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Friday, December 23, 2016 Written by Jacqueline McDowell, Systems and Solutions Manager, Cepheid

Creating a state-of-the-art PCR laboratory

Microbiology and Infection Control departments team up to improve the patient care continuum

One year ago, Seattle-based Stevens Hospital joined an established hospital group in Washington state. The move put immediate pressure on the Swedish laboratory, with MRSA test volumes more than tripling. Coupled with calls for greater sensitivity in C. difficile testing, the Microbiology team knew that change was in order.

Pattie Bolgen, Swedish’s Microbiology Supervisor, worked closely with Bobbi Raglan of Infection Control to champion plans for delivering better turn-around times, alleviating the isolation burden associated with MRSA and C. difficile status, and improving overall patient satisfaction.

Bolgen knew that testing by PCR would deliver optimal results. But she also knew that traditional PCR methodologies would pose physical space and human resource challenges that current budgets could not overcome.

Enter Cepheid’s GeneXpert® Infinity System. With it’s patented ease of use (read: no additional specialized staff), and on-demand workflow (read: rapid turnaround 24-hours a day), she knew the hospital-wide benefits would quickly offset any up-front costs in getting the program launched. But in today’s budget-constrained environments, the numbers had to make sense.

With the support of Laboratory Director John Boblett, Raglan and Bolgen began the journey of quantifying the benefits of providing patient results within hours versus days and adding routine core laboratory testing to the micro lab. Knowing the greatest benefits would be realized outside of the lab, Bolgen and Raglan created a report analyzing patient management workflow throughout the previous year. The report looked at isolation time, antimicrobial use, infection control workflow, and impact on employee attendance.

The findings were compelling. During the previous year, preemptive isolations consumed an astounding 563 days. The investigative work also uncovered that patients had an average of 90 contacts each 24 hour period by healthcare workers.

In addition, employee time spent getting into and out of Personal Protective Equipment (PPE) totaled approximately 1,300 hours during the previous 12 months. And the hospital spent nearly $170,000 on patient PPE for those ultimately found to be negative for MRSA and C. difficile. The hospital also spent $35,000 on empiric Vancomycin.

Raglan and the Infection Control team also knew that test results were not always acted upon immediately. With timely, accurate results, the Infection Control staff could move from monitoring patient results to proactively managing their patients.

The impressive multi-department effort to cost-justify state-of-the-art molecular testing has enabled the laboratory of Swedish Hospital to have a profound impact on patient management throughout the institution.

IMPACT OPPORTUNITY:
The Cepheid GeneXpert Infinity System will allow the laboratory at Swedish Hospital to become a state-of-the-art PCR laboratory, rivaling any of its neighboring facilities and competitors.