Becker's Hospital Review

26 Executive Briefing Sponsored by: E mployee burnout rates in the healthcare sector were exceptionally high even before COVID-19. Burnout has a significant adverse influence on clinicians' overall well-being, as well as their sense of job fulfillment, which results in higher employee turnover rates, lower- quality patient care and decreased patient satisfaction. The surge in COVID-19 testing has shined a spotlight on the importance of hospital microbiology labs and the critical role they play in infectious disease management. However, microbiology labs are facing a growing list of challenges. As laboratories have undergone consolidation, specimen volumes have increased significantly. At the same time, microbiology labs are seeing greater demand for rapid test results so clinicians can manage their patients effectively. There has also been a tremendous shift in the types of diagnostics that labs are performing, including increased demand for molecular and point-of-care testing. In addition to these pressures, many microbiology labs are struggling with the longer-term challenge of attracting and retaining talent, as seasoned microbiology experts retire, and fewer young people enter the field. Becker's Hospital Review recently spoke to Patrick Murray, PhD, vice president of Medical Affairs, Microbiology, at BD Life Sciences, about the current landscape facing microbiology labs and how automation solutions can increase operational efficiency, while delivering more accurate, timely and cost-effective testing. 1,2 The pandemic has exacerbated long-standing challenges within microbiology labs Prior to joining BD Life Sciences 10 years ago, Dr. Murray directed clinical microbiologylaboratories at major academic medical centers for 25 years. He then joined the NIH as chief of microbiology and served in that role for a decade. Through his current work, Dr. Murray regularly meets with laboratory directors, hospital administrators and government officials worldwide to discuss the wide range of microbiological challenges that they confront. This experience has given Dr. Murray a deep understanding of lab operations and trends in the microbiology sector. "We're very focused on what's happening in labs today," he said. "Virtually all of the problems that microbiology labs are currently dealing with are the same problems that existed before the pandemic began. Some of these issues have become more acute due to the need for rapid turnaround with COVID-19 diagnostics in combination with all of the same work that labs were already doing before." A comprehensive approach to lab automation leads to improved efficiency and accuracy Although microbiology labs have used automation to streamline discrete workflows like blood cultures, identification of organisms and antibiotic susceptibility testing, many organizations are now turning their attention to automation of all lab processes as a way to reduce variability and the need for repeat testing while increasing lab testing capacity and staff efficiency. "I think the real transformation that's occurring today is automating the entire microbiology laboratory, similar to what happened with chemistry, hematology and immunology laboratories," Dr. Murray said. "We are seeing a real push to work more efficiently in the lab." In a traditional microbiology lab, patient specimens come in throughout the day. Between each station — from inoculation and incubation to imaging and result reporting — techs often have to complete numerous manual steps and data entries in large batches that extend turnaround times and lead to compounding inefficiencies for overall lab operations. A better approach is to take each specimen as it arrives in the laboratory and begin processing it immediately to reduce delays in reporting results. "The BD Kiestra™ total lab automation solution process specimens as they are received in a very standardized and accurate way and then moves the specimens automatically to smart incubators on mobile tracks," Dr. Murray said. "In the incubator, plates are examined using a sophisticated imaging system. Then the imaging system applies algorithms to prepare a composite, high-resolution image to assist technologists in interpreting the results. Automation enables lab staff to focus on more complex work, such as selecting colonies for identification and susceptibility testing, rather than non-value add tasks like moving plates around in the lab or repeat testing due to human error." Automation alone isn't enough; it must be combined with lean workflow practices and informatics Although automation systems hold great promise for addressing the challenges facing microbiology laboratories, simply automating existing practices won't deliver optimal results. "I think it's important to emphasize that if you simply replicate your processes using an automated platform, you won't see the value of automation," Dr. Murray said. Total lab automation and the evolution of the clinical microbiology lab

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