Operationalizing COVID-19 testing: Who, what, when, where, why, and how

Abstract

The statements and opinions expressed in COVID-19 Curbside Consults are based on experience and the available literature as of the date posted. While we try to regularly update this content, any offered recommendations cannot be substituted for the clinical judgment of clinicians caring for individual patients.

Laboratory Interventions to Eliminate Unnecessary Rapid COVID-19 Testing During a Reagent Shortage

“…The COVID-19 global health crisis forced many health care organizations to set up impromptu stewardship initiatives where they previously did not exist to manage the clinical and operational challenges presented by the pandemic. 2 , 11 A COVID-19 Test Stewardship Committee was formed at our medical center to optimize test utilization with the aid of a dashboard. When rapid test supplies were critically low, dashboard analysis revealed inappropriate utilization of rapid tests that did not conform to hospital guidelines for rapid testing, prompting laboratory administration to intervene immediately.…”

“…1 Accurate and rapid identification of infected individuals is essential to guide appropriate therapies, determine isolation strategies, optimize patient flow in the hospital, and allow for workforce planning while also informing community surveillance and epidemiology. 2 Diagnostic testing is a critical component of the pandemic response strategy to confirm infection and carrier status of patients suspected to be infected by SARS-CoV-2. 3 However, persistent and unpredictable global infection rates have periodically led to shortages in test supplies, reagents, instrumentation, personal protective equipment, and personnel.…”

“…Early in the pandemic, several health care institutions began reporting the use of data analytic tools to bridge the gap between information systems for expediting COVID-19 management. 2 , 9-13 Our laboratory leadership proposed the creation of a COVID-19 test utilization dashboard to centrally monitor the complete testing process, including CPOE responses. This dashboard went live on the same day that CPOE was implemented.…”

Home testing for COVID-19: Benefits and limitations

“…However, there have been significant and ongoing issues with obtaining the testing supplies needed to address the demand, making it necessary to limit testing. 1 The recent FDA emergency use authorization of COVID-19 tests that can be conducted at home will substantially expand the ability of individuals to obtain a test and to receive the results quickly.…”