Lab Matters Fall 2024 | Page 123

APHL 2024 POSTER ABSTRACTS

LRN-C Moving Forward : A Comprehensive Approach to Laboratory Testing Capacity

J . Okoye , R . Favors , A . Watson Hardnett , Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention ’ s ( CDC ) Laboratory Response Network for Chemical Threats ( LRN-C ) aims to advance the national capacity and capability for large-scale chemical emergencies and other unknown chemical threats . To this end , CDC ’ s Division of Laboratory Sciences provides numerous support services to LRN-C laboratories such as quality control materials , proficiency testing , lab referral capabilities , secured data messaging , response , readiness drills , hands-on chemical threat methods training and laboratory technical assistance . LRN-C ’ s national preparedness infrastructure for chemical threats has been leveraged broadly by local and state jurisdictions to address numerous public health concerns .

In the last two years alone , LRN-C laboratories provided high quality sample analysis in 39 chemical emergencies related to unintentional poisonings , food and water contamination , drug overdoses and e-cigarettes , demonstrating their crucial role in public health emergency response nationwide . The LRN-C also supported investigations of ongoing harmful chemical exposures by analyzing over 56,000 samples for non-emergency chemical exposures including testing of blood lead , drugs of abuse , per- and polyfluoroalkyl substances ( PFAS ) and other metals . For example , the LRN-C laboratory located in Albany , NY tested blood and urine samples submitted by a Long Island occupational health clinic and found high levels of mercury in five patients . The successes of the LRN-C in implementing and applying comprehensive testing for chemical threats help public health officials rapidly assess health risks , ensure effective patient care and prevent additional exposure . The LRN-C infrastructure may also be leveraged by state and local partners to achieve future successes in opioid biosurveillance and wastewater surveillance . Moving forward , the LRN-C will continue to serve at the frontline of public health preparedness and response by working with CDC , local health officials , hospitals and poison control centers to maintain and expand critical infrastructure for measuring and responding to acute and ongoing chemical threats .

Presenter : Jordan Okoye , sfa0 @ cdc . gov

Modernization of Public Health Lab : Implementing the Inaugural LIS and Building It Into the Quality Management System of Dallas County

V . Amadi 1 , D . Silva 1 , C . Aroh 2 , C . Graggs 1 , M . Shabazz 1 , S . Berno 1 , J . Stringer 1 , L . Short 1 , Dallas County Health and Human Services 1 , South Carolina Dept . of Health & Environmental Control 2

Introduction : The Dallas County Health and Human Services Public Health Laboratory ( DCHHS-PHL ) supports a population of over 2.5 million citizens , surpassing the population of 16 US states . Historically , the DCHHS-PHL has processed an impressive 200,000 tests annually , remarkably managing 99 % of its workload without a laboratory information system ( LIS ) and an average staff size of 30 members . As a site for numerous and unique epidemics , like the first US Ebola cases , the absence of automation previously hindered the lab ’ s crisis response efficacy . Recognizing the imperative of supporting modernization efforts , laboratory management successfully lobbied for the financial and organizational support to acquire its first LIS . The DCHHS-PHL Informatics program targeted key objectives : enhancing efficiency and automation , ensure data accuracy and integrity of test results and supporting initiatives in regulatory compliance . We present here the strategy and methods the DCHHS-PHL employed to meet those objectives in both routine operation and in outbreak / emergency response .

Methods : The DCHHS-PHL utilized the APHL LIS implementation guidebook and CLSI AUTO08-A Managing and Validating LIS guidelines to provide guidance for implementation , project management and to formulate an administrative strategic plan for continuous LIS management .

Results : The DCHHS-PHL initiated the implementation process for the inaugural LIS in March 2020 and completed the onboarding of all test menus across various lab units into the LIS in July 2023 . Over 100 test codes , covering reflex tests , were involved in the validation and onboarding . Currently , the lab utilizes the LIS to send required test reports to the Texas Department of State Health Services ( DSHS ) and the CDC via HL7 ® messages in compliance with federal regulations . An internal audit of CLIA standards was conducted on the LIS . Audit findings include the discovery that approximately 30 final reports for the Syphilis , Trichomoniasis , HIV and TB tests did not generate properly . Among the implemented corrective actions were a review and reconfiguration of impacted test reports on the LIS , as needed , along with enhanced auditing tools and processes to capture these system errors more promptly .

Conclusions : This is the first report on the process of implementing the inaugural LIS and building it into the quality management system in DCHHS-PHL . Overall , the successful implementation of the LIS revealed the importance of strategic planning , compliance with guidelines and continual quality assurance efforts within the field of public health laboratories .

Presenter : Victor Amadi , victor . amadi @ dallascounty . org

New North Dakota State Lab - A Critical Piece of Public Health Infrastructure

N . Roisen 1 , C . Massen 2 , BWBR 1 , State of North Dakota - Department of Health and Human Services 2

The state of North Dakota has started construction on a new state lab facility to replace a deficient existing building . During early conceptual phases , the state set ambitious goals that treated the project as an opportunity to elevate the experience of working in , partnering with and visiting the facility . Some examples include :

1 . The project will be located on North Dakota ’ s state capitol grounds adjacent to the State Museum , giving it a publicfacing profile and highlighting the state ’ s investment in this key public health infrastructure .

2 . The project includes laboratory functions for both the Department of Health and Human Services and the Department of Environmental Quality . These separate departments are able to take advantage of shared resources in a number of locations in the facility , maximizing each department ’ s utilization of the facility .

3 . A “ citizen experience ” zone of the facility allows members of the public to participate in guided tours of a number of lab spaces , without needing to enter labs or interrupt testing functions . These spaces are a key part of a strategy