University Health

Stephanie Whitehead

Please walk us through your journey within the infection control industry and your current roles and responsibilities at University Health.

Over 15 years ago, I started my career in the blood bank department. With immense hard work, and perseverance, I worked my way up to laboratory administration.Throughout my career, I explored different pathways in laboratory medicine to find my niche and passion. Two years after completing my bachelor’s in medical technology, I went back to school to get my master’s in public health, as I found my interests in community health and community education as well as public health and epidemiology. It helped me understand how public health intersects with laboratory medicine for the benefit of the community.

After going back to school again to pursue my master’s in business administration and exploring my leadership roles, I worked as an infection preventionist at a healthcare firm for around a year. I learned and understood the importance of infection control in the healthcare industry and the various tactics and methods that employees can employ to keep themselves and their patients safe. I was also an adjunct faculty member for a while and taught health ethics for an online university.

I currently serve as University Health's executive director of pathology services in San Antonio, South Texas. Our healthcare system is very extensive, including inpatient and outpatient care.

An adequate laboratory infrastructure and an implemented bio-risk management system form the basis of infection prevention and control in the laboratory setting. How do you think this trend concerning emerging diseases develop in the future?

An adequate bio-risk management system enables the laboratories to carry out highquality tests, preventing laboratory accidents as well as assisting in proactively addressing potential risks, performing quality audits, and reducing any near-misses or incidents that may occur. As the world moves past the horror of Covid-19, there are many other emerging diseases on the horizon, like Ebola and Monkeypox, which have led us to review our current laboratory practices . By doing review inside a laboratory, we identify the shortcomings of the current practices and incorporate methods and tactics that can help us better address things that may be coming down the pipeline. We take an interest in evaluating our technical space and workspaces for additional tasks like our supply storage or where we keep our instrument reagents or our workstations to ensure that we have enough room for appropriate biosafety and biocontainment.

“good surveillance mechanism is as important as any other factor for an infection control program in the healthcare industry”

There are many developments we can be excited about and learn from the laboratory community. One of the biggest lessons we learned during COVID is the importance of collecting samples safely and enhancing communication between healthcare professionals to help minimize as much risk as possible.

There will be continued improvements to standard operating procedures concerning biosafety, like newer advancements in the usage of PPE that would help protect healthcare professionals from emerging diseases. Many vendors have come forward with advances in their instrument technology for disinfection and the carryover of diseases. We'll continue to see more enhanced evaluations and risk assessments, or predictive models, performed with our current practices and equipment. This includes the usage of bio containment, bio safety cabinets, and more detailed surveillance reports.

My experiences in our personal laboratory strongly indicate that the laboratory space will continue to work on evolving in two things: organization structure and physical structure. Through our organizational structure, we have found value in supporting or ancillary roles in our laboratory. We've added these positions, like facility and nursing staff, to our teams, such as our laboratory educator, project managers, and a more robust quality team, which were traditionally under a lab supervisor's or lab manager’s purview. However, like most other service lines in healthcare, the laboratory has also experienced a severe workforce crisis and a shortage of professionals, which was exacerbated by the pandemic. The ancillary roles step up in such situations and help ensure the management staff can continue to focus on staff engagement, team development, recruitment, and retention.

What approach should a healthcare organization consider while implementing an effective infection prevention program, ensuring it meets the regulatory requirements and goals regarding infection control?

There are a lot of aspects to having a strong infection control and prevention program. The foremost among them is having the expertise needed to support an organization, be it infection preventionists, laboratory support, or data support, from within, followed by developing an affection control plan. It helps guide and instruct an organization on protecting its staff and patients while identifying the risk for each population.

Employee training is something a healthcare organization can never compromise on, as it is imperative that the employees understand and are educated on their roles and responsibilities in infection control programs. Most firms in the healthcare sector make use of benchmarks to understand and evaluate their current state. It acts as a feedback tool and an encouraging factor for the employees by making clear the goal they are working toward. Once everything is in place, it is also a good idea to have clearly defined policies and procedures that everybody is following.

A good surveillance mechanism is as important as any other factor for an infection control program in the healthcare industry. Most accredited organizations have precise surveillance definitions to collect data consistently and have a mechanism in place to accurately report those definitions so that comparable data can be acquired on where the organization stands . Incorporating a multidisciplinary committee to assist with oversight will also be helpful as a final step.

What are some of the infection control initiatives or programs you have spearheaded as a leader at University Health, and how are they making a difference within the industry?

The transport assessment using our pneumatic tube was one of the initiatives spearheaded by the laboratory in our organization. As the intensity of the pandemic increased, there were shortages in staffing. Certain samples had to be handdelivered to the laboratory to reduce the biocontainment risk. We didn’t consider the pneumatic tube system initially as we weren’t ready to risk leakage and spillage of specimens.

With multiple shortages and different service lines, we noticed an increase in turnaround time and difficulty in the timely diagnosis of patients. So we worked on a detailed risk assessment guided by some information found through the CDC on transporting our specimens using the new pneumatic tube system that included detailed education for all the staff— an entire risk assessment on how to decontaminate.

What are some of the disruptions you envision in the infection control space, and how will it impact the industry at large?

I am optimistic about the advancements in infection control space in three major areas: our ability to better analyze tests, identify outbreaks sooner, and provide information that will help doctors and clinicians diagnose and treat their patients better. There are many antimicrobial resistance tests emerging in the industry right now, and many expansions are happening in the laboratory’s capability to detect new and emerging diseases. We are frequently the first to detect an outbreak and assist in identifying infection clusters. We help with contact tracing, infection control, and understanding the next steps to reduce the risk.

As a piece of advice for my peers, I would like to say that if you don't have the expertise that you need in your organization, make a financial plan to get the support that you need to enhance your infection control team and ensure that your employees see infection control as a part of their day-to-day job role. Work through your financial plans to correct any challenges that may prohibit you from maximizing your infection control plan. Investing in resources will pay off dividends with an immeasurable return