(1) Implementation of a new laboratory information management system: measuring the impact by staff perception, (2) Evaluating next generation sequencing HLA typing efficiency following process change utilising Laboratory Information Management System data, (3) LIMS in Focus: Trends and Insights in UK and Ireland H&I laboratories

1) Implementation of a new laboratory information management system: measuring the impact by staff perception

A laboratory information management system (LIMS) is a central component to a clinical laboratory. Fundamental features of a LIMS include sample, workload and patient management, test resulting and reporting. Additional functionalities may support interoperability, resource management and quality management.

To assess the impact, staff perception pre- and post-implementation of a new LIMS (HistoTrac, ThermoFisher Scientific) was measured using anonymous online questionnaires (Qualtrics™). The study group involved all departmental staff in three strategically timed, structured questionnaires. Quantitative data analysis of variation in staff perception was performed on closed questions with scaled responses and presented using diverging stack charts. Qualitative data analysis of open question responses was performed and presented as word clouds to highlight themes.

The response rate was 59% in the pre-, 41% in the one month post- and 57% in the 12 month post-implementation questionnaires, with a similar representation from each staff demographic observed across the three surveys. Staff satisfaction of the LIMS functionality improved across all areas surveyed following the implementation of the new LIMS. The greatest increase in mean score was observed in workload management and reporting functionalities with the least improvement detected in auditing, which was not a first phase implementation priority. Staff perception themes identified include reduced workload and improved efficiency through less manual transcription and duplication of data entry alongside simplified and streamlined processes.

The use of department-wide questionnaires has highlighted the benefits of a new centralised LIMS and has identified areas for future development that are perceived as important to the laboratory staff.

2) Evaluating next generation sequencing HLA typing efficiency following process change utilising Laboratory Information Management System data

HLA typing by next generation sequencing (NGS) has been the frontline typing technique since 2017 in this laboratory. In 2023, modifications to the AlloSeq Tx17 (CareDx) NGS typing workflow (two to a one-day protocol; upscale from 24 to 48 samples per batch) plus implementation of a new laboratory information management system (LIMS) were introduced. HLA typing process efficiency was evaluated to measure the impact of these changes.

To assess the performance of the process longitudinally from January 2022 to December 2024, turn-around-time (TAT), calculated from sample receipt to report date, was monitored. To calculate the time taken to perform the process, time-and-motion studies were performed before and after the changes to the workflow and the implementation of the new LIMS. The impact of the new LIMS on the pre- and post- analytical phases of the process was also evaluated.

A comparison of the NGS HLA typing TAT between 2022 (before the changes) and 2024 (after the changes) showed a reduction in the average number of days from 12.03 (± 1.82) to 8.40 (± 1.03), despite a 46% increase in samples tested (1740 v 2546 per year). In 2022, the monthly mean percentage of samples achieving the target TAT of 10 working days was 55.33% (±16.61) compared to 85.80% (±8.08) in 2024. The theoretical hands-on time per specimen for the NGS HLA typing process (set-up to result authorisation), reported in h:min:s, reduced from 00:41:05 to 00:25:36 between 2022 and 2024 respectively. The automated production of the NGS HLA typing worksheet from the LIMS contributed to an average efficiency saving of 00:04:55 per batch.

To address a rise in NGS HLA typing demand, process changes were introduced which increased the throughput whilst improving TATs and reducing staff hands-on time. Implementation of the new LIMS facilitated quality improvement through the monitoring of TATs using high quality, granular data and contributed to the streamlining of the workflow.

3) LIMS in Focus: Trends and Insights in UK and Ireland H&I laboratories

Laboratory information management system (LIMS) functionality has evolved over time to support various aspects of laboratory management. This study presents findings from a national survey assessing the current LIMS landscape in Histocompatibility and Immunogenetics (H&I) laboratories across the United Kingdom (UK) and the Republic of Ireland (ROI). The primary objectives were to identify areas for improvement, establish best practices, and evaluate the role of LIMS in laboratory quality management.

An anonymous online questionnaire (Qualtrics™) was distributed to all UK and ROI H&I laboratories. The survey included both open- and closed-ended questions, with responses collated in MS Excel for qualitative and quantitative analysis, respectively.

A total of 16 responses (66.6%) were received from 14 (58.3%) of the 24 H&I laboratories. Findings revealed that 60% of responding laboratories currently use commercial LIMS from six vendors, with 82% of laboratories relying on additional systems to supplement functionality. Notably, 40% of laboratories would not recommend their current LIMS, and 43% were considering replacing them. Surprisingly, only 69% of laboratories utilise LIMS data to drive quality improvement.

Results highlight significant variation in LIMS utility, leading to inefficiencies due to duplicated data entry. A key limitation is the inability to interface with internal and external systems for electronic patient data transfer. Furthermore, LIMS lack critical functionality to support quality management, which is essential for accreditation and continuous improvement. In conclusion, UK and ROI H&I laboratory LIMS require further development to align with NHS digitisation strategies, for the provision of safer, more efficient patient care.

Outputs

1. Poster presented at British Society of Histocompatibility and Immunogenetics Conference (Sept 2024) – https://bshi.org.uk/wp-content/uploads/2025/04/BSHI-2024-P17.pdf
2. Poster presented at European Federation of Immunogenetics Conference (May 2025) – EFI Abstracts, HLA, 2025.
3. Poster presented at British Society of Histocompatibility and Immunogenetics Conference (Sept 2025) – BSHI Abstracts, International Journal of Immunogenetics, 2025.