5_Laboratory

5. Adapt to variations in laboratory capacity and turnaround time

Using multiple labs

Consideration

Many local and university-affiliated laboratories are beginning to test for COVID-19.

Different labs require difference specimen collection materials. Be adaptable.

Some local labs may have shorter turnaround times because their use of alternative and innovative reagents and materials are outside of the larger labs’ supply chain issues.

Voices from the Field

“We have leveraged a lot of local labs that have the lab infrastructure… we certainly have a lot of pop-up lab businesses here that have been pretty active including ones that are within our county borders”
“If a university already has a genomics lab, what it would take for them to build up its ability to perform COVID testing?”
“It was historically an animal testing [facility] and now has an entire testing lab … they have gone from doing about 1000 tests a week to 5000 tests a week.”
“There's all of this intellectual capability, research capability inside of these academic institutions. Can they be deployed to serve their counties in this way?”
“[The type of test we conduct] is based on what the big commercial labs are able to provide to us and the availability of supplies … our lab in our clinic right now is primarily nasopharyngeal because that is what the commercial lab partners have the most access to.“
“I had two labs on contingency …one helped us … our big sites and then the other lab was getting our mobile sites. The moment that lab started having issues …I could immediately hop over to my other lab and not even give it a second thought … have multiple contingencies.”
“The lab partner has… been looking to innovate…to keep a very high quality of test, while improving throughput and lowering costs …that lab partner has been able to bring new modalities to market.”
“They chose alternative reagent so as such they really are not experiencing the supply chain challenges that everyone else in the testing universe seems to be experiencing. They demonstrated early on that they were committed to a turnaround time of test results of 24 hours or less which no one could beat.”
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Individual laboratories may need to offer multiple tests

Consideration

Laboratories need to be able to adapt to supply chain limitations.

Voices from the Field

“Laboratories have to validate various types of instruments because they're not sure which ones they'll be able to get supplies for, and they need to be able to pivot in order to continue services. So, they have kind of a buffet of platforms that they work between.”

Innovative laboratory-OSCTC contractual relationships

Consideration

Contractual agreements may benefit both the laboratory and the OSCTC.

Voices from the Field

“We've embarked on a number of different lab partnerships where labs aren't investing in the supply because the demand has been fluctuating so much so our relationships in our contracts really outline us guaranteeing demand if lab can guarantee supply.”

Community laboratory partnerships

Consideration

Local laboratories may work together to provide overflow capability.

Voices from the Field

“We have four local labs and those lab directors meet multiple times a week. We had what could have been a pretty significant crisis with the reagent shortage that happened just a couple weeks ago when the federal government diverted reagents to the states instead of to the private companies and the private labs and our four local labs were able to work together … if one lab had too many tests for them to process they would divert it to another lab”.
“Early on we formed a …testing action collaborative was a group of laboratory industry touched stakeholders…we share information and we help to support them.”
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State or community oversight

Consideration

Centralized coordination and communication between OSCTCs and laboratories can help build efficiencies in laboratory selection and help laboratories plan for future testing needs.

Voices from the Field

“If I find out today that a laboratory is running out of something it's not very easy for me to pivot  that  laboratory’s supplies and requisition to another lab… if I had that to do again, I would probably plan for a more global sampling and requisitioning process so that we could have that flexibility.”
“We began working with them to help us determine their operational workflows and [understand our] strategic needs for us as a county.”
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Know each lab’s turnaround times

Consideration

Turnaround times vary and some labs offer priority turnaround times for certain samples.

Voices from the Field

“There is priority one and that is for symptomatic, with that one is about 48hrs. With priority 2, it’s 48-72 but it can go up to 5 days depending on if it’s over the weekend.”
“They want all FQHCs to put the priority tag into all of our testing bags so that we would be able to get the specimens back within a 5 day turn around.”
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Laboratory staffing

Consideration

Laboratories may be struggling with exhausted staff which may be contributing to longer turnaround times.

Voices from the Field

“A lot of these testing laboratories have had the same staff [from the start of the pandemic]… this type of work requires a good experience and skills and pipetting because just a tiny bit off can make a big difference in accuracy of the result, but these molecular biology staff are beginning to get worn out and they're beginning to see impact to their staffing”