Molecular and point-of-care experience helps overcome lab


challenges By Kristine Russell


the physician receives results almost immediately and they can institute the treatment necessary to help the patient without any delays.


How does your PhD in Neuroscience help you address and overcome


Ghazala Nathu, MD, MS, PhD, FACB, Medical/Molecular Laboratory Director of Clinical Pathology, Director of Point of Care and Blood Bank/Tissue Compli- ance Officer, at Bassett Healthcare Network – Cobleskill Regional Hospital.


Cobleskill Regional Hospital (CRH) is located in Cobleskill, New York. CRH is a 25-bed critical access facility and is the only hospital for 50 miles in any direction. The hospital has a full service Emergency Department but no maternity or critical care. CRH excels at stabilizing and transporting of patients to another hospital when needed.


What made you decide to pursue a


career in medicine? Both my parents were physicians. My father, who is 85 years old, still practices medicine. Both my parents had a pas- sion for patient care. I became an MD because of my parents and because I wanted to challenge myself and to help patients through clinical pathology.


Why did you become a Molecular director for your lab?


Genetic and molecular testing is the future of clinical pathology. Artificial intelligence is catching up fast and is being used to help analyze genetic and molecular testing results. I studied these fields in order to improve patient care. For example, CRISPR is being used in clinical trials to engineer a cure for Sickle Cell Anemia. Pharmacogenetic testing is used to determine how genes affect the body’s response to certain medications.


What do you enjoy most about being


the Director of Point of Care? I am board certified in point-of-care (POC). POC is well regulated by regu- latory agencies. One of my greatest passions is being able to help patients and assure that they get a high standard quality of care. POC can also improve patient treatment outcomes because


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challenges as a Lab Director? Obtaining a PhD in neuroscience has helped me in many ways with my pas- sion for seeing that patient’s receive a high quality standard-of-care. In the process of obtaining my PhD, I learned to think outside the box. I learned the fundamentals of basic research. I obtained a better view of the whole picture when it comes to taking care of patients. That knowledge enabled me to understand pre-analytic, analytic, and post analytic phases of testing. I was able to promote and develop a laboratory developed test (LDT) in-house that was FDA approved and had clinical utility. The test is an Extraction free SARS- CoV-2 RNA detection by RT-Real Time PCR (polymerase chain reaction). In addition to being the Medical Director of CRH and the Molecular Director for BMC, I was also the Medical Director for a large reference laboratory. The reference laboratory performed 10,000+ COVID-19 tests per day. The develop- ment of the LDT, which was approved by CLIA and the local Department of Health, helped overcome shortages of materials.


Will you describe the role your lab has played as a regional healthcare center in New York in response to


the pandemic? We normally have two negative pres- sure rooms. But New York State allowed us to make six more rooms into tem- porary negative pressure rooms. There were so many COVID-19 patients in New York City and downstate, that the upstate hospitals were required to accept COVID-19 patient transfers from downstate. We had our fair share of COVID-19 patients. Patients who needed critical care were shipped to other facilities that had ICU beds avail- able. With our two Abbott ID Now’s, we did a great deal of COVID-19 testing and flu testing. For a while, there was an executive order for any patient sent for testing, to be tested for both flu and COVID-19. In the beginning, we were


the only facility in the area to offer a rapid COVID-19 test. A lot of patients came to our Emergency Department for testing after they were exposed to people who had COVID-19. I was overseeing, as a solo Molecular Director, for all of the Bassett Network to support the healthcare team and system in the immediate response for the diagnosis and prompt treatment of patients and employees. I was in constant commu- nication with my staff, Bassett Network Medical Directors, and the supply chain vendors to ensure constant feed of sup- plies to avoid any possible interruption in patient care.


What is the current vacancy rate at your lab? What strategies have you found to be successful in recruiting


and/or retaining staff? We are currently fully staffed in our laboratory. We did not have a staffing problem during the pandemic because, previously, we had to attract and keep workers. We are close to the Capital District area, which includes Albany, New York, so we had to be competitive to obtain staff. We changed to 12- hour shifts. Our hospital employees were treated equally and with respect. I used a team approach and was always posi- tive with the staff. If I had to talk to an employee about something negative, I would always start with something positive and then bring up the nega- tive aspect.


Are there particular ‘lessons learned’ you wish to share with fellow Labo- ratory Directors?


I learned that a single person or labo- ratory cannot do everything. During the pandemic, everyone learned that a collaborative approach got things done; this included outside agencies as well as internal personnel. The New York State Department of Health and Governor Cuomo had emergency pow- ers and were able to cut much of the red tape. CLIA also made exceptions with regard to the pandemic. The FDA and CDC also made exceptions with the pandemic. I learned that the col- laborative team approach works best in handling emergent situations. This includes the Department of Health, Federal agencies, executives, governors, and other persons.


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