X4-R

Planning for Challenges to Clinical Laboratory Operations During a Disaster; A Report

NCCLS document X4-R-Planning for Challenges to Clinical Laboratory Operations During a Disaster; A Report was written for use by laboratory managers, directors, and supervisors, and is intended to provide a checklist of considerations to be used to assess preparedness and begin planning for continuance and redirection of clinical laboratory services during emergency situations. Emergency situations that are associated with large numbers of injured or dead (which will require an acute demand for laboratory services) may also result in catastrophic disruptions in laboratory services. The emergency may be associated with a variety of very different causes: natural, accidental, or terroristic. In each case, emergency operational procedures are necessitated by loss or degradation of infrastructural elements, upon which routine laboratory operations are dependent. Sample infrastructural insults include: interrupted access to utilities (electrical power, clean water, and refuse disposal), climate control, transportation of clinical specimens, and electronic test ordering and reporting. In both natural and man-made disasters, including events such as hurricane, flood, earthquake, and explosion, it is likely that more than one infrastructure element will be lost. In other instances, including accidental or terroristic exposure to infectious, chemical, or radiological agents, it is likely that utility infrastructure will remain operational, but there may be breakdowns in system components, possibly including quality assurance for clinical specimen testing and reporting, as well as reporting public health issues. All of these issues are complicated by the possibility that some laboratory staff may be unable or unwilling to report to work. This report is written in an expanded checklist format. It outlines the important considerations laboratory professionals must make to identify infrastructure and systems that may be at risk of failure during natural and man-made disasters.