Improving Our System

photo: lab work (male)Background on improvement

The reason for conducting an assessment of laboratory system performance was to provide the basis for collaborative efforts at improvement. It is our hope that by working collaboratively we can significantly improve the overall performance of our local laboratory system in Orange County and ultimately protect, maintain and improve the health of all Orange County Residents.

Success with the Laboratory System Improvement Program (L-SIP) necessitates an external focus, involving all system partners to address quality improvement centered on the Local Public Health Laboratory System (LPHL System) itself. The improvement process, in reality, begins with the assessment. The dialogue and discussion that occur during the assessment begins development of ideas and interest in improving collaboration.

photo: lab work (female)The Orange County Public Health Laboratory will be convening follow-up meetings to begin prioritizing areas for improvement based on those results. In addition, a process will be initiated to design the ideal laboratory system by initiating three Quality Improvement groups that represent the Clinical, Environmental and Molecular Epidemiology disciplines of the public health laboratory. These design groups will be made up of both internal public health laboratory staff as well as external partners. The improvement/design process will be led by the Laboratory Quality Improvement Committee members, the Laboratory Supervisors and the Laboratory Director.

Quality Improvement Groups

The following three Quality Improvement (QI) groups make up the larger L-SIP Quality Improvement Committee

  • Clinical QI Group
  • Environmental (Water and Chemistry) QI Group
  • Molecular Epidemiology QI Group

Meeting Dates and Times

Steering Committee Meeting March 26, 2014 – Public Health Laboratory 3:00 pm

Quality Improvement Meeting #1
Clinical QI Group: To be determined
Molecular Epidemiology QI Group: To be determined
Environmental QI Group: To be determined

NEXT STEPS – FROM L-SIP ASSESSMENT CONDUCTED ON MARCH 18, 2014

These steps are not listed in order of when they will be addressed. The Public Health Laboratory Quality Improvement Committee will be assigning these next steps as projects to teams made up of laboratory staff and laboratory system partners. The L-SIP Steering Committee assigned “importance” from Low to High to each of the proposed next steps.

Next Step

Importance

Contact

Outcome

Make Electronic Laboratory Reporting (ELR) to State CalRedie program operational

High

Laboratory Director

Completed (see e-mail below) 4/2/2014. Orange County PH Laboratory ELR operational.

Simplify laboratory results on reports sent to partners/clients

Medium

Laboratory QI Committee

 

Meet with IT and Partners (EPI, Public Health Programs) to see what programs are available to extract data from Cerner LIS. Request IT training of Lab, EPI, and Clinical supervisory staff.

Medium

Laboratory QI Committee

 

Compare Laboratory Continuation of Operations (COOP) to partner COOP’s to make sure they are compatible.

Medium

Laboratory QI Committee

 

Improve Networking with commercial laboratories through interactive communications

Medium

Laboratory QI Committee

 

Provide pre-analytical and post-analytical information and necessary training to physicians and staff when a new assay is introduced

High

Laboratory QI Committee

 

Network with Veterinary and other nontraditional partner laboratories. Perform site visits of partner laboratories.

Low

Laboratory QI Committee

 

Contact speaker groups and local colleges to improve visibility of Public Health Laboratory and laboratory profession.

Medium

Laboratory QI Committee

 

Participate in activities outside laboratory during Public Health Week

Medium

Laboratory Director

During Public Health week April 7-11, 2014 laboratory staff did not have an opportunity to participate. Activities this year were around recognizing community health partners. Plan to actively participate in 2015.

Provide a quarterly Laboratory Newsletter to partners

Medium

Laboratory QI Committee

 

Improve Laboratory website by including search capabilities in the online Laboratory Test manual.

High

Laboratory QI Committee

 

Survey laboratory system partners regarding how they want to receive relevant information from and about the Public Health Laboratory i.e. e-mails, faxes, quarterly calls, website, newsletter, workshops with CEUs.

High

Laboratory QI Committee

 

Assure that Laboratory and partners are represented when laboratory policies are being discussed

Low

Laboratory Director

 

Contribute data to influence laboratory policies

Low

Laboratory QI Committee

 

Create a new position and hire a full-time Quality Assurance Coordinator

Low

Laboratory Director

 

Review California public health laws and regulation to determine what if any local regulatory powers exist

Low

Laboratory QI Committee

 

Monitor partner laboratory case reporting through EPI and ensure cultures or blood film slides are submitted to Public Health Laboratory for all Salmonella, MTB and Malaria cases as required by State law,

Medium

Laboratory QI Committee

 

Review (survey) use of Public Health Laboratory for routine clinical work by clinic partners – reduce outsourcing of clinical tests to reduce costs and improve service

High

Laboratory QI Committee

 

Improve Turn-around time for clinically relevant samples.

High

Laboratory QI Committee

 

Review sputum testing protocols in bacteriology – consider modifying clinical guidelines

 

High

Laboratory QI Committee

 

Improve assessment of employee performance and competency by reevaluating current PTCR tool.

High

Laboratory QI Committee

 

Review PIP goals as a tool for Quality Improvement

Medium

Laboratory QI Committee

 

Review future staff retirements and expand succession planning

High

Laboratory Director

 

Improve outreach to schools and partner laboratories for recruitment of future laboratory employees

Medium

Laboratory QI Committee

 

Conduct laboratory employee job satisfaction survey

Medium

Laboratory QI Committee

 

Conduct a client survey on quality of Public Health Laboratory services. Ask which additional tests need to be offered

Moderate

Laboratory QI Committee

 

Update the laboratory’s mission statement

High

Laboratory Director

Laboratory Staff

 

Write a strategic plan for the Public Health Laboratory consistent with the Department’s goals and the partners needs

High

Laboratory Director

Laboratory Staff

 

Improve methods of sharing research out comes with partners

High

Laboratory QI Committee

 

Continue to conduct applied research in the Public Health Laboratory

High

Laboratory Director

Laboratory Supervisors

 

Support PhD fellowships to assist in research projects

High

Laboratory Director

Laboratory Supervisors


From: Meesey, Jill (CDPH-CID-DCDC)
Sent: Wednesday, April 02, 2014 12:57 PM
To: Zahn, Matthew
Subject: in production

Dear Dr. Zhan,
The CalREDIE ELR team is pleased to report that the Orange County Public Health Laboratory has progressed to ELR production status as of midnight 4/02/2014. This is the first Public Health Lab in production in California. Congratulations!

Sincerely,
The CalREDIE ELR Team
Jill M. Meesey

CalREDIE ELR Analyst
Communicable Disease Emergency Response
Division of Communicable Disease Control
California Department of Public Health