Focus On: Specimen Transport

The transportation of clinical specimens and organisms is an aspect of laboratory services that doesn’t always receive a lot of attention, but remains a vital part of quality control and safety procedures all the same. As healthcare facilities handle patient specimens, the laboratory must triage samples for STAT analysis, standard laboratory processes or even send out tests to reference labs for extended analysis.

In recent interviews with ADVANCE, Christina Egan, PhD, director of the biodefense laboratory at Wadsworth Center, New York State Department of Health, and Michael Pentella, PhD, D(ABMM), Massachusetts State Public Health Laboratory Director, provided insight on the importance of well-executed specimen transport in the laboratory industry.

“Laboratories should have a robust training program to ensure that all staff that are involved with transport of specimens-including individuals that may [be] working in receiving departments-understand the packaging and shipping process,” said Egan. “Only Individuals that have been appropriately trained should take part in the packaging and shipping process.”

With the increasingly common utilization of reference laboratories for more specialty or specific testing options, the role of the clinical laboratory has expanded dramatically as a department in regards to shipping and receiving. Additionally, the presence of a core laboratory in larger facilities results in a surplus of specimen transfers within the healthcare organization or institution. Because of this, laboratory leadership must ensure regulatory compliance to the International Air Transport Association (IATA) and the Department of Transportation (DOT). According to Pentella, all clinical specimens must be shipped as either Category A or Category B infectious substances.

“If specimens are shipped between clinical laboratories using commercial carriers, there are DOT and IATA regulations that must be maintained during the shipping process,” continued Egan. “These regulations ensure that appropriate packaging is utilized as well as appropriate documentation is transported with the specimens.”

Not only are there governing organizations, but also state and federal regulations to provide oversight on clinical specimen shipping. In 24 hour labs, the constantly changing shifts of medical laboratory personnel require multiple professionals to be certified to handle clinical transport in order for the facility to always have someone on hand to handle shipments.

In addition to maintaining regulations, the true importance of shipping and receiving protocols ultimately comes down to the safety of patients and healthcare staff. As clinical technology has improved over the years, the role of the laboratory in the everyday healthcare environment has become unprecedented in both diagnostics and confirmatory testing. By requiring certification and training in clinical shipping processes as well as competencies to assure adherence to shipping and receiving SOPs, laboratories have standardized the process, providing structure and mitigating potential threats.

“What we ship and receive hasn’t changed much, but there are more requests for testing. The requirements for shipping have changed a great deal over the years, so now there is much more standardization and structure to the process,” explained Pentella.

As is the case with all aspects of the clinical laboratory in modern day healthcare, specimen transport is a precisely monitored and regulated practice. The extensive knowledge base provided by training and oversight has led to a relatively low-risk laboratory shipping environment. Pentella mentioned that there has never been a reported incident of a laboratory shipping infectious disease agents that have resulted in an infection.

Since its inception, clinical laboratory testing has become a staple of the healthcare industry. The ability to send out or receive specimens for extended or specialty testing is an aspect of care that both patients and practitioners rely on – even if it isn’t commonly discussed. The presence of safety protocols, regulatory measures and quality practices in specimen transport is essential to maintaining the innumerable benefits of laboratory testing.

Michael Jones is on staff at ADVANCE.