sustainable development of the team.