Analysis. Answers. Action. www.aphl.org Trading Places and Mentoring in New Spaces: Biosafety Peer Network Sean Page Associate Specialist, Public Health Preparedness and Response Association of Public Health Laboratories (APHL) This presentation was 100% funded with federal funds from a federal program of $2.2 million. This publication was supported by Cooperative Agreement #1U500E000094-01 from the US Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC or the Department of Health and Human Services.
Agenda • About APHL • Biosafety Charge • Public Policy • Biosafety Community of Practice • Overview of Peer Network Program – Structure – Deliverables • Peer Network Pairings – NYC & ID – WI & MT • Key Takeaways & Outcomes Analysis. Answers. Action. www.aphl.org
About APHL • A non-profit, non-governmental US based organization • Over 900 members from state and local public health laboratories, state environmental and agricultural labs and others federal agencies and academic institutions. • Advocates at the national level to shape public health policy and to secure increased support and resources for member labs • Provides training, model practices, technical assistance domestically and internationally Analysis. Answers. Action. www.aphl.org
Biosafety Charge • Biosafety and Biosecurity Initiatives – Housed under APHL’s Public Health Preparedness and Response Program; cross-organizational approach to strengthen biosafety domestically and globally • Coordinate national efforts to improve biosafety in PHLs and support outreach to clinical laboratories – *CDC Funding: PHLs received $21 million over 3 years with a one- year extension to strengthen internal biosafety and assist clinical labs – **CDC Funding: APHL received $2.2 million to serve as a resource for laboratories and coordinate the strengthening biosafety initiatives. *Domestic Ebola Supplement to Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) -Building and Strengthening Epidemiology, Laboratory and Health Information Systems Capacity in State and Local Health Departments **APHL-CDC Cooperative Agreement Domestic Laboratory Biosafety for Ebola and Other Highly Infectious Diseases Analysis. Answers. Action. www.aphl.org
Public Policy [] Other State • Addressed [] 2% Biosafety 2% [] importance of [] audience and targeted messaging • Federal government [] contributes 94% of [] funds Federal - ELC Federal - PHEP State Local Other Analysis. Answers. Action. www.aphl.org
APHL Biosafety Community of Practice • Goal: To provide PHL Biosafety Officers (BSOs) from state, local, territorial and US Affiliated Pacific Islands (API) with opportunities to network, share ideas and resources and build biosafety and biosecurity skills. • Community of Practice: – ColLABorate Platform (over 140 members) – Biosafety Peer Network (52 PHLs Paired) – Biosafe360 Program (200+ participants) – Technical Skills Building Workshops and Webinars (750+ participants) – Leadership Development Workshop Series For more information: aphl.org/biosafety Analysis. Answers. Action. www.aphl.org
BIOSAFETY PEER NETWORK Analysis. Answers. Action. www.aphl.org
Biosafety Peer Network Overview Guam US Virgin Islands Micronesia Palau Puerto Rico Northern Mariana Islands Analysis. Answers. Action. www.aphl.org
Peer Network Structure • The Network utilizes a twinning concept. Laboratories are paired based on responses to an application. • Traditional Pairing – Option A: Paired BSOs travel and visit each other’s institutions. • Alternative Pairing – Option B: Host Site Visit Only – A paired colleague is unable to travel but can host another’s institution. – Option C: Web Format - APHL will set up a Skype or other web based meeting in lieu of travel so paired peers can discuss biosafety practices. Analysis. Answers. Action. www.aphl.org
Peer Network Deliverables 1. A Trip Report 2. A PowerPoint presentation explaining: (a) Purpose of the Visit (b) Lessons Learned/Key take away messages and (c) Changes implemented as a result of the visit Analysis. Answers. Action. www.aphl.org
Analysis. Answers. Action. www.aphl.org Trading Places and Mentoring in New Spaces: Biosafety Peer Network New York City Idaho Bureau Public Health of Laboratories Laboratory
Participants Idaho Bureau of Laboratories: • Michael Stevenson, PhD ◦ Deputy Lab Director • Cassie Dayan, MPH, MLS(ASCP)cm ◦ Health & Safety Specialist Michael and Cassie on the 86 th floor of the Empire State Building New York City Public Health Laboratory: • Anna Liddicoat, MPH ◦ Chief of Health and Safety ◦ Biosafety Officer Analysis. Answers. Action. www.aphl.org
Part 1: IBL Visits NYC PHL Analysis. Answers. Action. www.aphl.org
Days 1 and 2: PHL Tour - Highlights • Biosafety Level 3 (BSL3) Lab Spaces • Serology Unit – Zika, HIV, MMRV • Molecular Sequencing Unit – Next Generation Sequencing • Environmental Microbiology Unit – Legionella, PulseNet • Chemistry Unit – houses environmental chemistry testing and Laboratory Response Network (LRN) Chemical Threat Level 3 lab • PHL Safety and Security – Health Police are stationed in key locations Analysis. Answers. Action. www.aphl.org
Day 2: Safety Practices • Understanding Anna’s role as PHL BSO • Sample management – from receipt by Lab Support/Accessioning staff to lab delivery to biohazard waste disposal • Chemical Hygiene Analysis. Answers. Action. www.aphl.org
Day 2: Risk Assessments • Required for every procedure, and in some cases, specifically for a pathogen being tested (e.g., Zika virus) • Performed by BSO and testing unit chief or supervisor • Involves observing lab process and filling out RA form for risk management, including: ◦ Biological safety ◦ Chemical safety ◦ PPE ◦ Engineering controls ◦ Waste management ◦ Emergency preparedness Analysis. Answers. Action. www.aphl.org
Day 2: Quality Management System • Major highlights include: ◦ Regular internal audits in testing sections ◦ Regular external audits ◦ Competency assessments ◦ Training ◦ Electronic document control ◦ Event reporting for non-compliance and other incidents Analysis. Answers. Action. www.aphl.org
Day 3: Bellevue “Meet & Greet” • Exchange between agencies on practices for patient sample management for test submission to PHL • PHL binder given to Bellevue for reference • Tour Pathology Medicine facility ◦ Ebola treatment hospital isolation ward ◦ TB testing lab in Ebola isolation ward ◦ Microbiology, mycology, parasitology, HIV testing labs NYC Health + Hospitals/Bellevue Source: https://www.burns-group.com/project/cogeneration-system-for-bellevue-hospital/ Analysis. Answers. Action. www.aphl.org
Take Home Points • IBL reviewed and received examples of PHL policies on biosafety, respiratory protection, exposure control, and Select Agent program, and plans to incorporate relevant items that may be absent in IBL’s own programs • Anna’s demonstration of PortaCount fit testing helped boost IBL’s confidence in using this equipment and developing a “loaning library” to Idaho state partners • IBL used binder and other given materials for its own “Meet & Greet” to sentinel labs
Part 2: NYC PHL Visits IBL Analysis. Answers. Action. www.aphl.org
Day 1: IBL Tour Highlights Chemistry Section • LRN-C, Organics, Inorganic, Air Filter Lab programs Clinical Section • Arboviral, Influenza, Rabies, TB (in BSL3 suite) programs • PPE requirements listed at entrance to labs • Rabies work – necropsy performed in biosafety cabinet with respiratory protection • TB work – respiratory protection required when generating aerosols (processing sputum and other sample types) Analysis. Answers. Action. www.aphl.org
Days 1 and 3: IBL Tour Highlights Microbiology Section • Reference Bacteriology, Molecular Biology, LRN-B (in BSL3 suite) • Biothreat samples in BSL3 suite progress through pass-through windows to respective rooms for initial assessment, processing, and biochemical testing Lab Improvement Section • Regulatory inspection programs ◦ X-ray facilities, CLIA labs, air monitoring instruments • Developmental Science, Biorepository programs Analysis. Answers. Action. www.aphl.org
Day 2: Sentinel Clinical Laboratory Outreach • Labs in Idaho volunteer to be in the Idaho Sentinel Lab Network (ISLN). • IBL created a “roadshow” biosafety workshop that they take around the state. • Discussed Packaging and Shipping Category A Drills Analysis. Answers. Action. www.aphl.org
Day 2: Clinical Section Internal Audit • Shadowed Quality Management (QM) Team’s internal audit of Clinical Section • Excel risk assessment template of 21 questions to address potential exposure hazards. Analysis. Answers. Action. www.aphl.org
BSL2 PPE Signage Analysis. Answers. Action. www.aphl.org
BSL3 Suite PPE Signage Analysis. Answers. Action. www.aphl.org
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