Koror, Republic of Palau 57th PIHOA Executive Board Meeting 9-13 March 2015 Koror, Republic of Palau 12/7/2018 Manasa Mainaqelelevu

AUL Association of US-Affiliated Pacific Island Laboratories (AUL) 12/7/2018 Manasa Mainaqelelevu

Overview of the USAPI Laboratories PAL ASA THC CHK ASA LBJTMC CLIA-regulated PIHOA Regional Lab Initiative PNI CNMI CLIA-waived Association of USAPI Labs KOS GPHL Non-regulated YAP EBE MAJ All (except GPHL) provide both public health & clinical lab services

Vision The vision of Association of US-Affiliated Pacific Island Laboratories (AUL) is to provide support and resources to the laboratories in the USAPI region ensuring delivery of quality assured laboratory testing services that impact the health and welfare of the people in the region 12/7/2018 Manasa Mainaqelelevu

Mission Statement The mission of Association of US-Affiliated Pacific Island Laboratories (AUL) is defined as: The AUL is organized as a unified voice to advocate for support in addressing the needs and challenges of the medical laboratories and promote the value of our profession in the USAPI. 12/7/2018 Manasa Mainaqelelevu

STRENGTHS Commitment and dedication of the members to sustain the AUL. Desire of AUL members to implement LQMS Collaboration among AUL members despite geographical and cultural diversity Established and effective specimen transport system Effective communication network 12/7/2018 Manasa Mainaqelelevu Manasa Mainaqelelevu

Major Goals that Support the Objectives Strengthen lab network in the USAPI countries through information sharing and open communication Objective Sustain quarterly telephone conferences Methods The AUL president initiates scheduling of teleconference with the AUL members and the PIHOA regional laboratory coordinator. The PIHOA regional laboratory coordinator confirms schedule with AUL members and participants. Outcomes The AUL meeting are held quarterly and minutes for each meeting are compiled by the AUL secretary and president. 12/7/2018 Manasa Mainaqelelevu

Sustain biennial AUL meeting Objective Sustain biennial AUL meeting Methods The AUL membership creates proposal for continued support to sustain AUL biennial meeting to the PIHOA board. Outcomes Depending on availability of funding, biennial meetings are convened. Promote excellence in laboratory services through collaboration and implementation of laboratory quality management system criteria 12/7/2018 Manasa Mainaqelelevu

Objective Develop jurisdictional national laboratory policies and plans by December 2014 Methods: PIHOA - collect and share samples of national laboratory policies and plans by September 30, 2013 Review existing national laboratory policies by AUL members by March 2014. Draft/update policies by June 2014. 12/7/2018 Manasa Mainaqelelevu

Endorsement of drafted national laboratory policies and plans by December 2015 Methods: Individual jurisdictions present the national laboratory policy and plan to their Ministry of Health by January 2015 Presentation of national laboratory policies and plans to the PIHOA Board of Directors by end of 2015 Outcome: Endorsed national laboratory policy and plan in each USAPI 12/7/2018 Manasa Mainaqelelevu

Implement LQMS in the USAPI laboratories Methods: Objective Implement LQMS in the USAPI laboratories Methods: Development of quality laboratory manual for each USAPI laboratory by June 2015 PIHOA will share with USAPI laboratories the CLSI-WHO-CDC LQMS training toolkit by October 30, 2013 USAPI laboratory managers conduct onsite LQMS training for all laboratory staff by December 2014 Outcome: Drafted laboratory quality manual Completed LQMS training on the 12 QSE 12/7/2018 Manasa Mainaqelelevu

Maintain NCD surveillance activities Methods Objective Maintain NCD surveillance activities Methods Compile NCD-related laboratory testing data for sharing with jurisdictional partners monthly Submit compiled data to PIHOA quarterly Outcomes Updated NCD-related laboratory testing statistics shared with NCD stakeholders 12/7/2018 Manasa Mainaqelelevu

Strengthen jurisdictional networking activities during outbreak events Methods Review and update existing laboratory response plans with PHEP program and hospital by March 2014 Implement laboratory protocol during outbreak response by June 2014 Outcomes Documented protocol Developed checklist for lab response to outbreak Evaluation report from checklist 12/7/2018 Manasa Mainaqelelevu

WEAKNESS Lack of jurisdictional resources (human and financial) If the HR & financial management can confirm a budget for laboratory >> lab management plan & function accordingly. Challenging transportation issues This issue is inevitable>> inconsistency in shipping. Communication gaps between laboratory and departments/ministries of health management If the PIHOA board can communicate with the hospital management and the Ministry of Health regarding the AUL request>>> we need a feedback on the negotiation developments to alert us on the follow ups that we need to do. Low salaries and incentives for trained laboratory professionals All laboratory jurisdictions need to develop a career ladder >> liaise with HR in terms of salary grading and incentives and get it endorsed>> PIHOA board needs to be acknowledged. Jurisdictional laws that impede laboratory operations (e.g. procurement laws) Different jurisdictions have different procurement operations and laws. AUL need to be acknowledged about these differences and address the issue with the PIHOA board >> influence change in the procurement laws to ease laboratory operations. Retention of qualified laboratory professionals Development of a bond agreement should be initiated before staff goes off for a training programme [e.g.. BMLS ] to retain them>>> lab management should cite the bond agreement before succession planning for continuous staff training. 12/7/2018 Manasa Mainaqelelevu

OPPORTUNITIES Technical assistance and financial support from PIHOA, APHL, CDC, CLSI, SPC, WHO, PPTC Available training opportunities in LQMS and other laboratory-related subjects Access to professional development opportunities – WHO-POHLN/PPTC PPTC –administered EQA Access PACNET-lab 12/7/2018 Manasa Mainaqelelevu

How can PIHOA assist the AUL in: Consistent support in maintaining its capabilities and strength Resolving its weaknesses and be an influential mediator of negotiations with the upper hierarchy of leadership in the jurisdictions. Stepping up prior opportunities in terms of educational development, technical assistance and financial support. 12/7/2018 Manasa Mainaqelelevu

AUL GUAM MEETING 2015 AUL need do know: How Guam Public Health Laboratory [GPHL] can assist AUL members in terms of testing capacity and capabilities? How GPHL can assist the AUL members in professional development? 12/7/2018 Manasa Mainaqelelevu

Endorsement of our NCD tests by the AUL members PIHOA board to cite and endorse that ALL jurisdictions should have these tests available. 12/7/2018 Manasa Mainaqelelevu

LABORATORY COURSES/CERTIFICATION Any completion of a course or certification [PPTC Diploma MLT, BMLS, ASCP, AMT] needs to be recognized and incentives provided accordingly. PIHOA can assist in dialogue to the upper hierarchy of management and leadership if this could be put in place. 12/7/2018 Manasa Mainaqelelevu

LABORATORY ATTACHMENT Training and off island laboratory attachment is very vital and beneficial for laboratory staff. Senior laboratory staff are recommended for this attachments. Upon completion, they should implement development and ‘train the trainer’ in their relevant lab departments. [Capacity Building] PIHOA/SPC can assist in negotiating staff attachments in the recommended laboratory through Laboratory Management and Ministry of Health and having a MOU in place for this important activity of development. Also if PIHOA can identify certain funding organizations to cater for the attachments. 12/7/2018 Manasa Mainaqelelevu

TRAINING Continuous short term training/refresher training to be initiated by all the jurisdictions for their laboratory staff. PIHOA can identify funding organization who can partially fund this short term training programme together with the Hospital/ MOH of each jurisdiction. 12/7/2018 Manasa Mainaqelelevu

Career ladders need to be established by individual laboratories. All professional development activities need to be acknowledged by the respective jurisdictions and incentives provided accordingly. 12/7/2018 Manasa Mainaqelelevu

COMMON SUCCESSESS Improved Turn Around Time [TAT] of test results. Provision of new testing analyzers. Staff upgrade > PPTC Diploma MLT graduates > BMLS graduates CONSISTENCY NEEDS TO BE MAINTAINED!!!!! 12/7/2018 Manasa Mainaqelelevu

COMMON CHALLENGES Shipping costs MOU for shipping for outbreak prone diseases. Suggest using PIHOA revolving fund where each lab submits $2K for shipping…rather than trying to reimburse after the fact. Reagent shortage Depending on transportation route and proximity of geographical location; island jurisdictions can assist relieve reagent shortage, therefore, communication and networking is very important. Lack of qualified staff 12/7/2018 Manasa Mainaqelelevu

BIENNIAL AUL Funding support required to sustain biannual meetings, conference calls and training support. PIHOA secretariat can’t commit to providing funds but will work with APHL to try to secure these funds. 12/7/2018 Manasa Mainaqelelevu

Short term laboratory attachments. Overall if PIHOA can assist AUL by identifying funding organizations for the following Short term laboratory attachments. Short term training offered by educational institutions. 12/7/2018 Manasa Mainaqelelevu

Overall if PIHOA can assist AUL in negotiating the following with the respective MOH: Any completion of a course, training or certification [PPTC Diploma MLT, BMLS, ASCP, AMT] needs to be recognized and incentives provided accordingly. Attachment of laboratory staff in major laboratories of their choice and convenience through establishment of a MOU. 12/7/2018 Manasa Mainaqelelevu

AUL recommendation: Face to face meeting is more informative, interactive and productive. Issues are deliberated, resolution timelines are confirmed and updates of feedback from PIHOA , APHL, CDC and SPC is consistently delivered. Recommend that the AUL meeting is held annually with the above organizations to consistently follow through with our jurisdictional developments, issues and resolutions. 12/7/2018 Manasa Mainaqelelevu