The Westgard Rules

A covid19 view from Connecticut

Posted by Sten Westgard, MS

Here's a glimpse of the covid19 situation in Connecticut this morning:

"As of Thursday morning, the state’s public health lab in Rocky Hill had completed just 90 of the 1,200 tests it has received from the federal Centers for Disease Control and Prevention.

"'That’s horrible. We are vastly, vastly, vastly under-testing at this point,' Dr. Howard P. Forman, director of the health care management program at Yale School of Public Health, said Wednesday. 'Without testing, you don’t know what prevalence of disease you have in the community.'"

Later in the article it becomes more stark.

"Because the state lab only had the staffing capacity to run 20 tests a day, a decision was made to only test those whose condition had deteriorated enough to be hospitalized....

"By next week, the state lab will have more staff trained so it can complete 60 tests daily. A cohort of nine employees will take turns working three shifts, 7 days a week. But that’s the maximum capacity the state lab will have going forward."

60 tests a day isn't going to help us - we probably need 1,000 tests a day.

When you "lean" out the lab staff, cut costs, reduce funding for public health labs, and labs in general, you set yourself up for these kind of failures. We reap what we sow.

https://www.wnpr.org/post/connecticut-has-run-only-90-covid-19-tests-thats-problem?utm_source=Connecticut%20Public&utm_campaign=d1c5f37cb3-NEWSLETTER_YOUR%20START_20200302_COPY_01&utm_medium=email&utm_term=0_685fda1a0e-d1c5f37cb3-115441717&mc_cid=d1c5f37cb3&mc_eid=07420def70

 

Labs: Lean to the bone?

Posted by Sten Westgard, MS

Here's a brutal return to reality from the celebrations of LabWeek.

The April 2010 CAP Today inside cover story is titled, "Thanks to weak economy and more, efficiency is king." It's not a surprise that laboratories are trying to cut costs again, but there was one paragraph that jumped out at me. The first interview is with Heidi Riggenbach, CLS, MT(ASCP), the lab director of a small hospital. She describes staff layoffs and 10-hour shifts, things that are becoming the standard practice of this era, but then she notes that even that is not enough:

"Why not pursue the cost savings said to stem from Lean principles? Though Riggenbach admires the Lean philosophy, she doesn't think it's practical to implement in her laboratory: 'When you're this small, it's really hard to Lean down anymore, because you just don't have the space to do it with. I know a lot of labs have done Lean, and that's great, but most of the ones that have gone through major changes like that have been able to remodel at the same time.'"

Riggenbach goes on further to explain how her staff is now rearranging the layout of the laboratory equipment, seeking even slight improvements in efficiency that might be gained by the right permutation of instruments.

Riggenbach is one of the unsung heroes of the new laboratory economy, an Atlas on which everything rests. She's cut all she can cut, laid off all she can lay off, and still she tries harder, Lean-ing every last bit of speed out of her laboratory. The chronic malady of labs is cost-cutting.

Labs are Vital, to be sure. But Vital Signs of these Labs seem more frightening by the day.

Isn't it time to start investing in labs and the people who run them?