Iskander: Hello, I'm Dr. John Iskandar.
Welcome to CDC Beyond the Data.
I'm here today with Dr. Steve Monroe the first Associate
Director for Laboratory Science and Safety at CDC.
Thank you very much for joining us today, Dr. Monroe.
Monroe: Well thanks for the invitation to be here.
Iskander So in today's Grand Rounds
on strengthening a culture of laboratory safety,
we heard a lot of different types of information
about lab science at CDC.
Could you start just by giving us a quick tour of the history
of lab science and of its significance at the modern CDC?
Monroe: Lab science has been at the core of what CDC does
since its inception and even since the early days
of the Malaria control in war areas that preceded CDC.
And particularly in the early days when all the focus
of CDC was on infectious work,
the laboratory component was an important part
of what CDC did every day as it is today.
Iskander: So now sort of fast-forward to the present,
we now have labs that are involved in more
than just infectious disease pathogen detection.
What are some of the areas that people might not be aware
of where CDC has a strong lab presence?
Monroe: Right, so in addition to the things people know about,
our work with Ebola, our work with influenza,
our work on foodborne diseases.
CDC's mission has expanded into noncommunicable disease work.
So has our laboratory activities expanded.
So now we have labs that look at components of smoke and smoking.
We have labs that look at what kinds of components are
in the blood samples of people in the population to look
at the presence of toxins
or abnormal lipids things like that.
We also have labs that work on issues surrounding worker safety
and worker health so evaluating the effectiveness
of protective equipment that firefighters wear
or our hospital staff wear.
Iskander: So put another way, really, lab work that affects,
you know, almost everybody in the population whether their,
whether the issues are infectious diseases,
chronic diseases, environmental health, or occupational health.
So we heard today from Dr. Conrad Quinn an example
of a high performing laboratory at CDC.
What are some of the broad learnings
from his experience with that lab?
Monroe: Right, so one of the things that I want to do
from our new office is to take the best practices
that we see every day across the labs at CDC and make sure
that those are at work in all of our laboratories
and that we can set an example for our public health partners
in state and local territorial public health labs.
And what Dr. Quinn's presentation demonstrated is
that the kinds of continuous improvement and quality systems
that he's implemented are applicable not only
in more routine diagnostic settings but are also applicable
to our research labs to ensure that the quality
of the science that's coming
out of our labs is the highest that it can be.
Iskander: Yes, he certainly has established
through his lab a track record of quality and safety
and scientific accomplishment.
Since 2014 there has been a renewed emphasis
on laboratory safety.
Can you tell us, give us your perspective on that,
what initiatives is CDC pursuing
in that area and towards what end?
Monroe: So the main thing that I'm focusing
on right now is making sure that we have a consistency
in our approach across CDC of how we're both assessing risk
and also responding to risk.
We know that we'll never be able to completely eliminate risk
from the kinds of work that we do in the laboratories.
By nature the work that we do has some risk,
but we need to carefully consider each experiment
and each step in every experiment
to see could we do this differently?
Could we do it more safely?
And importantly what might happen if things go wrong?
And how can we be sure that we're ready to respond
if something does go wrong when we're conducting an experiment?
Iskander: So following onto that,
are there specific initiatives in either training
or leadership development that fit into that?
Monroe: So the first thing we're doing with training is looking
at our whole approach to risk assessment
and we've enhanced our training around risk assessment
and made sure that everybody who is engaged
in laboratory activities is familiar
with the basic principles of risk assessment.
And, that goes to this notion of the culture of responsibility
and the culture of safety.
We want every person who's working in the lab
to think every day, what am I doing today?
Is there some risk that's involved in what I'm doing?
And what can I do to eliminate or minimize
that risk is much as possible?
Iskander: Now, we also heard today from Dr. Joseph Kanabrocki
from the University of Chicago,
who co-chaired an advisory committee to the director of CDC
on some of these issues.
He's a research safety officer at the University of Chicago,
the chief research safety officer there.
What are some of the learnings that he brought
to our Grand Rounds audience in his presentation today?
Monroe: In the approach that they've taken
at the University Chicago is unique in several ways
and as Dr. Kanabrocki pointed out the first part was
to establish his office that was high up in the organization
so it had the organizational visibility
to implement the programs effectively.
The other thing he pointed out is their training program
where they're training professionals in biosafety.
And this is something that we also have started at CDC.
So, we've recently started our laboratory leadership service
or LLS as we call it, with the first class
of seven fellows is currently at work and we're actively working
to match the second class of fellows
that will start this coming July.
So to train them in not only how
to best approach laboratory safety and quality, but to serve
as leaders going forward.
And as Dr. Kanabrocki pointed out some
of his fellows have gone on to train other fellows in the sort
of compound interest approach to things.
The other thing that he's done there is to,
to more personalize, I guess you would say, the safety messaging
and to make sure that they're getting their messages
out in a way that people are receptive to
and so they don't just overlook the messaging
but are taking it to heart .
Iskander: Yes, for people who want to consult the slides of
or view the video of today's session they've done some nice
work using, using Internet type of means as part
of their communication.
So to wrap this all up, for public health workers,
healthcare workers, whether or not they interface
with laboratories or work in laboratories or not.
Are there some broader lessons here?
Monroe: I think there's at least two things that come
out of today's presentations.
I mean one is that that safety
and quality are really linked together and that enhancements
to a safety system should be done in the context
of enhancements to continuous quality improvement and that's,
I think, the fundamental message is that this is not a one time
and done kind of approach to things that people need
to be thinking about this every day and thinking
about how can we do it better tomorrow than we're doing today?
And the fact that something was true yesterday
or five years ago doesn't necessarily mean
that it's the best approach today and so we need
to always be thinking about how to continuously improve.
Iskander: So some broader learnings
for occupational health, workforce protection and really
for leadership in general.
Thank you very much, Dr. Monroe.
Monroe: Thank you, it's been my pleasure.
Iskander: Please join us next month for Beyond the Data.