On March 16th, 2020, the World Health Organization Director-General Tedros Adhanom Ghebreyesus stated the WHO’s key aggressive public health response to combat COVID-19 is to “test, test, test. Test every suspected case.” 

U.S. medical facilities and public health departments have responded to the need for increased testing by rapidly implementing off-site testing centers, which reduce the risk of exposure to patients and medical staff as well as minimize the use of Personal Protective Equipment. To develop practical considerations based on the early lessons learned from implementation of these testing sites, the Network for Regional Healthcare Improvement (NRHI) and NRHI member and research partner, Qualidigm, kicked off a four-week rapid cycle research project at 11 sites across the country. 

The resulting timely guidance was identified based on qualitative analysis of interviews with regional leaders. Roles of the interviewees varied depending upon responsibility for setting up the testing sites and ranged from medical directors to safety and quality officers to infection preventionists. The questions were aimed at capturing description of the testing site including physical aspects, staffing and procedures, partners involved, and importantly, the challenges these early sites were navigating through. The research team included an epidemiologist, infection control expert, and qualitative research scientist and was supported by a private foundation, national thought leaders, and regional advisors across the NRHI membership. They identified five key preliminary considerations for off-site testing:

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Early feedback from regional and national leaders indicate a strong need for this information, and advisors were eager to obtain and disseminate the information to partners on the front lines. A detailed one page summary of the key considerations has been disseminated broadly to support sites looking to establish testing centers. Feedback received indicates appreciation for this easy to access resource that can be adapted for needs of a community that is first establishing or work to scale and improve their off-site testing. With the full report expected to be published in a peer-reviewed journal next month, we will work with well-networked national thought leaders to accelerate spread and adoption.  

While the results of this early work have been quickly adopted by leaders across the country, we recognize ongoing research is imperative given the ever-evolving landscape which includes changes to the availability and types of testing and supplies. With predictions for a second wave of the virus spiking in the fall, the nation needs to be better prepared for testing demand. To that end, we will expand our research over the next several months by working with clinical leaders and public health departments to develop guidelines and an online toolkit for use by those aiming to accelerate ongoing improvement of off-site testing practices. 

To learn more, contact the project team at covid19@nrhi.org.

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Author, Member

Craig Brammer

President and CEO - Network for Regional Healthcare Improvement

Craig Brammer serves as President and CEO of the Network for Regional Healthcare Improvement (NRHI) & The Heal... Read Bio

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Timothy Elwell

President and CEO - Qualidigm

Timothy Elwell serves as President and Chief Executive Officer of Qualidigm. Read Bio

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