Medical laboratories have been shortly overwhelmed by elevated demand as COVID-19 swept the U.S., main public well being departments and personal labs to endure lengthy delays in returning outcomes.
A number of hospitals determined to depend on their very own in-house labs to expedite the method, and people selections got here with their very own rising pains.
Suppliers advised Fashionable Healthcare what they discovered about scaling up capability and sustaining a profitable testing lab operation amid the pandemic.
1. Be versatile with lab protocols and employees
Firstly of the pandemic, many hospital labs have been compelled to develop their very own COVID-19 exams because the Facilities for Illness Management and Prevention confronted delays rolling out the primary accredited check.
Dr. Karen Kaul, chairwoman of the division of pathology and laboratory medication at NorthShore College HealthSystem in Evanston, Sick., stated quite a lot of the preliminary work was finished “on the fly” as they cross-trained lab personnel to help molecular lab employees as they scaled up capability.
Being nimble was key to creating the transition work, Kaul stated. Whereas molecular lab technicians did the tougher elements of creating the exams, different employees helped with pattern preparation and clerical duties.
“Redefining roles shortly made an infinite distinction in maintaining some individuals who have been being underutilized busy and likewise permitting our employees to get the work out,” she stated.
2. Diversify testing platforms to deal with provide chain challenges
Labs have seen shortages of testing supplies together with reagents, swabs, kits and chemical substances as COVID-19 testing fails to decelerate. Hospital labs usually search to make use of a single testing technique or platform to get a unified set of outcomes.
However that rigidity would power many hospital labs to close down if they cannot get the supplies they want. To handle potential shortages, some suppliers have been utilizing a number of totally different COVID-19 testing platforms and switching strategies after they run low on some supplies.
CommonSpirit Well being selected three totally different testing platforms from three totally different distributors to keep away from shortages or points if one system failed, in line with Karen Smith, vp of laboratory companies.
The well being system received its distributors to decide to offering sure volumes of exams in order that they couldcomplete10,000 exams per day, Smith stated.
“There are vendor limitations, and I did not need to put all my eggs in a single basket,” Smith stated.
three. Keep a fast check end result turnaround time
Materials shortages apart, hospitals and people have skilled delays in receiving check outcomes. Whereas turnaround instances began at three or 4 days, they’ve crept to every week or extra as labs had problem increasing shortly sufficient to fulfill demand.
The sluggish return rendered some coronavirus exams ineffective as diagnostic instruments, since some asymptomatic sufferers would depart isolation sooner than advisable and doubtlessly unfold the virus.
Against this, hospital labs have typically been capable of course of and get admitted sufferers their outcomes inside 24 hours.
NorthShore’s common turnaround has been a pair days even after they processed as much as 1,800 exams per day. Establishing a centralized testing system helped keep effectivity, in line with Kaul.
The well being system additionally developed smaller capability testing devices at every of its hospitals for conditions the place they want faster check outcomes, reminiscent of for psychiatric sufferers within the emergency division or for these being admitted for high-risk medical procedures.
“Having each the massive throughput testing and the small variety of exams that should be rotated in a short time is actually splendid,” Kaul stated.
four. Set up stronger collaborations between laboratory, scientific and administrative personnel
Six months of COVID-19 has reminded hospitals they want sturdy, in-house laboratory capability to keep up affected person care, Kaul stated. The labs present as much as 70% of the info in a affected person’s digital well being file.
“We’re so behind the scenes that we’re typically forgotten until there’s an issue,” she stated.
Since that begin of the pandemic, NorthShore has held frequent multidisciplinary workforce discussions on how you can deploy new exams.
The important thing to a profitable testing lab is offering ongoing, predictable testing that employees can depend on, in line with Dr. Dwayne Breining, government director for Northwell Well being Labs. In March, Northwell Well being was one of many first programs within the nation to start mass COVID-19 testing of its sufferers. It scaled up capability inside a month, from finishing 100 exams to greater than 1,000 a day.
Hospital labs ought to have clear, anticipated targets supported by management, in line with Smith. CommonSpirit just lately opened a brand new laboratory hub in Arizona that Smith stated will triple the well being system’s capability to course of COVID-19 exams. The brand new facility will finally concentrate on precision medication after the pandemic lapses.
“We made the choice that was a long-term technique for CommonSpirit Well being that simply received moved up by just a few years,” Smith stated.