Lab Matters Fall 2024 | Page 119

APHL 2024 POSTER ABSTRACTS a sample . However , it could not be used to evaluate risks beyond routine procedural considerations , such as decommissioning of equipment used in biologic settings . The existing RA form could only be used to document potential hazards and lacked a mechanism for users to calculate risk level . In contrast , the new Excel ® -based RA tool streamlines risk evaluation with a user-friendly digital format and easily navigable tabs ( instructions , tool definitions and RA ), facilitating collaborative editing and sharing . The instructions tab guides data entry . The tool definitions tab provides guidelines for assessing risk effects and likelihood and instructions on assigning each score from 1 to 5 . The RA tab enables users to calculate overall risk score by multiplying effects and likelihood scores and space to document comments , concerns and mitigating strategies .

Conclusion : DCLS responded to an independent evaluation of RA processes and developed a systematic , user-friendly RA tool . The tool enhances the RA program depth and quality by calculating a comprehensive risk level for any process , improving assessment capabilities to evaluate nonprocedural based activities and ensuring standardized risk determinations . It addresses the lack of standardized instructions and guidance in the original form , minimizing bias and inconsistent interpretation of risk levels . The transition from the paper-based RA form to the Excel ® -based tool rectifies identified limitations and features digital formatting , customizable tabs , clear instructions and precise definitions .

Presenter : Courtnee ’ Bell , tqa7 @ cdc . gov

Examining the Impact of Outbreaks on Public Health Infrastructure : A Comparative Analysis

I . Eaves , S . Ahmadi , Association of Public Health Laboratories

Public health infrastructure provides the foundation for all public health services , including developing vaccines , treating chronic illnesses and responding to public health emergencies . Post-COVID , the importance of ensuring a strong public health infrastructure is ever more apparent . When we examine the past 25 years , outbreaks ( such as the swine flu pandemic , the cholera outbreak in Haiti , COVID-19 and others ) have plagued the global community , including a new generation entering the public health workforce . This study examines , through a comparative analysis , how the strain of past public health emergencies and the threat of future outbreaks impact public health infrastructure .

Presenter : Isaac Eaves , isaac . eaves @ aphl . com

Improving Laboratory Testing Accuracy Through In-house Calibration and Accreditation to ISO 15189 : The Impact of Operationalizing Calibration Centers in Zambia .

M . Hamomba 1 , C . Phiri 1 , D . Nsama 2 , P . Kafweta 2 , T . Machawi 2 , P . Choonga 3 , Association of Public Health Laboratories 1 , Ministry of Health – Zambia 2 , Centers for Infectious Disease Research in

Zambia 3

Background : Zambia ’ s Ministry of Health ( MOH ), in partnership with the US Centers for Disease Control and Prevention ( CDC ), the Association of Public Health Laboratories ( APHL ) and the Centers for Infectious Disease Research in Zambia ( CIDRZ ), identified medical equipment calibration as a bottleneck for timely accreditation of public health and medical laboratories ( PHML ) to ISO 15189 in 2017 . Central to this accreditation is laboratory testing accuracy .

Establishing calibration centers was crucial in decentralizing calibration activities . Therefore , the initiative aimed to facilitate efficient medical equipment calibration and expedite accreditation .

Methods : We conducted operational research to develop strategies for improving the operationalization and quality management system ( QMS ) implementation in three calibration centers : University Teaching Hospital ( UTH ), Ndola Teaching Hospital ( NTH ) and Mansa General Hospital ( MGH ). The study focused on adopting in-house calibration to meet metrological traceability . APHL trained MOH personnel ( UTH = 6 , NTH = 5 and MGH = 4 ) in speed , time , uncertainty of measurements ( UOM ), ISO / IEC17025 training and QMS document development . The National Medical Equipment Calibration Framework ( NMECF ) was developed to guide policy and implementation . Reference equipment was recalibrated for traceability and APHL hired a consultant to lead the calibration efforts . Data were analyzed using descriptive statistics .

Results : UTH , NTH and MGH calibration centers are operational with a competent team of 15 MOH personnel . In April 2023 , local staff conducted the first round of in-house calibrations . Turn-around time ( TAT ) was reduced from two months to 14 days , compared to when calibration services were outsourced from different countries . The cost of outsourcing calibrations was reduced to below $ 9,000 per cycle from around $ 25,000 . ISO / IEC 17025 QMS documents ( quality manual , quality policy and standard operating procedures ( SOPs ) were developed . Reference calibration equipment was recalibrated . 42.9 % ( 6 / 14 ) of certification sites were promoted to the accreditation program . 100 % ( 14 / 14 ) sites accredited to ISO15189 maintained accreditation post calibration center establishment . In Zambia , it took 6-7 years for PHML to get accredited to ISO15189 . The introduction of MOH calibration centers and continued support from CDC and stakeholders shortened the accreditation process to 2-3 years on average .

Conclusion : ISO / IEC 17025 QMS implementation and local calibrations reduced outsourcing costs and PHML accreditation time to ISO 15189 . Funding will expand calibration measurement parameters from two ( speed , time ) to five with the addition of temperature , volume and mass and ensure quality laboratory results for clinical decisions .

Presenter : Matthew McCarroll , matthew . mccarroll @ aphl . org

Introducing an Excel ® -based Laboratory Cost Accounting Tool and Training for Public Health Laboratories

B . Adhikari , K . Kines , L . Fischer , J . Seonghye , G . Rainish , B . Greening , L . Bull-Otterson , Centers for Disease Control and Prevention

Background : The rising incidence of infectious diseases poses substantial burdens to public health laboratories that process large volumes of specimens . Estimating the costs and throughput of sample processing can be helpful for resource allocation . To address this gap , the Centers for Disease Control and Prevention ( CDC ) developed an Excel ® -based laboratory cost accounting tool . This tool enables the compilation and analysis of costs linked to specimen / sample processing , allowing public health professionals to gain a comprehensive understanding of laboratory expenses and throughput . The tool facilitates informed funding decisions , resource allocation and overall enhancement of laboratory efficiency . Through a poster presentation , we aim to illustrate the tool ’ s functionality using figures and charts that highlight key cost categories .