Project Details
About the Project
The Island Health Microbiology Laboratory supports multiple inpatient and outpatient care areas as well as antimicrobial stewardship and infection prevention and control programs. Optimization of the pre-analytic phase (ordering, requisitioning, collection, use of proper swabs/containers and transport) is essential for the production of reliable, reproducible and timely results. This phase is dependent primarily upon non-laboratory personnel, making it particularly important to engage with physicians for improvement efforts.
With the overarching goal of improving laboratory test ordering practices, the microbiology laboratory team focused their efforts on the addition of a microbiology-specific site on Firstline to assist in improving order practices. This digital resource was designed to support clinicians, nurses, and other healthcare professionals by providing easy, real-time access to best practices for test ordering, specimen collection, and submission requirements.
Recognizing that this initiative represented a significant change for many different designations within the hospital, the team partnered with a website/Firstline content manager, antimicrobial stewardship pharmacists, a professional practice consultant, and nurse educators, alongside physicians from laboratory, hospitalists, infectious disease, and the emergency department.
According to the specimen rejection analysis of a three-month period, a total of 32,428 specimens were received for sexually transmitted infection (STI) specimens for molecular testing and urine cultures, and of these, 634 specimens were rejected. The most common reason for rejection of STI samples was the use of incorrect swab types. To address this issue, the team incorporated photos of the correct swab types. These images are in the process of being incorporated into the microbiology specimen collection guides to support frontline staff in using the correct collection tools and help reduce rejection rates moving forward.
Reflecting on this initiative, Dr. Lee shared how important it was to engage with her colleagues across designations: “This engagement initiative offered a valuable opportunity for me to collaborate closely with nurse educators and physicians”. By exploring practical ways to provide clearer guidance aimed at reducing specimen errors and rejections and improving turnaround times, the team was able to offer an invaluable opportunity to enhance both patient care and clinician experience.