Most of us will never forget the shock, uncertainty, and helplessness we felt after the September 11 terrorist attacks. Following those attacks and the anthrax scare weeks later, many agreed that clinical labs were not up to the challenge of dealing with the aftermath of the attacks. The recent tsunamisand to a lesser extent, the torrential rains in Southern Californiawere additional reminders of the importance of being prepared for disasters, natural or otherwise. Laboratory and hospital managers must prepare and implement plans that will allow them to maintain service despite damages. Moreover, in a terrorist attack, clinical laboratory personnel must be prepared to recognize and respond to emerging infectious diseases or other illnesses caused by the intentional release of biological and chemical agents.
Recognizing the need for improvement in how laboratories respond to disasters, the American Society for Clinical Pathology (ASCP) has addressed emergency preparedness in a number of ways. At its October 2004 meeting, the ASCP board of directors passed a policy statement acknowledging the critical role that clinical laboratories play in bioterrorism preparedness. In addition, the association has worked with the Centers for Disease Control and Prevention (CDC) to enhance laboratory testing practices and to develop specific training programs for medical technologists, medical laboratory technicians, and pathologists.
According to Jeff Jacobs, ASCPs vice president of public policy in Washington, greater attention needs to be given to ensuring that clinical laboratories are ready for an emergency, whether for a pandemic flu or a bioterrorist attack. We need to ensure adequate training and communication between clinical and public health labs, he says.
The Clinical Laboratory Management Association (CLMA) has been on top of this issue as well. An article in CLMAs October 2004 electronic newsletter Vantage Point recommends a number of steps laboratories can take before, during, and after a natural disaster to operate as efficiently as possible. These include ordering enough supplies to sustain the lab for a minimum of 1 week, closely monitoring equipment during the emergency, and being prepared for an increase in workflow.
Its also worth taking a look at what has been done at the state level. The State of Minnesota developed a database of all the clinical laboratories in the state, including those at universities and in community hospitals. In addition, the state instituted a communications system between all of the clinical laboratories and the state laboratory. For example, if one laboratory starts to see patients with an unusual ailment, other laboratories will be alerted to look for that same condition.
In another state, the Mississippi Department of Health (MDOH) and the University of Mississippi Medical Center (UMC) are working to implement a statewide public health surveillance system that will enable earlier identification of and intervention against naturally occurring infectious diseases, chemical exposures, and strategically introduced biological agents. TheraDoc, a Utah-based medical informatics company, will provide the clinical decision-support software that will be utilized to create the system. Ultimately, the plan is for TheraDocs monitoring and alerting capabilities to provide real-time infectious disease reporting to the MDOH, allowing state officials to respond quicker and avoid widespread outbreaks.
Emergenciesnatural and otherwiseare a fact of life and a certainty in this era. Clinical labs must be prepared in order to minimize the casualties.