Lab Matters Summer 2018 - Page 72

APHL 2018 Annual Meeting Poster Abstracts diagram and clarify the algorithm by which specimens are processed, identified and reported. This process map was used to identify key gaps in current practices and areas that could be improved. Key indicators, such as turnaround time data, were retrospectively queried to identify areas that were not meeting our benchmark goals. Results: Four key areas were identified that hold the potential for improvement: Initial identification of specimens, anti-mycobacterial susceptibility testing (AST), recording and reporting of results and media contamination. In order to improve these key areas, between three and five actionable recommendations were made for each. Key indicators were assigned to monitor each of these metrics quantitatively, including monitoring of turnaround time for individual steps in the process map, overall turnaround times, rates of reporting error and contamination rates. As individual changes are implemented on an ongoing basis, continued monitoring of these indicators will be compared to baseline to see which changes are useful in improving laboratory processes and efficiency. Presenter: Dana Woell, MPH, New Jersey Public Health and Environmental Laboratory, Ewing, NJ, Phone: 609.671.6428, Email: dana.woell@doh.nj.gov Laboratory Testing for HIV on OCME Specimens at the New York City Public Health Laboratory: History and Opportunity A. DeVito 1 , M. Moy 1 , K. Rabinovitz 1 , V. Streva 1 , E. Westheimer 1 , S. Ly 1 , S. Braunstein 1 , J. Rakeman 2 ; 1 New York City Department of Health and Mental Hygiene, New York, NY, 2 New York City Public Health Laboratory, New York, NY At the start of the AIDS epidemic in the 1980s, the New York City Department of Health and Mental Hygiene (DOHMH) Public Health Laboratory (PHL) began HIV testing of all cases of suspicious death brought to the NYC Office of the Chief Medical Examiner (OCME) for fear of missing AIDS cases. Currently, the Bureau of HIV/AIDS Prevention and Control (BHIV) maintains NYC’s HIV Registry, a population-based registry of all diagnosed cases of AIDS and HIV infection in NYC¹. The goal of this study was to retrospectively determine the number of cases from OCME that had been previously diagnosed with HIV and therefore were already present within the HIV Registry prior to death and use this information to inform the future direction of HIV testing of these cases at PHL. Using data retrieved from the PHL laboratory information system, StarLIMS, all reactive and indeterminate results from specimens received from the NYC OCME for HIV testing between October, 2013 and November, 2017 were analyzed. PHL data was matched against the HIV Registry using a deterministic matching algorithm. Descriptive statistics were gathered using Microsoft Excel and PowerPivot. This retrospective analysis included data from October 15, 2013 (the earliest data available in StarLIMS) through November 21, 2017. During this period, PHL conducted 30,529 HIV tests on 19,920 unique specimens received from the NYC OCME. Of these, 1,101 (5.5%) specimens from unique cases were reactive for HIV. Forty-eight (0.24%) specimens from unique cases had indeterminate results. After matching against the HIV Registry, 1,060 (92.25%) cases were found to already be known HIV-positive patients. HIV-positive OCME cases were overwhelmingly male (852 male and 272 female) and had a median age of 53 years at the time of death. Sixty-nine and 21 patients had no record of date-of- birth or sex-at-birth, respectively. Fifty-nine (5.13%) patients were 70 LAB MATTERS Summer 2018 diagnosed by post-mortem testing performed at PHL (i.e., were not in the HIV Registry at the time of death). Results for 30 patients were unable to be matched to the registry. This was due to a number of reasons including indeterminate status, lag time between testing and entry into the registry, pediatric exposures, missing lab results, and missing name and/or DOB in the PHL dataset. Because so few new HIV cases were found through post-mortem testing, this data strongly suggests that DOHMH testing, outreach and surveillance is reaching at-risk populations. Future efforts include modifying OCME specimen testing algorithms so PHL staff are able to search the name of the decedent in the HIV Registry prior to testing, reducing unnecessary testing. Overall, this study provided a new lens into New York City’s evolving approach to HIV testing and revealed an opportunity for saving precious laboratory resources. Presenter: Andrea DeVito, MPH, CPH, New York City Department of Health and Mental Hygiene, New York, NY, Phone: 212.671.5742, Email: adevito@health.nyc.gov Arbovirus Molecular Testing at New York City Public Health Laboratory During the Zika Outbreak B. Deocharan, J. Fu, R. Gu, M. Rasul, J. Hom, S. Glaesker, D. Liu, J. Rakeman, New York City Public Health Laboratory, New York, NY After the first confirme