Cortney Stafford1, Robyn Atkinson-Dunn2, Sarah N Buss3, Tracy Dalton1, Debbie Gibson4, Stephanie Johnston1, Ewa King5, Shou-Yean Grace Lin6, Kara K Mitchell7, William A Murtaugh8, Heather Sease9, Timothy R Southern10, Julie L Tans-Kersten11, Emily A Travanty12, Laura R Triplett13, Kelly Wroblewski8, Angela M Starks1. 1. 1 Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA. 2. 2 Utah Public Health Laboratory, Taylorsville, UT, USA. 3. 3 Wyoming Public Health Laboratory, Cheyenne, WY, USA. 4. 4 Montana Public Health Laboratory, Helena, MT, USA. 5. 5 Rhode Island Department of Health, State Health Laboratories, Providence, RI, USA. 6. 6 California Department of Public Health, Microbial Diseases Laboratory, Richmond, CA, USA. 7. 7 New York State Department of Health, Wadsworth Center, Albany, NY, USA. 8. 8 Association of Public Health Laboratories, Silver Spring, MD, USA. 9. 9 North Dakota Department of Health, Bismarck, ND, USA. 10. 10 South Dakota Public Health Laboratory, Pierre, SD, USA. 11. 11 Wisconsin State Laboratory of Hygiene, Madison, WI, USA. 12. 12 Laboratory Services Division, Colorado Department of Public Health and Environment, Denver, CO, USA. 13. 13 Denver Health Medical Center, Denver, CO, USA.
Abstract
OBJECTIVES: Public health laboratories (PHLs) provide essential services in the diagnosis and surveillance of diseases of public health concern, such as tuberculosis. Maintaining access to high-quality laboratory testing is critical to continued disease detection and decline of tuberculosis cases in the United States. We investigated the practical experience of sharing tuberculosis testing services between PHLs through the Shared Services Project. METHODS: The Shared Services Project was a 9-month-long project funded through the Association of Public Health Laboratories and the Centers for Disease Control and Prevention during 2012-2013 as a one-time funding opportunity to consortiums of PHLs that proposed collaborative approaches to sharing tuberculosis laboratory services. Submitting PHLs maintained testing while simultaneously sending specimens to reference laboratories to compare turnaround times. RESULTS: During the 9-month project period, 107 Mycobacterium tuberculosis complex submissions for growth-based drug susceptibility testing and molecular detection of drug resistance testing occurred among the 3 consortiums. The median transit time for all submissions was 1.0 day. Overall, median drug susceptibility testing turnaround time (date of receipt in submitting laboratory to result) for parallel testing performed in house by submitting laboratories was 31.0 days; it was 43.0 days for reference laboratories. The median turnaround time for molecular detection of drug resistance results was 1.0 day (mean = 2.8; range, 0-14) from specimen receipt at the reference laboratories. CONCLUSIONS: The shared services model holds promise for specialized tuberculosis testing. Sharing of services requires a balance among quality, timeliness, efficiency, communication, and fiscal costs.
OBJECTIVES: Public health laboratories (PHLs) provide essential services in the diagnosis and surveillance of diseases of public health concern, such as tuberculosis. Maintaining access to high-quality laboratory testing is critical to continued disease detection and decline of tuberculosis cases in the United States. We investigated the practical experience of sharing tuberculosis testing services between PHLs through the Shared Services Project. METHODS: The Shared Services Project was a 9-month-long project funded through the Association of Public Health Laboratories and the Centers for Disease Control and Prevention during 2012-2013 as a one-time funding opportunity to consortiums of PHLs that proposed collaborative approaches to sharing tuberculosis laboratory services. Submitting PHLs maintained testing while simultaneously sending specimens to reference laboratories to compare turnaround times. RESULTS: During the 9-month project period, 107 Mycobacterium tuberculosis complex submissions for growth-based drug susceptibility testing and molecular detection of drug resistance testing occurred among the 3 consortiums. The median transit time for all submissions was 1.0 day. Overall, median drug susceptibility testing turnaround time (date of receipt in submitting laboratory to result) for parallel testing performed in house by submitting laboratories was 31.0 days; it was 43.0 days for reference laboratories. The median turnaround time for molecular detection of drug resistance results was 1.0 day (mean = 2.8; range, 0-14) from specimen receipt at the reference laboratories. CONCLUSIONS: The shared services model holds promise for specialized tuberculosis testing. Sharing of services requires a balance among quality, timeliness, efficiency, communication, and fiscal costs.
Entities:
Keywords:
Mycobacterium tuberculosis; laboratories; public health laboratories; referral of testing; tuberculosis
Authors: Stanley L Inhorn; J Rex Astles; Stephen Gradus; Veronica Malmberg; Paula M Snippes; Burton W Wilcke; Vanessa A White Journal: Public Health Rep Date: 2010 May-Jun Impact factor: 2.792