Lab Matters Fall 2023 | Page 95

APHL 2023 POSTER ABSTRACTS to ensure all pre-analytical processes were compliant with regulatory requirements .

Presenter : Scott Shone , scott . shone @ dhhs . nc . gov

Effective Solutions for Maintaining Specimen Integrity during the Pre-analytical Testing Phase

H . Cheung , J . Shaji , H . Schrader , T . Hudka , V . Apollon , S . Suah , A . Shah , S . Patel , J . Davis , A . Oyelade , M . Carpinona , A . Gross , R . Finney , R . Siderits , T . Kirn ; New Jersey Department of Health Public Health and Environmental Laboratories

Ensuring appropriate specimen storage conditions and timely delivery is essential for meeting the acceptance criteria during the pre-analytical phase of testing . The Public Health and Environmental Laboratories ( PHEL ) plays an important role in maintaining the integrity of specimens by identifying and resolving issues impacting specimen integrity during transportation . Last year , we observed an increased number of delivery delays , furthermore , there was no mechanism in place to track the specimen storage temperatures while in transit . To identify factors that were causing the delays and identify solutions for reducing delivery times , we conducted individual interviews and online surveys with our state-contracted courier and client facilities . The survey results indicated that finding parking spaces and long , complicated navigation through the hospitals were two important reasons for delays . Additionally , specimens were often not readily available for pickup at some facilities . Our courier and clients also had differing responses on pickup duration , which may be due to a lack of understanding of the logistical challenges faced by the courier during the pickup process . Following process changes , we observed that the solutions we implemented at the select facilities contributed to reducing pickup durations by up to 50 %. During this study , we also tracked specimen storage temperatures by using temperature data loggers . By using these devices , we standardized and improved procedures for transporting specimens to meet the acceptance criteria . In conclusion , strengthening partnerships with our courier and clients is vital for improving pre-analytical processes and the quality of testing . Therefore , it is important that we engage with them regularly and identify issues and collaboratively develop solutions . Best practices and lessons learned from this study be incorporated into our workflow to promote good specimen handling and transportation practices .

Presenter : Hanayo Cheung , hanayo . chueng @ doh . nj . gov

Improving Public Health Laboratory Testing Processes in Iowa

D . Shostrom , W . Aldous , M . Pentella , C . Cass ; State Hygienic Laboratory at the University of Iowa

The COVID-19 pandemic forced the State Hygienic Laboratory at the University of Iowa ( SHL ) to alter testing processes to meet the dramatically increasing test volume . Laboratory staff worked 20 / 7 for several months before reverting back to a single shift , 6-day work week . SHL hired additional staff to meet the data entry , verification , and accessioning and testing workload . Simultaneously , SHL instituted the Test Iowa program using a digital format on behalf of the Iowa Department of Public Health and the Iowa Governor ’ s Office to increase testing outreach statewide . To date , the two testing programs have reported over 1.6 million PCR results . SHL ’ s conventional testing required increased staffing for data entry and verification , accessioning and testing , which lead to long turnaround times ( TAT ). SHL made sequential improvements by implementing a COVID-19 electronic test request form , providing web portal access for expedited result retrieval , and modifications to the accessioning process to improve testing efficiency . Although these improvements contributed to decreasing laboratory TAT , Test Iowa ’ s program still proved to be more efficient than SHLs conventional testing . We hope to demonstrate the efficiency of using a digital format similar to that of the Test Iowa program to improve patient care and laboratory testing efficiency .

Presenter : Derrick Shostrom , derrick-shostrom @ uiowa . edu

LIS Automation of a Point of Care Field Deployable Laboratory

J . Ochal , S . Malaviya , D . Rivera , M . Rostash , S . Eldridge , L . Kimball , S . Delaney , S . Markos , L . Yeldell , R . Finney , S . Higgs , R . Siderits , T . Kirn , S . Parikh ; New Jersey Department of Health Public Health and Environmental Laboratories

During the pandemic , one of the greatest assets to limiting spread and notifying positive cases was the use of pop-up point of care ( POC ) testing events . These pop-up events were a great way to perform rapid BinaxNOW tests or other POC tests . A member of the public would register , take the test , and receive a result . At the end of the day , the entire days results would be delivered to the lab for resulting into the LIS- Orchard Point of Care . This entire process was manual and , in most cases , written on paper . There were many issues related to this process ; data integrity , result to patient on a small piece of carbon paper , and delay in reporting for possible outbreak situations to name a few . We took this problem and saw an opportunity to use technology to automate this entire process . The State of New Jersey was attending POC events with a Field Deployable Laboratory ( FDL ), where a Cepheid GeneXpert PCR instrument was installed . We outfitted the FDL with a dual band wireless router with dual sim cards with 5G network speeds . This allows the FDL to maintain internet connectivity wherever it would travel throughout the state and is the key to automating the POC process . With this network connectivity , we were able to create a mobile laboratory that has access to our cloud-based LIS . Network connectivity was only part of attaining the automation process desired . To accomplish full automation , we installed a small microcomputer in the van that acts as an inbound / outbound HL7 server that communicates with the instrument in the FDL to receive orders and send results back to the LIS . With this server in place , we fully automated the entire POC process within our LIS . At registration , a staff member will input the order into our ETOR system , while sample collection is occurring , this order is delivered from our LIS and received on the server in the FDL , and a label prints out . Simultaneously , the order is sent to the instrument to be run . Once the instruments run is completed , the result is automatically sent back up to our LIS to wait for approval . While other tests are being run , the scientist can approve the tests as they are sent back up to the LIS . At approval , the results are delivered electronically based on the Provider , HL7 messages are delivered accordingly , and finally an official lab report is printed inside the FDL to hand to the patient . At last , a manual process converted to an electronic one ; resolving data integrity issues with handwritten