title: Training costs and investment payback of implementing molecular diagnostics for identification of vancomycin resistant enterococci in a clinical microbiology laboratory.
abstract: Molecular diagnostics may be a more efficient method to manage resources; but most Microbiology laboratories have not introduced them into routine use due to the specialized training required. Using vancomycin resistant enterococci (VRE) screening during a comparison of a multiplex PCR (MPCR) and conventional biochemical testing (CBT) we studied 3 objectives: 1) to develop a molecular diagnostics in-house training program, 2) to assess the training program outcomes for competency and confidence, and 3) to determine laboratory payback. A training program for 14 technologists using multiple adult learning methods was implemented. Methods to minimize technical errors were introduced and included: use of a calibrated loop to deliver sample; prealiquotting reagents; increasing volume of specimen; addition of gel loading dye directly into reaction tubes; and establishment of an equivocal zone. In our laboratory MPCR costs $7.06 less than CBT, therefore the payback period for training and implementation would be approximately 3 years.
authors.affiliation: Hamilton Regional Laboratory Medicine Progam, St. Joseph's Hospital, Hamilton, Ontario, Canada.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Page
authors.forename: Astrid
authors.initials: A
authors.lastname: Petrich
authors.forename: Don
authors.initials: D
authors.lastname: Stevens
authors.forename: Kathy
authors.initials: K
authors.lastname: Luinstra
authors.forename: Sandra
authors.initials: S
authors.lastname: Callery
authors.forename: Amiram
authors.initials: A
authors.lastname: Gafni
authors.forename: James
authors.initials: J
authors.lastname: Mahony
authors.forename: Max
authors.initials: M
authors.lastname: Chernesky
authors.forename: David
authors.initials: D
authors.lastname: Groves
mesh_terms: D003362:Cost-Benefit Analysis; D004493:Education / Q000191:economics* / Q000379:methods / Q000592:standards; D016983:Enterococcus / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D007753:Laboratories / Q000191:economics / Q000592:standards; D013677:Medical Laboratory Science / Q000191:economics; D008829:Microbiology; D016133:Polymerase Chain Reaction / Q000379:methods* / Q000592:standards; D020713:Vancomycin Resistance; D000078329:Workforce