LAB MANAGEMENT :: SUPPLY FORECASTING & HANDLING
• 8.8% of labs have a shortage of supplies for routine parasite testing.
• 19.4% of labs have a shortage of supplies for routine fungal testing (ranging from superficial, localized skin conditions to deeper tissue infections to serious lung, blood (septicemia) or systemic diseases).”4 When asked if her laboratory’s process of acquiring and/ or integrating supplies has changed since the COVID-19 pan- demic, Mary Greeley’s Bower replied, “We still tend to utilize our KanBan system for most supplies. However, any item which has been subject to a backorder receives special treatment. We may order more than our usual number of the product, or order more frequently, depending on the advice of our buyer in the purchasing department. We have become much more “tuned in” to laboratory news with respect to national shortages.”
Best practices and future pandemic readiness Having experienced the COVID-19 pandemic, and the effects of supply shortages, the idea of a preparedness plan seems likely, and necessary, at the same time. Mary Greeley Medical Center is among those laboratories that is continuously working to institute such a plan, based on the awareness brought about through the COVID-19 pandemic. Additionally, the pandemic shown a light on collaboration with borrowing and sharing supplies among labs and hospitals and creating partnerships. “We have not yet determined a definite plan for future pan- demic readiness as it relates to supplies. However, one thing that became very apparent to us was that our collaborative relationships with nearby clinics and hospitals was instrumental to effectively managing unexpected shortages. We were able to loan blue top tubes to a very large hospital who otherwise would not have been able to get them at all. When we ran perilously low on purple and green top tubes, we received small loans of tubes from several other institutions that helped us make it to the next shipment,” Bower said. To help laboratories deal with supply shortages, The Choosing
Wisely program was created, which is an initiative of the ABIM Foundation that focuses on avoiding unnecessary medical tests, treatments, and procedures.5 “Programs such as Choosing Wisely, and other laboratory medicine stewardship guidelines, have been designed around the patient-centric and fiscally prudent principle of reducing testing that adds no value to patient care, and that even may be associated with increased risks…COVID-19 supply chain issues have clearly created a healthcare crisis, including for the practice of laboratory medicine. But this crisis presents laboratorians with a golden window of opportunity to initi- ate or strengthen our effective test utilization and labora- tory stewardship efforts, using Choosing Wisely and other guidelines as a foundation for engaging in interdisciplinary organizational discussions.”6
Suppliers/Vendors:
Managing the needs of laboratories Lee H. Hilborne, MD, MPH, FASCP, DLM(ASCP)CM, and col- leagues, in an article entitled, Laboratory Supply Shortages: Turning Crisis to Opportunity, wrote, “as the pandemic continues to ravage the global medical community, supply chain issues have intro- duced new challenges that extend far beyond COVID-19 testing. Shortages of specimen tubes, personal protective equipment, and other common laboratory consumables threaten access to all aspects of diagnostic testing.”
36 MAY 2022
MLO-ONLINE.COM Vendors, as suppliers for laboratories and hospitals, also
have been affected by the upheaval occurring, due to short- ages and the pandemic. Fortunately, not all suppliers have experienced, or have been negatively affected by current pandemic-type shortages. Richard Noel, Marketing Director, North America, Lumira
DX, a supplier of COVID-19 antigen tests, was asked, “What are you doing to manage labs’ needs?” Responding, Noel said his company has been fortunate and has never had “to put any customers on allocation or gone on backorder for the SARS- CoV-2 Antigen Test.” As a way to explain, Noel referred to the company’s “in-
novative test strip manufacturing process…and automated manufacturing lines that can produce tens of millions of tests per month.”
Richard Noel
While Noel’s experiences regarding the on-going supply chain in the pandemic and post-pandemic timeframe are notable, they are not the norm, for suppliers. Because of the long-standing difficulties brought on by the shortages, government agencies have stepped in with suggestions for buffering such adversities.
Recommendations For the time being, while pandemic shortages still exist, the FDA has provided recommended strategies for the conserva- tion of supplies. The FDA recommends healthcare providers, laboratory direc-
tors, phlebotomists, and other personnel consider the following conservation strategies to minimize blood collection tube use and maintain quality and safety of patient care2
:
• Only perform blood draws considered medically necessary. • Remove duplicate test orders to avoid unnecessary blood draws. • Avoid testing too frequently or extend time intervals between tests whenever possible.
• Reduce tests at routine wellness visits and allergy testing only to those that target specific disease states or where it will change patient treatment.
• Consider add-on testing or sharing samples between laboratory departments if previously collected specimens are available.
• If you need a discard tube, use a tube type that has a greater quantity available at your facility.
• Consider point of care testing that does not require using blood specimen collection tubes (lateral flow tests)
REFERENCES:
1. CBER-Regulated Products: Shortages and Discontinuations. https://
www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/ cber-regulated-products-shortages-and-discontinuations
2. UPDATE: Blood Specimen Collection Tube Conservation Strategies - Letter to Health Care and Laboratory Personnel.
https://www.fda.gov/medical-devices/ letters-health-care-providers/update-blood-specimen-collection-tube- conservation-strategies-letter-health-care-and-laboratory
3. CBER-Regulated Products: Possible Causes of Shortages. https://
www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/ cber-regulated-products-possible-causes-shortages
4. Supply Shortages Impacting COVID-19 and Non-COVID Testing. https://asm. org/Articles/2020/September/Clinical-Microbiology-Supply-Shortage-Collecti-1
5. ABIM Foundation,
https://www.choosingwisely.org/
6. Lee H Hilborne, MD, MPH, FASCP, DLM(ASCP)CM, Greg Sossaman, MD, MACSP, Barbara Caldwell, MS, MASCP, MLS (ASCP)CM, SHCM, et al. Laboratory Supply Shortages: Turning Crisis to Opportunity. American Journal of Clinical Pathology, aqac035,
https://doi.org/10.1093/ajcp/aqac035.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52
