Inside a Clinical Lab During the COVID-19 Pandemic

Laboratories are challenged to maintain testing quality and efficiency amid an increased demand for service and the ever-changing dynamics of the pandemic

The COVID-19 pandemic has challenged the healthcare industry across the spectrum in the effort to deliver patient care. The challenges have been particularly stark for our laboratory system, Sentara Healthcare, in meeting the need to provide accurate, reliable testing, not only for COVID-19, but also for all other patient testing. Amid the increasing demand for services and the ever-changing dynamics of the pandemic, our laboratory system’s goal is to maintain testing quality and efficiency.


            Our laboratory system quickly responded to the crisis by setting up a Laboratory Incident Command Center (LICC) to direct the flow of information across 18 labs. Clear communication is critical to the coordination of supplies and other resources across a large multi-state healthcare system, especially when the situation on the ground is continuously changing. Having a central command to discuss issues from different perspectives contributed to arriving at the best answers.

            The LICC is manned by the laboratory administrative directors and the system quality coordinators. Numerous reports are generated daily and shared with the laboratory managers and administrators throughout the system through video-conferencing. During the daily morning report, laboratory managers are provided information on the highlights, problems, solutions to issues that arise in an attempt to provide testing for patients and answers to healthcare providers. The phone lines are continuously ringing with questions from all across the system.

            The LICC also keeps track of the daily volume of tests and swabs used, the level of personal protective equipment supplies, and handles even small issues like a label printer not printing in the emergency room. With the shelter-in-place order from the state and the closing of schools, there have been additional staffing variables requiring solutions.  

Blood utilization

            In the beginning, the issue of blood utilization was a concern. To avoid a possible blood shortage, elective surgeries were categorized on a tier system to prioritize only those needing to be performed to eliminate harm to patients. Another issue involving blood was that our healthcare system frequently promotes and assists the American Red Cross in blood drives. The blood drives usually involve mobile units; however, it was quickly noticed that using mobile units would reduce the number of people able to donate because of the need to practice social distancing. Fortunately, our local hotels and restaurants stepped up and volunteered their spaces for blood donation locations.


            In response to the increased public demand for testing, our healthcare system set up four tents for drive-in public COVID-19 sample collection. Dedicated laboratory employees assist healthcare providers from our medical group in swabbing patients arriving to get tested for COVID-19. Despite inclement weather, these committed medical workers continue to provide essential services to the public.

            Our laboratory system also decided to do something about one of the biggest problems of the pandemic—the lack of testing. Our molecular scientific director worked tirelessly to set up a lab in a former lab office with new equipment to start onsite testing. Despite experiencing the same obstacles as the rest of the nation in getting the reagents needed for testing, our laboratory was able to get an instrument validated and up and running in about a week. In addition, we’ve also begun implementing a plan to bring in a larger instrument to increase our testing capacity.

            The laboratory professionals in our system have certainly answered the call of the nation in adapting and sacrificing to continuously provide quality patient care. 

Darryl Elzie, PsyD, MHA, MT(ASCP), CQA(ASQ)

Darryl Elzie has been an ASCP medical technologist for over 30 years and has been performing CAP inspections for 15+ years. He is also a certified quality auditor (ASQ). He currently works for Sentara Healthcare. Darryl provides laboratory quality oversight for four hospitals, one ambulatory care center, and supports laboratory quality throughout the Sentara system.