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Inside the Lab COVID-19, Laboratory management, Profession

Is Your Laboratory Flexible Enough for a Pandemic?

Is your laboratory prepared to handle the COVID-19 pandemic? The vast majority of laboratories have been seriously thinking about and making plans for a “pandemic situation” for some time, after a surge of renewed interest during the recent Ebola outbreak. However, labs typically need space, staff, and funds to implement their plans – all of which are in short supply. There always seem to be more pressing demands on hospitals’ and health systems’ limited funding: patient rooms, operating rooms, imaging equipment, emergency department treatment bays, nurses, and more. Another barrier to laboratory expansion is that the equipment and analyzers specifically purchased to provide rapid response testing in a pandemic situation sit idle when they are not needed – and must therefore be revalidated and certified before they can be brought into service. Often, they require unique reagents whose limited shelf life means that they expire before they are needed and must then be restocked. 

The vast majority of hospital labs don’t have the infrastructure or trained staff required to self-develop new, non-FDA-approved molecular testing.

There has been a fair amount of criticism regarding the slow response of the laboratory community to the need for COVID-19 testing. It’s important to keep in mind that, for this (as with all new pathogens), there were no “off the shelf” tests available – and the vast majority of hospital labs don’t have the infrastructure or trained staff required to self-develop new, non-FDA-approved molecular testing. Not every lab has facilities for DNA and RNA extraction, “Master Mix” creation, or the development of other specialty reagents not used in routine clinical testing.

But that’s not to say that labs can’t optimize their available space. Open planning concepts – such as “floors-free” services (power, data, water, and gas from overhead) and end-user reconfigurable mobile benches and workstations – offer the ability to quickly reconfigure areas of the laboratory. The traditional fixed casework and “honeycomb” of rooms found in most laboratories, in contrast, are inherently inflexible and require time, funds, and construction to adapt.

Most clinical labs are adept at flexing their workflows – a daily occurrence in pretty much every hospital-based laboratory. Staffing levels expand and contract with every shift and with the seasons, as do testing volumes. But what happens when the resources run out? “Lean” supply chains and “just in time” delivery models save institutions money by reducing the capital tied up in inventory and can free up valuable laboratory space – but recent emphasis on these approaches has contributed to today’s chronic supply shortages. When supplies become scarce, these models tend to crack… or fail completely. If even one link in the supply chain is disrupted, labs can’t access the materials they need.

[Automation] only goes so far toward solving a problem that runs much deeper than individual laboratories.

Many labs have also been struggling for years with serious staff shortages. Some have resorted to hiring staff from overseas (at a fairly high cost) or opening their own training schools, but these initiatives require time and space. Investing in a higher degree of automation can compensate for a lack of staff, but only goes so far toward solving a problem that runs much deeper than individual laboratories.

It’s fortunate that laboratory staff are both dedicated and versatile – and, in today’s climate, equally good that they are knowledgeable about protecting themselves. Ultimately, however, what laboratories need – especially in times of crisis – is the same as what every other medical department needs: enough supplies, enough staff, and enough flexibility to cope with unprecedented demand.

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About the Author

Andrew Jaeger

Senior Medical Planner and Principal at HKS Architects, Detroit, Michigan, USA.

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