Laboratory Efficiencies Initiative (LEI)

The Nation’s public health laboratories perform critically needed services to protect the public’s health and support patient treatment. However, state and local public health laboratories operate under intense pressures. Deep budget cuts have affected their resilience and led to: reduced laboratory testing capacity; termination of certain types of tests; and, in some cases, impaired support for outbreak investigation, surveillance, and emergency response.
The goal of the Laboratory Efficiencies Initiative (LEI) is to build a sustainable public health laboratory system in the United States. The LEI will help public health laboratories across the country adopt new, high-efficiency management practices, building a strong platform for current and future test services.

Partnership for Health Protection

CDC and the Association of Public Health Laboratories (APHL) co-sponsor the LEI, with important contributions made by public health laboratory partners. The high-efficiency management practices that are being explored are:

Sharing of testing services across states
Optimum models of service organization
Adoption of standardized testing platforms
Laboratory workflow assessments to identify operating system efficiencies
Generation of new revenue sources
Procurement cost-savings
Application of informatics solutions
Public health laboratory workforce development

Initial LEI Activities

Beginning in mid-2011, APHL and CDC have:

Sponsored focus groups on a few of the above-mentioned management practices, in addition to focus groups to identify practical metrics for measuring the return on investment in public health laboratories.
Initiated recommendations and activities to improve the collection, management, and access to data on existing test service capability in state and local public health laboratories. Access the December 2011 Test Service Data Meeting summary at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2012Jan_PHL-Service-Data-Meeting-Summary.pdf [PDF 27.29KB] and the April 2012 Test Service Data Meeting summary at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2012April6_APHL-CDC-PHL-Service-Data.pdf [PDF 178.51KB].
Launched the development of a test platform standardization strategy so that assays can be developed, deployed, and used by public health laboratories in a manner that maximizes the financial and personnel resources available. Access the April 2012 Standardization Meeting summary at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2012April11_Standardization-Platforms-Summary-Report.PDF [PDF 259.48KB].
Initiated a project to assess public health laboratories' informatics capabilities and address barriers to efficiency. Access the December 2011 Informatics Meeting summary at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2011Dec15_Informatics-Meeting-Summary.pdf [PDF 193.76KB] and the May 2012 Informatics Meeting summary at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2012May_Informatics-Meeting-Summary.pdf [PDF 185.34KB].
Held Director’s Forums to gain invaluable input from state public health laboratory directors from across the country. Access a summary of the Forums at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2012April_PHL-Directors-Forum.pdf [PDF 360.36KB].
Initiated a project to identify the legal and policy barriers and potential solutions for public health laboratories to achieve greater efficiency. Access the August 2012 Policy Meeting summary at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2012Aug17_Legal-Policy-WorkGroup-Meeting-Summary.pdf [PDF 153.07KB].

New Sustainability Resources in Development

Laboratory Service Change Guide
A practical guide for public health laboratory directors considering new approaches to testing services. The completion of the guide was announced at the 2012 APHL Annual Meeting & 6th Environmental Laboratory Conference (May 2012) and is available in the “LEI Information” box above.
Informatics Self-Assessment with Guidance
A tool to assist laboratories in sustaining current capabilities and addressing gaps through standards-based best practices.
Procurement Strategies
Helping laboratories implement new business approaches to make equipment, services, and supplies more affordable. Access the January 2012 Procurement forum summary at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2012March_NCPHLL-Procurement-Meeting-Summary.pdf [PDF 2.64MB].
LEAN Training
Helping laboratories analyze workflow techniques to eliminate inefficiencies from laboratory procedures and the laboratory workspace.
Workforce Competencies
Developing a comprehensive set of competencies for the public health, environmental, and agriculture laboratory workforce to address multiple workforce needs such as defining appropriate job descriptions and performance appraisals. Access an overview of the laboratory competencies project at http://www.aphl.org/aphlprograms/lss/Laboratory-Efficiencies-Initiative/Documents/LEI_2013Jan_PHL-Competencies-Project-Overview.pdf [PDF 500.81KB].