By Scott Becker, Executive Director, APHL 

Every year APHL members and staff plan every detail of the annual meeting as if we were headed to space instead of the Space Needle. And then in a whirlwind, it’s over. How can four days go byso quickly?

This conference – our 60^th annual meeting – brought us the insights of leaders at CDC, EPA, FDA and the World Bank; exchange with our corporate partners at the Industry Workshops and exhibit hall; information on EMAC, CLIA, FERN, ERLN, LRN, WLA, KM, HIEs, SCID, LEI and LEAN — which I wouldn’t be if I lived here with all this fabulous food – and sessions that examined how laboratories fit within the One Health model, not to mention discussions of Washington state’s Pertussis outbreak. Speaking of Pertussis, it is my fervent hope that none of our attendees return home with any pathogenic souvenirs.

As you head to the airport or wherever your travels take you, I urge you to think forward. How do we want to shape the role of public health laboratories moving towards 2020? Where might we be in eight years? Will we have –

• Expanded our genetic testing capabilities to support programs to prevent chronic disorders and metabolic diseases?
• Replaced routine use of culture-based methods with new technologies and methods?
• Built capability to conduct advanced testing for surveillance programs to detect genetically engineered bio-threat agents?
• Assigned a greater role to bioinformatics in outbreak detection and investigations?
• Become more involved in assuring product safety and consumer protection?

I frankly don’t know. But what I do know is that, working together, we can craft solutions that advance APHL’s member labs, our governmental and corporate partners, and the public’s health.

Don’t forget to mark your calendar for the 2013 APHL Annual Meeting & Seventh Government Environmental Laboratory Conference, June 2-5, in Raleigh, NC. We also hope to see you at the other upcoming events listed below.

As for me, I think I’ll sleep well tonight.

Other Upcoming APHL Meetings:

• 16^th Annual PulseNet Update Meeting/8^th Annual OutbreakNet Conference, August 27-30, 2012, Atlanta, GA
• 2013 Joint Meeting of the Newborn Screening & Genetic Testing Symposium and the International Society for Neonatal Screening, May 5-10, 2013, Atlanta, GA
• 8^th National Conference on Laboratory Aspects of Tuberculosis, August 19-21, 2013, San Diego, CA

Meet Laurie Garrett

by Kim Ross, senior specialist of Communications, APHL

The threat of a major pandemic might scare the daylights out of most of us. But hats off to science writer Laurie Garrett who writes about it all the time—and enjoys it!

Laurie, a Pulitzer-prize winning journalist, studies global health and disease prevention and has penned several bestsellers about epidemics worldwide. The author of two major public health books, Betrayal of Trust and The Coming Plague, she tells the frightening stories of diseases like the avian flu, tuberculosis, malaria and SARS—and the world’s vulnerability to them.

A native of Los Angeles, Laurie graduated with honors in biology from the University of California and attended graduate school in the Department of Bacteriology and Immunology at UC Berkeley. But it was her job as a science reporter at a local radio station that sparked her interest in the global health crisis; in particular, the lack of attention and investment in public health.

Following a brief stint at the California Department of Food and Agriculture assessing the human health impacts of pesticide use, Laurie headed overseas to southern Europe and Sub-Saharan Africa reporting on everything from the AIDs epidemic in Africa to the “collapse of public health” in the former Soviet Union. She recalls watching a baby die in her arms of measles in Zambia, and the mother—whose older child died of the disease minutes before—fall into a near catatonic state of grief. “Africa taught me both how deep the chasm of health between rich and poor countries was, and the complexity of solutions,” she said in an interview with Lab Matters magazine. “That pushed me to study why public health had failed with HIV and seemed unable to deal with epidemics.”

She later became a science correspondent at National Public Radio before joining the science-writing staff of Newsday in the late 80s, and continued chasing outbreaks globally in the 90s.

Today, Laurie is the Senior Fellow for Global Health at the Council on Foreign Relations, where she recently traced the history of US pandemics like the Spanish flu outbreak of 1918 that killed more than half-million Americans. Check out her insights online at lauriegarrett.com. Laurie’s stories—written in her signature, blunt style—present a sobering wake-up call for the public and policymakers alike.

Quotes in this article were published in “15 Minutes with Laurie Garrett,” Lab Matters Magazine, Spring 2012, pg. 28, Association of Public Health Laboratories, http://www.labmatters-digital.com/aphl

Top Tweets

@go_vikes Large # of internationally acquired cases of disease reported in King County (WA) attributed to foodborne bugs! #APHL

@scottjbecker CDC’s MicrobeNet is a hit at the #APHL member experience! Labs value this excellent resource. pic.twitter.com/Mos9dtlR

@meganlatshaw Who said feds don’t cooperate? Emergency preparedness & response exercise coordinated by EPA included state labs CDC, FDA, USDA & FBI #aphl

@chrisnmangal Garrett: More than 400,000 false tips after anthrax. Millions of dollars spent responding although threats were not credible. #aphl

@sharishea23 The foods we consume today are not the same as the foods eaten 50 years ago. The food safety system needs to adjust to changing needs #aphl

See more top tweets from the day here!

One World – One Health: Labs Protecting the World’s Health

Are you ready to participate in a “One Health Collaboratory?”

At the opening session of the 2012 APHL Annual Meeting, James Hughes, MD, Emory University; Lisa Conti, DVM, MPH, One Health Solutions; and Terry F. McElwain, DVM, PhD, Washington State University, examined the implications of the One Health concept for governmental health laboratories.  One Health posits that growing connections between humans, animals and ecosystems require integration across national borders, academic disciplines and health systems. Though One Health is not a new concept — Hippocrates introduced the idea that public health depends on a clean environment — it is a relatively new as an initiative.

Below are key points from the session. Visit our website to view the speakers’ PowerPoint presentations.

• Laboratories are at the hub of human, animal and environmental health because of their role as data providers. They can – if they choose – play a pivotal role in building trans-disciplinary partnerships to protect global health. The biggest challenges will be cultural, not technical. We must reach across disciplines to build partnerships.
• One Health offers a systems approach that can reinforce existing efforts to link laboratories. For example, the FERN and LRN networks both include animal labs.
• Disease in animals can serve as a sentinel for human disease. Animals are more than vectors of disease; they share our susceptibility to specific diseases and environmental hazards.
• “Smart surveillance,” using data from all available sources both governmental and commercial, can lead to improved health outcomes. Pork producers, for example, maintain detailed records of potential value in disease surveillance.
• Building laboratory capability/capacity in under-resourced countries is integral to strengthening health security in the US. Microbes know no borders; no part of the world is immune from emerging and reemerging diseases.
• 2.7 billion people on the planet live on less than $2 per day. For them, livestock are the primary source of labor, fertilizer, food and income. Public health practitioners must weigh the economic impact of animal diseases in shaping health interventions.

“Efficiency” – The New Buzz Word

The discussion on the Laboratory Efficiencies Initiative (LEI) drew a standing-room-only crowd of lab leaders eager to hear more about this hot topic. Co-sponsored by CDC and APHL, the LEI is a significant effort to help lab directors deal with intense budget pressures and other change factors. The main goal of the partnership is to ensure labs achieve long-term sustainability through higher operating efficiencies.

One potential practice for laboratory efficiency is consolidation and shared testing services. Three lab leaders, joined by a representative from CDC, described their approaches to these innovative practices. One speaker, Christine Bean, PhD, MBA, MT (ASCP), of the New Hampshire Public Health Laboratory, talked about their lab’s consolidation with the state’s environmental lab, in an effort to reduce the state’s budget by 2.6 million. Before the merger could happen, PHL leadership assessed duplication of services and testing, as well as potential gaps, as part of their efficiency objectives. While they continue to address culture differences between the agencies and some employees are resistant to change, the merger has been positive. The newly consolidated lab has seen enhanced opportunities for federal funding and are planning to take on new test methods, like molecular water testing.

Top Tweets

@chrisnmangal ”Vision means applying care and concern we give to jobs on a daily basis with eye to the future.” Executive Director, Scott Becker #APHL

@scottjbecker Dr Victor Waddell of @AZDHS gives his address to #APHL, he’s been a great leader for us at a critical time in the US. http://pic.twitter.com/GVy6jpzH

@go_vikes We need to shift our view of the more classic “public health” lab to encompass forensic, vet and other types of laboratories. #APHL

@sharishea23 FERN initiated a response to 2011 radiation release in Japan. Calming public fears and providing credible website were first prioities #aphl

@meganlatshaw Studies show that you can distinguish kids who are treated kindly vs those abused by looking at epigentic markers – Ken Olden at #APHL

See more top tweets here!

Other Annual Meeting blog posts:

• APHL Annual Meeting Day 1
• Welcome to Washyourhandsington!
• One World. One Health… and the Vector at Our Back Door

Climate Change & Public Health: So Much More than Drowning Polar Bears

Howard Frumkin, MD, DrPH, and Jonathan Patz, MD, MPH, of the two UWs (respectively University of Washington and University of Wisconsin), instructed, charmed and inspired a standing-room-only crowd at this session. Here are a few random takeaways:

- The dynamics of climate change are anything but simple. Climate change arises from complex, reinforcing feedback loops, and the pace of change is rapidly accelerating.

- Climate change is very regional in how it plays out even though it is a global phenomenon. Yes, sea levels will rise (Please note, those of you who live in lower Manhattan or Brooklyn!) but arid regions such as the US Southwest will become dryer, potentially leading to wild fires and a reduction in arable land.

- Public health practitioners, environmental scientists and climatologists must integrate their data to respond effectively to the effects of climate change. [Could public health laboratories, with their experience in developing laboratory informatics standards and systems be conveners in launching a multidisciplinary approach to data collection?]

- Urban design is public health policy. It’s difficult to exercise in your neighborhood if there are no sidewalks.

- Public health laboratories can mitigate the effects of global warming by greening their facilities. Individually and collectively, such changes do have an impact.

- We must rethink how we communicate with public audiences about the health impacts of climate change. Research demonstrates that, although the public trusts scientists as spokespeople, it is not persuaded by scientific data. What works?  Messages from celebrities and discussion of pocket book issues. I know, it’s frustrating. And we can’t use a single set of messages because popular opinion diverges widely on the issue of climate change.  We need messages for each audience.

- Climate change could be the greatest public health opportunity we’ve had in over a century. If we respond by eating less, exercising more, changing how we design our cities and reducing carbon emissions – among other interventions – we could create a healthier world.

Newborn Screening: Adding New Tests

Newborn screening (NBS) experts from Wisconsin, New York and the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children (SACHDNC) gave a thorough rundown of the newborn screening process and how new conditions are added. Alex Kemper, MD, MPH, MS gave an overview of the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children; Dr. Chuck Brokoff, DrPH, director of the Wisconsin State Laboratory of Hygiene, shared their experience expanding newborn screening testing in Wisconsin and beyond; and Dr. Michele Caggana, Sc.D., FACM discussed the Implementation of NBSG tests in New York. From ethical considerations to regulatory hoops, there’s lots to consider when expanding an NBS program. Check out the highlights:

-States choose what to screen for, but it’s informed by the committee’s evidence-based recommendations.

-Anyone can nominate a condition to be evaluated by the committee. Key criteria considered: It should be a well-defined condition, a good screening test must be available, and treatment should lead to better outcomes.

-The committee’s recently recommended conditions, like Severe Combined Immunodeficiency (SCID) and CCHD, all have similar characteristics: well-characterized condition, early intervention leads to benefit, accurate and feasible screening test, diagnosis and treatment is available. (Characteristics of conditions not recommended for addition include: uncertain benefit of early detection, challenges establishing diagnosis, and lack of diagnostic and treatment services.

-Traditional Screening Criteria: Screen for conditions that are an important health problem, the natural history should be understood, detectable at an early stage, a suitable test is available, and risks should be less than benefits.-Wisconsin conducts newborn screening for approximately 68,000 newborns a year in Wisconsin and 15,000 non-Wisconsin newborns.

-Educating parents and health care providers about the NBS process and significance of screening is key to any NBS program.

-Elements of a genetic screening program: Availability to all babies, education of parents, timely follow-up on positive results, appropriate diagnostic workup and treatment, cost-effective assessments, continuous monitoring of program.

-Lab characteristics of a good screening test: Simple, rapid, safe, reliable/precise, accurate

-Ethical Considerations: Should genetic screening be conducted? Should NBS be mandatory? Can screening specimens or DNA be saved for later use?

-Screening for SCID has a high potential for successful treatment. Early intervention leads to better outcomes, more than 97% survival.

-Key considerations when adding a new condition to an NBS panel: input from experts and constituents, consider conducting a pilot study, public and professional education for the public, validation of screening method.

-Wisconsin implemented routine screening of SCID in January 2008 – and later, the Secretary’s committee added it to the core screening panel for all states, Jan 2010.

-How are new tests added? By legislation or commissioner’s signature. The lab’s NBS program puts together a package (the condition, outcomes, cost data, etc), sends to regulatory affairs at the dept of health, and the executive secretary and governor’s office signs off.

- In new York state, on average 1,000 babies born a day.

-New York added Krabbe Disease to their panel: substantial preparation, put together regulatory impact statement/package, conducted feasibility and pilot studies, ensured supplies of reagents for daily testing, and ensured follow-up procedures were in place. They commenced testing in 2006.

-When adding a new condition to a panel, clinical community buy-in early on is key, and they must remain engaged.

Top 5 Tweets

@APHLnews Mary Selecky is singing to us about Washyourhandsington– I’m not even kidding. What a cool Secretary of Health! @wa_deptofhealth #APHL

@MHeintzAPHL Dr. Conti: “everything we do is environmental health.” #APHL

@meganlatshaw For every 1°C increase in temperature, saw 7% increase in diarhheal disease in Peuvian hospital. – Jonathan Patz #APHL

@Go_Vikes PulseNet helped detect at least 8 of 10 of the past decade’s largest national foodborne outbreaks! #APHL

@ShariShea23 Metrics! Metrics! Metrics! They are becoming increasingly important to demonstrating the value of foodborne illness programs. #APHL

See more of the top tweets here!

Other Annual Meeting Blog Posts:

• Welcome to Washyourhandsington!
• One World. One Health… and the Vector at Our Back Door

You don’t have to explain to public health laboratorians that the health of humans, animals and the environment are inextricably linked. HIV/AIDS, SARS, 2009 H1N1, West Nile Virus: laboratorians know the inner workings of these enterprising pathogens that travel (from jungle, field or suburban neighborhood, etc.) to animal hosts (chimpanzees, bats, birds, field mice, etc.) and on to us.

And they know that more of these smart bugs are coming our way. Population growth, climate change, deforestation, diminishing species diversity and changes in land use are all interfering with established patterns of interaction among people, animals and the environment. Vectors that were once in a distant forest are now at our back door. Already the majority of emerging infectious diseases affecting humans (approximately 75%) are of animal origin.

This dynamic has broad implications for public health as well as human medicine, veterinary medicine and environmental science. In a world where the interface between animals, humans and the environmental is in flux, it’s perilous for health and science professionals of any stripe to operate in professional silos. To protect the health of all species, those of us in public health must join with our colleagues in veterinary science, human medicine and environmental science to adopt a holistic approach to disease surveillance, detection and control. To put it simply, we must be about one health, not several.

At the 2012 APHL Annual Meeting, “one health” will be center stage. Participants will have the opportunity to meet leaders in the One Health movement – including James Hughes, MD; Lisa Conti, DVM, MPH; and Terry McElwain, DVM, PhD – and discuss actions required to operationalize One Health objectives. Here are a few questions to get you started with these discussions. How can we:

• Expand and improve national and global surveillance networks, particularly those that capture the animal-human interface?
• Enhance sentinel event coordination to detect and reduce environmental health threats?
• Build efficient global reporting and sample submission systems to support surveillance systems?
• Communicate the benefits of investment in surveillance? (Too often disease surveillance is viewed as an old-school public health function, one that’s not sexy enough to warrant sustained investment.)
• More effectively employ animals as sentinels for human health—and humans as sentinels for animal disease risk?

For an introduction to the “one health” concept, see the websites of the One Health Initiative and CDC’s One Health Office.

And a parting thought: When was the last time you took your state veterinarian or your colleague in environmental science to lunch? It’s a small step, but remember: One Health is collaborative; you can split the check.

By Dr. Romesh Gautom, Director of the Washington State Public Health Laboratories

Welcome to the 2012 APHL Annual Meeting and 6^th Environmental Laboratory Conference in what we now call WashYourHandsingTon!  Just to make our laboratorian colleagues feel at home, we’re experiencing Washington’s worst outbreak of Bordetella Pertussis in decades at this time. So, anyone with free time after sessions is expected down at the state lab to assist with accessioning of specimens.  We’ll bus you over.

And take the hint — wash your hands frequently and cover your cough — and enjoy Seattle. If you haven’t been here before, I think you’ll find it to be a friendly, highly walkable city where there is no shortage of good restaurants, interesting attractions and, of course, great coffee. Seattle also offers a fine public transportation system.

The Westin Hotel is located in the center of downtown close to Pike Place Market, the waterfront and ferry terminal, and the Olympic Sculpture Park.  The Space Needle and the EMP Museum (Rock on, Jimi!) are minutes away on the monorail. If you are staying in the city after the conference, I highly recommend a trip to Deception Pass, a large state park where the saltwater flows like a river and the views of Puget Sound are stunning. To get there, you can rent a car or join a bus tour. No, we will not divert the bus to the lab, despite the pertussis outbreak. I’m available to provide additional recommendations of local sites should you want them.

I look forward to talking with my long-time colleagues and meeting attendees who are here at the APHL Annual Meeting for the first time. Speaking of which, give a special welcome to the delegates attending from Japan and the US Associated Pacific Islands.

By Linette Granen, APHL Director, Membership & Marketing

While at the APHL Annual Meeting in Seattle, you may be wondering how to learn more about technology that is on the cutting edge, is easily implemented in your laboratory and is a new way of thinking about analysis in general.  The answer is by attending the Industry Workshops!  These workshops will be held after the sessions on Monday, May 21 from 5:30-8 pm.  The first four will run concurrently from 5:30-6:30 pm.  Do not fear, there will be refreshments between sessions from 6:30-7pm.  At 7:00, the next three workshops will take place.  All are on the 2^nd and 3^rd floors of the Seattle Westin.  Check out page 15 of your program for more information!

Leading off the pack at 5:30 pm will be Abbott, QIAGEN (Cellestis)), Life Technologies, and PerkinElmer.

• Abbott: Their workshop will focus on their PLEX ID, and the speakers will be our own members, Robyn Atkinson (UT), Dee Pettit (VA) and Billie Ann Juni (MN).  The presentations will highlight how the PLEX ID can be a tool for broad detection and surveillance.
• QIAGEN (Cellestis): Although not generally known, Cellestis is now a QIAGEN company. Their workshop will about the implementation of Quantiferon testing for TB in public health laboratories.  The two speakers will be Jim Beebe (San Luis Obispo PHL) and Scott Lindquist (WA State TB Consultant).
• Life Technologies: If you haven’t heard of low cost, rapid sequencing, you should attend the Life Technologies presentation on their Ion Torrent with a myriad of uses in influenza typing, bacterial identification and newborn screening.  Brian Kelly from the company will be presenting.
• PerkinElmer: A hot topic in newborn screening, the screening for lysosomal storage disorders, will be presented by Alex Cherkasskly of PerkinElmer.  An informative, interesting workshop should be on tap there.

After you’ve attended one of the preceding workshops, migrate to the foyer of the second floor where libations and light cuisine awaits for your drinking and eating pleasure.  At 7 pm the second round of workshops will begin.

• Roche’s Carol Hausrath will discuss the newly FDA approved Roche cobas® CT/NG Test.
• Luminex will offer information on improving efficiency in newborn screening, enhancing RVP surveillance and GI pathogen screening utilizing the company’s newest multiplex analyses.  The speakers will be Susan Neill and Charudutt Shah from Luminex, and Sanjib Bhattacharyya (Milwaukee).
• ThermoFisher will be offering a presentation on sensitive determination of hexavalent chromium in drinking water, with Brian Luckenbill from Thermo as the speaker, for all of the environmental laboratory folks who are interested.

I am confident that the companies have some surprises for all of us during the presentations, so I cannot wait to attend!  Also, be sure to visit these companies and all of the rest of the exhibitors in the exhibit hall beginning on Sunday afternoon.  As always, there will be a raffle and you must complete your entry card before 3:30 pm on Monday to enter the prize drawing for a whole host of exciting prizes.

APHL would like to thank the companies presenting these workshops for their on-going support through their membership and partnership, and we extend that appreciation to all of APHL’s sustaining members!

During the APHL Annual Meeting, May 20-23, our blog will be your center for session recaps, commentary, attendee profiles, photos, video and a daily Twitter summary. Whether you are on-site in Seattle or back at your office or laboratory in Boston, Tampa or Santa Fe, you can join us at the annual meeting.

Look for regular postings on our Twitter, Facebook, Pinterest and Vimeo sites. Please feel free to leave comments or questions on any of those sites!

If you will be at the annual meeting and if social media is not your forte, APHL is here to help. APHL Communications staff will provide pointers on using social media at the APHL booth (located adjacent to the APHL registration desk) from 12:30 – 4:30 pm on Monday, May 21. We look forward to chatting with you there.

Those of you who aren’t packing your bags for Seattle can follow the meeting in real time on Twitter even if you don’t have a Twitter account. Simply search on Twitter for the annual meeting hashtag, #APHL.

Below is an actual letter sent by parents of a baby boy born with a genetic disorder that was caught by a routine newborn screening test.  It was published here with permission from the family and the State Hygienic Laboratory at the University of Iowa.  We love a happy ending.  

____________________________

Iowa Newborn Screening Program
Pediatrics/Medical Genetics
University of Iowa Children’s Hospital
200 Hawkins Drive
Iowa City, IA 52242

Dear Doctor,

We were overjoyed at the birth of our first child, Brody, on October 12, 2011.  As a school psychologist who works with children with educational challenges on a daily basis, I did everything possible to give my child a healthy start.   With a full-term pregnancy and a successful natural delivery, we took our newborn home from the hospital believing he was completely normal.  However, we were shocked when Brody was diagnosed with profound Biotinidase Deficiency at one week of age.

If it had not been for Iowa’s newborn screening test, we would have been completely unaware of Brody’s genetic deficiency.  Never did we imagine as healthy adults, we were both carriers of this recessive gene. The gene has been unknowingly passed down for generations on both sides, as Brody is the first child in both of our families to have the genetic deficiency.

Because Biotinidase Deficiency is 100% treatable with early detection and continuous treatment, we expect Brody to live a completely normal and healthy life. Without the newborn screening which was performed within his first few days of life, Brody would have likely began exhibiting serious symptoms including developmental delays, loss of hearing, loss of vision, coma, and even possibly death. We are humbled and grateful to live in the state of Iowa which offers newborn screening which saved Brody from experiencing significant delays and problems.  He now has a chance to live a quality life full of joy, health, and opportunity. Without Iowa’s newborn screening, Brody’s future would be in jeopardy and our family could be in crisis.

Thank you so much for believing in the importance of providing this screening to Brody and all newborns of Iowa.  Families, like ours, are testimonies of how this screening has positively affected our lives.  We are thankful and most appreciative of Iowa’s newborn screening program.

With sincere gratitude,

Nicholas and Kelsey, parents of Brody

This week is National Medical Laboratory Professionals Week and National Environmental Laboratory Professionals Week.  APHL is honoring the many individuals working public health and environmental laboratories around the world.  Stay tuned for blog posts this week featuring the work of many of those unsung heroes working to protect the public’s health.

_____________________________

By Sadira Daher, Senior Specialist, Quality Systems, APHL

State Public Health Laboratories have been facing serious financial cutbacks. Many laboratories have had to reduce staff by nearly 25%, affecting testing services. Lab directors are concerned about having difficulty maintaining services, which could potentially hinder the state’s outbreak investigation, emergency response, surveillance and public health prevention programs.

In response to these hardships, APHL and CDC developed the Laboratory Efficiencies Initiative (LEI). The goal of LEI is to help labs maintain their public health testing services despite decreased funding in an effort to build a sustainable public health laboratory system in the United States.

Through LEI, representatives from public health labs, APHL and CDC have met to begin implementing a framework for an efficient data gathering and reporting process; to identify models to improve purchasing of laboratory equipment and supplies; and to provide input on ideas on methods of improving the delivery of public health laboratory services.

Many laboratories already have processes in place to improve efficiencies. Some examples include participation in Lean activities and the creation of a group of laboratories as a consortium with neighboring states. The laboratories within the consortium stay in touch through scheduled periodic conference calls where they can exchange ideas and discuss processes and practices that have been working well.

The consortium has also been useful for education and training. The labs have set up training workshops together and have shared their programs with other states through a variety of modalities. They are keeping track of what is going on in their region through this increased communication.

The strengthening relationships between the labs have made it easier for them to share services as necessary. For example, when a lab had unexpected problems with some of its equipment, it could easily send specimens for testing to a neighboring state.

Another laboratory used Lean to identify inefficiencies in its receiving process for newborn screening specimens. The laboratory addressed the problems and was able to decrease turn-around time. On the first day of implementing the new process, a newborn screening sample arrived after what had previously been the cut-off time for processing, but because the new more efficient system was in place, it was processed.  The test returned an abnormal result which was able to be reported to the baby’s pediatrician a day earlier than if they had used their previous process.

An important part of the LEI is the sharing of experiences and lessons-learned with other public health laboratories.

Other Lab Week blog posts:

• Public Health Laboratories: A Critical Component of the Public Health Puzzle
• Hydraulic Fracturing and Laboratories: What Does it Mean for You?
• Using Technology to Combat HIV/AIDS in Swaziland
• Five Reasons You Should Hug a Laboratorian
• Flu Vaccine: How it finds its way into the needle
• All in a Day’s Work