Dave Majewski
Mayo Clinic Labs @Work
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I'm one of the two supervisors of the HIV/Hepatitis Laboratory. I've been a supervisor in the Department of Laboratory Medicine and Pathology (DLMP) for more than 15 years, and I've been in my current role for 2½ years.
Before COVID-19, I was supervising the Hepatitis/HIV Lab, which has two separate work units: Hepatitis/HIV Serology Lab (HHS), and Hepatitis/HIV Molecular Lab (HHM). I had about 42 staff members. In HHS, we focused on antibody and antigen testing for diagnosis of hepatitis and HIV. HHM focused mainly on testing for those two diseases, confirming diagnoses, performing quantitation of virus for patient monitoring, and sequencing for drug resistance.
Both halves of the lab have been affected by COVID-19 testing, but there's been significantly more impact on HHM. The HHS test volume dropped when the pandemic began. We had several HHS staff volunteer to temporarily move to HHM to help with testing. But then COVID antibody testing came along, so we brought up testing for that in HHS and moved those staff back.
The impact was more dramatic in HHM. We went from 21 people originally to somewhere in the range of 240 people now. We went from two shifts Monday through Friday, with one Saturday shift, to 24/7 testing. We'll soon hit two million COVID tests performed since we went live.
The overall day-to-day for me has changed. I spend more time communicating to DLMP leadership and others in the institution to keep them informed on what is happening in the lab, so they can make decisions. I have been required to delegate large portions of my previous workload to the assistant supervisors and specialists. The amazing work of the HHM redeployed assistant supervisors and specialists has really driven the majority of our successes.
Our staff makeup has flipped in that we now have a large majority of the staff being relatively new to a testing laboratory. The staff have all had accelerated onboarding and learning plans with less-than-ideal, one-on-one feedback from being in a high-production/pressure lab, which brings training, efficiency, and quality challenges. Over time, this has improved, and we continually work on improvements.
Continuous and rapid change. For example, I recall being on a routine phone conference with a vendor on a Wednesday evening in early March. At the end, they said, "Dave, we'll have to contact you in a couple of days about a possible COVID test we may have available." I didn't think much of it.
The following morning, I got called to a meeting with our lab director, operations manager, and administrator who told me our team had about three to four weeks to come up live on a COVID-19 test. That usually takes six to nine months. The HHM management team jumped in and refocused our priorities and started to figure out how to get it done. Then in a meeting at the end of that day, the timeline changed, and it needed to be done in two weeks. By nine a.m. the next morning, the timeline changed again and leadership said, "Dave, your team will have until next Wednesday."
Within 119 hours, our team was able to adjust staffing, add equipment, validate the test, train staff, and go live. This was only achievable with a lot of support from many other areas. And that was just the first COVID test platform go-live. HHM has gone through five separate platform implementations. Within the first several months of the first test, we had to remodel our lab three times to expand for additional testing platforms. Now we have the equipment and infrastructure to test about 27,000 tests a day, just for COVID.
It's all the teamwork and effort toward a common goal for a greater cause. Everyone in the institution is supporting us. The entire HHM staff, Facilities, Administration, departmental Information Technology, DLMP leadership support, and especially Dr. (Joseph) Yao, our lab director, who has worked tirelessly to lead us. Three other groups — DLMP process engineers, Specimen Operations and Supply Chain Management — have been key partners. Without their help, we would not have met expectations.
We had many redeployed staff come to help. Without them, it would have been very difficult, if not impossible, to have met the early volumes to produce results in a timely manner. Facilities did a remarkable job to rearrange with short notice on multiple occasions. All the supervisors around us offer to help, knowing we're completely swamped. If we need something, someone is there to provide assistance. The attitude of overcoming challenges as a team and not dwelling on individual concerns is inspiring to me.
I've always enjoyed my co-workers, both learning from them as well as working with them for a greater cause in a team environment. I've never lacked this at Mayo Clinic and certainly have had no shortage of this in the last eight months. It challenges me to get better and inspires me to come to work with a smile every day.