< Back to all articles
< Back to all articles
< Back to all articles
Helping Canada’s Food Inspection Agency Go Lean
Read next article

Helping Canada’s Food Inspection Agency Go Lean

How bioMérieux helped Canada’s Food Inspection Agency increase productivity and reduce turnaround time
March 28, 2017

Helping Canada’s Food Inspection Agency Go Lean

The Canadian Food Inspection Agency (CFIA) is dedicated to safeguarding food, animals and plants, in order to enhance the health and well-being of Canada's people, environment and economy.

bioMérieux provides diagnostic solutions (reagents, instruments, software) that determine the source of disease and contamination to improve patient health and ensure consumer safety. Part of bioMérieux’s approach is also to look at laboratory workflow for its customers to answer the growing need for a leaner approach—to help them improve efficiency and productivity by working smarter.

Let’s take a look at a lean initiative undertaken with a CFIA laboratory to improve efficiency and reduce turnaround time.

The goal: improve turnaround time

Neil Vary was the Section Head of the Food, Feed, and Fertilizer Microbiology Section of the CFIA Ottawa Laboratory when he met with Mohammed Ahmed from bioMérieux. They discussed workflow optimization, with a view to reducing the time it takes to analyze samples for CFIA inspectors. Mohammed is a Six Sigma Black Belt in DMAIC (an acronym for Define, Measure, Analyze, Improve and Control) and an expert in helping companies improve efficiency by optimizing workflow.

“At the time, we had three distinct areas in the laboratory, each dedicated to working with specific pathogens: one area looked for Salmonella, another for Listeria and a third for other food borne pathogens,” Neil says. As a result, there was a considerable amount of duplication in routine tasks. For example, each laboratory accessed samples brought in from the field and prepared them for analysis, and there was little communication or interaction among the different areas. Neil felt there might be ways to make the laboratory more productive by improving the workflow.

After analyzing a year’s worth of data from the laboratory, Mohammed and another bioMérieux employee, Arlene Larson, literally followed scientists over the course of several days, observing each step in their work. Their objective was to identify bottlenecks and other opportunities to optimize workflow. They came back with a report containing a series of recommendations for Neil and his team.

Hallway huddles became a daily ritual

Neil says some of the ideas were strikingly simple. “For example, we implemented a hallway huddle every afternoon around a white board, which displays information on workload and deadlines, so we can shift resources to where they are needed.” He says the daily hallway huddles had multiple benefits: sharing information helped improve workflow, enrolled everyone in the process, and also had a social benefit in terms of team building.

Another recommendation from the bioMérieux team was to reorganize workflow in the laboratory, with a view to standardizing tasks. “At the time, each area was completely self-contained and independent. The report suggested that we eliminate these work ‘silos’ by grouping the laboratories by activity instead of by pathogen,” says Neil.

As a result, each laboratory took responsibility for one step in the process, with the first area dedicated to preparing samples for testing. “We also modified work stations to place materials within arm’s reach. Now we have five work stations with almost identical layouts, which has made the process much more efficient.”

Side benefit: cross learning among co-workers

“Another benefit is that technicians working on the same task at the same time also began to learn from each other by observing and adopting better work methods from their colleagues. So now we have more sharing of knowledge and techniques, which has led to further efficiency gains,” says Neil.

“The lean initiative complements quality assurance (QA),” says Neil. “QA is about ensuring that we always have high-quality results in the lab, but it’s not necessarily about improving efficiency, whereas the lean initiative is aimed at that. We saw these two approaches complement each other very well.”

Evidence-based outcomes create buy-in

Like QA, the lean initiative involves examining current practices, targeting certain areas for improvement, designing and implementing a plan, then measuring the results against a baseline. “The last step is to come back and assess the impact of the changes,” says Neil. “We are scientists, so we really need to see evidence; as time went along and we started to make changes and do evaluations, we got more buy-in because everyone saw the evidence.”

Impressive gains despite greater workloads

Neil says the results were quite an eye-opener: “Our sample turnaround time went from about six days to 4.4 days, a 27% reduction. We also had a 36% reduction in manpower requirements, which freed up time from sample testing for other high-value projects for the Agency. Coincidentally, as we were implementing these changes, the number of food samples that came to us went up by 38%. Thanks to the ongoing efficiency gains, our technicians did not even feel this increase since their work efficiency had improved throughout the year.”

Lean initiatives: a journey rather than a destination

Just as QA is an ongoing process, so is a lean initiative. Along the way, additional challenges and opportunities are often identified and noted for future optimization initiatives. The efficiency gains and other benefits of the first workflow optimization initiative in the CFIA laboratory led Neil to believe in the value of regularly undertaking lean initiatives as a sustainable project.

According to Neil, the key to carrying out a successful lean initiative has been to involve the entire staff in identifying problems and brainstorming over solutions. “Their input was critical to its success, and they were valued. Showing them the results reinforced the importance of their contributions and helped them believe in it.” 

< Back to all articles
Reducing the time to diagnosis with BioFire FilmArray – Results from a clinical study
Read next article

Reducing the time to diagnosis with BioFire FilmArray – Results from a clinical study

It seems logical that obtaining test results more quickly from the hospital laboratory might ultimately help to improve patient outcomes, by reducing the time to diagnosis and treatment.
March 28, 2017

Reducing the time to diagnosis with BioFire FilmArray – Results from a clinical study

It seems logical that obtaining test results more quickly from the hospital laboratory might ultimately help to improve patient outcomes, by reducing the time to diagnosis and treatment. This logic has now been put to the test in a two-year study conducted at a major U.S. health centre.

Dr. Raquel Martinez presented the results of a study conducted at the Geisinger Health System in Pennsylvania, a multi-hospital group that includes a 560-bed facility in Danville and a total of eight hospitals and several outpatient clinics in the surrounding counties.

The study assessed the clinical benefits of a first-in, first-out (FIFO) approach to molecular testing using the FilmArray Respiratory Pathogen Panel (BioFire Diagnostics, a bioMerieux company) versus conventional once-daily batch testing.

Data were collected on the time from specimen collection to reporting of results, length of hospital stay, number of days in the ICU, patient mortality at 28 days, bacterial and viral antimicrobial use, plus other variables. Priority for testing was given to the ICU and Emergency departments.

In addition to implementing the random-access or FIFO approach to laboratory testing, the team developed various protocols and testing algorithms designed to aid in clinical decision-making and to improve the efficiency and timeliness of testing.

Using the FIFO approach with BioFire FilmArray was associated with significant improvements:

  • Shorter Emergency department wait times (mean reduction of 1.2 hours, p<0.02)
  • Fewer days spent in the ICU (mean reduction of 3 days, p<0.0001)
  • Shorter hospital stays (mean reduction of 2.1 days, p<0.03)
  • Improved survival (relative rate improved by 10%, p<0.02)
  • Fewer days on antibiotics (mean reduction of 1.9 days, p<0.002)
  • Fewer total tests and fewer days on ventilation (both p<0.05)

 

It is also worth noting that rapid and more sensitive testing methods were associated with a significant reduction in antibiotic use, which should contribute to improving antimicrobial stewardship and minimizing overall healthcare costs.

While more rapid turnaround time in laboratory testing has many benefits, there are no shortcuts to actually acquiring state-of-the-art testing equipment, such as FilmArray, in the first place. According to Dr. Martinez, the process starts by preparing a solid business plan for the hospital’s leadership.

“Once we receive the instrument, we collect data to demonstrate its utility. For example, we demonstrate how the instrument simplifies workflow, or reduces turnaround time, or even better, how faster turnaround time can positively impact patient care.” Hence the need for evidence-based medicine to validate current practices, make informed decisions about future investments in new technology, and continue improving performance in the clinical laboratory.

< Back to all articles
Promoting Continuing Education on Food Safety
Read next article

Promoting Continuing Education on Food Safety

bioMérieux Canada is proud to participate in continuing education on food safety in partnership with the University of Guelph’s Canadian Research Institute in Food Safety (CRIFS).
March 28, 2017

Promoting Continuing Education on Food Safety

bioMérieux Canada is proud to participate in continuing education on food safety in partnership with the University of Guelph’s Canadian Research Institute in Food Safety (CRIFS). 

Our first symposium, in November 2016, drew no less than 85 industry participants to the University of Guelph for a lively and illuminating session. A panel of highly respected speakers provided deeper understanding and proposed innovative solutions aimed at improving the early detection and control of food-borne pathogens, with a focus on Listeria in the food production environment.

Listeria Hysteria II - Symposium Highlights

Jeffrey Farber, PhD, Director of CRIFS and a professor in the Department of Food Science at the University of Guelph, presented an overview of Listeria-related outbreaks in dairy, meat and poultry, produce and fish that have occurred in recent years. Dr. Farber explored the root causes of these outbreaks and described the lessons learned.

John Mills, Senior Staff Scientist for Industry Scientific Affairs at bioMérieux, presented an in-depth review of Listeria monocytogenes as a food supply contaminant. He also described a model environmental control program that meets the criteria for Listeria risk assessment from the United States Food and Drug Administration (FDA), supported by a case study.  Mr. Mills also presented the rationale for strict microbiological control, and outlined what manufacturers should consider when selecting the type of analysis used to detect Listeria in their facilities.

Steven Tsuyuki, Senior Director, Sanitary Design and Corporate Sanitation at Maple Leaf Foods, presented a detailed summary of the devastating Listeria outbreak at Maple Leaf Foods in 2008. He described food safety requirements at the time of the outbreak, what caused the outbreak, and how safety practices have been upgraded to improve Listeria detection in their facilities.  He concluded by noting that the company’s attitude today is to assume that Listeria is present and that it’s their job to find and eliminate it.

Angela Tellez, PhD, Director of the Food Science Technical Group at the University of Guelph, focused on prevention and control of Listeria in the dairy industry. She presented an analysis of Listeria outbreaks linked to the dairy industry and proposed corrective actions that should be deployed in the production and manufacturing process.

To learn more, listen to this podcast from Dr. Farber.

Look for our 2nd Food Safety Symposium in November 1st 2017!

< Back to all articles
Bringing innovation to healthcare: a slow and bumpy road
Read next article

Bringing innovation to healthcare: a slow and bumpy road

Managing the health of our aging population is putting pressure on the healthcare system to do more with less. How will we meet this growing challenge?
June 6, 2016 - Healthcare

Bringing innovation to healthcare: a slow and bumpy road

Managing the health of our aging population is putting pressure on the healthcare system to do more with less. How will we meet this growing challenge?

Given our aging population, it seems inevitable that healthcare costs will keep climbing for the foreseeable future. At the same time, healthcare technology is evolving "faster than our system can make room for it," says Joanne Castonguay, an economist with the Center for Interuniversity Research and Analysis of Organizations (CIRANO), who has a special interest in public policy in healthcare.
Considering some of the sticker prices associated with ‘better and faster’ medications and machines, it’s not surprising that decision-makers in the healthcare system are not exactly rushing to embrace innovation. It doesn’t help that, in some cases, "new technology has been brought into play without really understanding its impact on the system," adds Ms. Castonguay. 

Cost-based procurement impedes the integration of new technology... 

Another barrier to the adoption of newer healthcare technologies is institutional inertia: for the most part, purchases are based on competitive bidding, with the order going to the lowest bidder. Cost-based procurement is simple to explain and easy to justify. Problem is, this bottom-line approach makes no allowance for indirect savings that could accrue from implementing a new technology. 

...and centralized decision-making doesn’t reward innovation

Ms. Castonguay explains: "In other parts of the world, two forces are at work simultaneously: the first is the trend towards healthcare integration that considers the full range of services required to treat a patient and get them back to full functioning. The second is a growing tendency for governments to become policy makers rather than service providers. In contrast, the Government of Quebec is currently the policy maker, service provider and payer."

"As an example, look at our FilmArray® analyzer," says Xavier Nouvelot, General Manager of bioMérieux Canada. "We have a respiratory test panel capable of identifying up to 20 viral and bacterial pathogens from a single sample, with results in one hour—and a total time of about 4 hours from sampling to results at the bedside." 

Certainly sounds more efficient than conventional laboratory tests that take a day to complete and as many as four days to get results back to the patient’s bedside. "Four hours versus four days: think of the cost savings we could achieve by avoiding unnecessary hospital stays and unnecessary use of antibiotics," adds Mr. Nouvelot. 

But according to Ms. Castonguay, the way hospitals are financed now actually discourages innovation. "When you implement innovation, cost savings don’t accrue to the innovator; usually, they migrate back to the payer," she says. As a result, there is no net benefit to the innovator and no incentive to innovate.

Inching toward a brighter future

"I think the decision-making process is going to improve; there is now greater understanding that looking at new technology from a straight cost perspective is taking a narrow view—and that more enlightened decision-making will benefit patients, governments and society," says Ms. Castonguay. "This is an evolutionary process. Our payment system won’t be overhauled all at once. The next step will be to look at payment per patient; this value-based approach determines a dollar value that should be assigned not just to a treatment, but to a patient, from the time of diagnosis to his return to normal living." 

"Sooner or later, there will have to be a major shift in the political culture [concerning healthcare]; we have no choice in light of our changing demographics." - Joanne Castonguay, CIRANO

 

Joanne Castonguay is vice president at CIRANO and associate professor, Pôle Santé at HEC Montréal. 

 

< Back to all articles
What is the syndromic approach? Why does it matter?
Read next article

What is the syndromic approach? Why does it matter?

George had been feeling under the weather for days when he finally dragged himself to the hospital, looking for help.
June 6, 2016 - Healthcare

What is the syndromic approach? Why does it matter?

George had been feeling under the weather for days when he finally dragged himself to the hospital, looking for help. 

When poor George arrived at the hospital Emergency Room (ER), he didn’t tell the triage nurse he was suffering from pneumonia; all he could do was reel off his symptoms. “I feel miserable, I feel weak, I have no appetite and I’ve been coughing for four days,” he said. “Help me. Please.”

In George’s case, as in most, it takes more than a list of symptoms to arrive at a diagnosis. Health care professionals (HCPs) also look for signs of illness—indicators that can be detected or measured objectively, like a heart murmur heard through a stethoscope, or a fever measured by placing a thermometer under the tongue.

A syndrome consists of symptoms and signs

“When you put symptoms and signs together, this is called a syndrome,” says Dr. Mark Miller, Chief Medical Officer of bioMérieux Inc. “The concept of a syndrome is important because this is how a patient presents to their doctor or nurse.”

Does George have pneumonia, the flu, heart failure, or another type of respiratory infection or disease? Dr. Miller says there are several good reasons to get the diagnosis right:

  • George is suffering: he has the right to expect a timely diagnosis and effective therapy and relief
  • Identifying the precise cause of George’s problems facilitates the selection of the appropriate therapy
  • Having a definite diagnosis determines the appropriate infection control for George and those with whom he has been in contact

We can add one more item to this list: having the means to quickly identify pathogens will also help George get out of the hospital and back home sooner, which is win-win for both George and the hospital. Clearly, the ability to pinpoint the pathogen responsible for a syndrome of signs and symptoms is key to achieving a successful outcome.

bioMérieux leads in taking the syndromic approach

bioMérieux is a world leader in applying the syndromic approach to diagnostic testing. “Our approach mimics the way a patient presents in the hospital or clinic,” reveals Dr. Miller. “The most common syndromes are respiratory and gastrointestinal (GI), with others down the list, like sepsis syndromes and meningitis. We have panels that include 20 or more pathogen tests for each of these syndromes.”

Accurate test results in a fraction of the time

George appears to have a respiratory syndrome, so the HCP takes a simple and easily-obtained sample from George’s nose and sends it to the lab to be tested using the respiratory panel in the FilmArray® system from bioMérieux. Compared to conventional testing, results from the FilmArray® test can be back in the HCP’s hands in about an hour (versus up to several days) and, using this single sample, can positively identify any one of 20 different respiratory pathogens.

A syndromic approach isn’t always necessary: if a patient has been hospitalized for two weeks and develops diarrhea, we know the most likely cause is C. difficile. Because the list of potential pathogens is very long, syndromic testing is more appropriate for patients who, like George, just come into the ER with respiratory or GI symptoms.

“Conventional testing can result in a lot of waiting and, of course, ongoing discomfort for the patient—perhaps even an unnecessary hospitalization,” says Dr. Miller. “It becomes very cost-effective to simultaneously test for multiple pathogens that could be responsible for a syndrome, rather than just look for one cause at a time.”

“The ability to test for multiple pathogens in a single procedure results in better management of the patient and better infection control.”

- Mark Miller, MD

Having a diagnosis can be reassuring 

A syndromic approach to testing is also helpful because patients are reassured when they receive a precise diagnosis rather than an educated guess. “Being able to say, ‘We have a positive test for a virus. You can go home and rest without the need for unnecessary antibiotics’ gives patients a great deal of comfort and is more rewarding for the HCP,” says Dr. Miller.

In addition to shorter hospital stays and less unnecessary time in isolation (which is very expensive), taking a syndromic approach encourages the responsible use of antibiotics.

Preserving antibiotics’ effectiveness

“Antibiotic resistance is a growing problem around the world. Antimicrobial stewardship means giving the right antibiotic in the right dose to the right patient at the right time. You can do that when you have definitive test results that come back rapidly,” says Dr. Miller. “Reducing the inappropriate use of antibiotics is important. FilmArray® is one of the major tools hospitals can use in their antimicrobial stewardship program.”

Getting back to poor George. How long will he wait, and how many tests will be ordered to diagnose the cause of his illness? We can only hope the ER he visited is served by a laboratory that has adopted the syndromic approach, so that he can look forward to a quick recovery.

< Back to all articles
bioMérieux Canada building a strong case for innovation
Read next article

bioMérieux Canada building a strong case for innovation

bioMérieux Canada is spearheading an effort to persuade stakeholders that innovation adds value to the healthcare system.
June 6, 2016 - Healthcare

bioMérieux Canada building a strong case for innovation

bioMérieux Canada is spearheading an effort to persuade stakeholders that innovation adds value to the healthcare system. 

The FilmArray® diagnostics system, an unimposing unit about the size of a desktop printer, is at the centre of a paradigm shift in how patients presenting to the Emergency Room (ER) are assessed. While physicians currently use educated guesswork or order one lab test after another to help make their diagnoses, the FilmArray® system can test for 20 or more pathogens from a single specimen in about an hour.

Replacing guesswork with clinical certainty

This innovation, called a syndromic approach to diagnostic testing, complements the way physicians work through the process of making a diagnosis. “Having the ability to obtain test results and to quickly make a diagnosis has benefits for both patients and physicians,” says François Turgeon, Senior Clinical Marketing Manager at bioMérieux Canada.

Studies seek to bolster evidence

The company is currently supporting studies to test the hypothesis that a syndromic approach to laboratory testing will add sufficient value to justify its cost. In a clinical study at Montreal’s CHU Sainte-Justine pediatric hospital, children presenting to the ER with respiratory symptoms (about 280 patients so far) provide a specimen for testing using FilmArray®. The diagnosis—and the right course of action—are determined right on the spot, versus the conventional approach that would keep the child in observation for the time it takes to go through a battery of tests (up to three or four days).

Will users see the value?

“This innovation is more expensive, so we hope to show that it saves hospital resources and improves patient care,” says François. “We also want to know if physicians and laboratory personnel appreciate having the means to quickly obtain reliable results. Do they see an increase in patient satisfaction? Do technicians find the equipment easier to use?”

The goal of this research is to help persuade stakeholders that innovation can make a significant contribution to improvements in the healthcare system, from multiple perspectives:

  • Less waiting and uncertainty, better outcomes and greater satisfaction for patients

  • Fewer delays and more precise decision-making for physicians

  • Greater efficiency and simplicity for laboratory technicians

  • More rational use of scarce hospital resources, for administrators

A second study, involving adults with respiratory symptoms at Vancouver General Hospital, will have a more limited objective: to determine if reducing the time to diagnosis yields a cost advantage to the system due to spending less time on the ward, avoiding unnecessary tests, and so on. 

Rapid diagnosis of GI complications

A third study, at Maisonneuve-Rosemont hospital in Montreal, uses the syndromic approach to diagnose gastrointestinal (GI) symptoms. Study participants, about 100 so far, are bone marrow transplant recipients whose immune systems have been wiped out by anti-rejection drugs, so they are vulnerable to developing GI issues.

When these patients develop symptoms, the challenge is to determine whether they are having an adverse reaction to their medications or to the transplanted marrow, or if they caught a virus or picked up a bacterial infection. Physicians have been using FilmArray® to help them make a diagnosis.

Early results from this study indicate that about 25% of patients had a change in their management as a direct result of testing; the next step will be to review patient files to assess the clinical impact and cost savings attributable to these changes.

“So far, every clinical oncologist we have spoken to wants to keep using FilmArray®. The final analysis will tell us if it makes economic sense.”

- François Turgeon, bioMérieux Canada

Encouraging signs of collaboration

Healthcare in Canada is fragmented because funding is provided by the federal government, but budgets are set by each province—and some provincial regimes are more progressive than others. François likes what is happening in Alberta. “They gathered suppliers together in 2015 and announced that they had identified areas, such as critical care and cancer, where they saw room for improvement. They challenged companies to propose innovative solutions.”

According to François, this is a more enlightened approach than exists in other provinces, where companies can propose a new technology but usually have no idea where problems exist that their technology could address. By comparison, Alberta’s approach is more collaborative. “It would be great to have this kind of approach in Quebec, because we could help our partners in healthcare find innovative solutions.” 

François says this type of initiative could also move the conversation forward in more provinces, once bioMérieux recruits local advocates who understand the value of the syndromic approach. “If we get the results we hope for, it will confirm that bioMérieux is at the forefront of infectious disease diagnosis, specifically with respect to taking a syndromic approach.”

< Back to all articles
Extra pepperoni with that?
Read next article

Extra pepperoni with that?

Chances are you never gave a second thought to the pepperoni on your pizza – but you will after you read this.
June 6, 2016 - Industry

Extra pepperoni with that?

Chances are you never gave a second thought to the pepperoni on your pizza – but you will after you read this. 

The last time you chowed down a pizza at half-time or during movie night on the couch, it’s all but certain that the pepperoni and some of your other pizza toppings were made by Les Produits Alimentaires Viau Inc., a Laval, Quebec based food company. An international pizza chain is just one of dozens of customers Viau supplies with sliced meats, Italian sausage, meatballs, steak and so on. What’s more, Viau was the first company in Canada to produce dry cured pepperoni, which makes the ideal pizza topping.

And this has to do with bioMérieux because…

Didier Leroux, Director of Operations at Viau, credits a long-standing collaboration with bioMérieux for some of the company’s success. “For as long as I can remember we’ve had an in-house laboratory to do our own quality and safety testing. It’s part of our mentality. We think of the lab as an essential step in the process of meat transformation, just like the slicers and grinders,” says Didier. 

Most of the laboratory test equipment is from bioMérieux. Didier says “they have a good team and their products work well and are very reliable. Every time a client visits our plant they come away impressed with the laboratory. We have been well served over many years by bioMérieux and it has been a great partnership.”

Accredited in-house laboratory is a win-win for Viau

  • Fast test results help reduce costly production downtime
  • Allows protection of proprietary information
  • Ensures consistent product quality
  • Demonstrates a commitment to food safety

“When Viau was still a small enterprise, having our own laboratory was a way of showing potential customers that we take food safety very seriously. It’s not a stretch to say it was partly a marketing tool,” says Didier. As he sees it, some fast food restaurants are very demanding because they cannot afford to jeopardize their brand name. “It’s hard to quantify the impact of having our own lab in dollars and cents, but it reassures our clients and gives us peace of mind as well. How do you place a value on that?”

Viau was the first company in Canada to invest in an industrial microwave oven to thaw their meats and in infrared technology to analyse their products on the line.  “We are constantly on the lookout for new technology that can improve our ability to detect problems as quickly and precisely as possible; the cost of this technology is a secondary concern,” he says.

Build it and they will come?

The plant in Laval includes five new slicing rooms, each with its own completely independent plumbing and ventilation system, an array of UV lamps to provide continuous air purification – and production workers suited up like astronauts – all with the aim of reducing the risk of cross-contamination. Viau is the only meat transformation company in Quebec to offer high pressure pasteurization (HPP), which is performed after products are packaged.

According to Didier, part of the current business plan is to offer slicing, packaging, pasteurization and laboratory testing for companies with private label brands. “We think that sooner or later, a number of large supermarket chains could come knocking. It really is a ‘vision thing’ and we are ready today to take on new growth.”

Look for Viau Italian-style prepared and sliced meats at your grocers under the Fantino & Mondello brand name. Visit fantinomondello.ca to learn more and to see mouth-watering recipes.

< Back to all articles
Detect to protect
Read next article

Detect to protect

The Canadian food supply is one of the safest in the world, but an estimated 4 million Canadians get sick each year due to food-borne diseases.
December 16, 2015 - Industry

Detect to protect

Virus or bacteria, which is to blame?

The Canadian food supply is one of the safest in the world. However, the Public Health Agency of Canada estimates that each year approximately 1 in 8 Canadians gets sick due to domestically acquired foodborne diseases. No food safety system can guarantee zero risk. At any point in the production system, food can become contaminated with bacteria, viruses, parasites, chemicals or undeclared allergens.

Viruses account for about 65% of known cases of foodborne illness in Canada.

To help address the issue of foodborne illnesses, the Government of Canada recently announced the establishment of the Food Virology National Reference Centre at the Canadian Food Inspection Agency (CFIA) laboratory in St. Hyacinthe, Quebec. The Centre will be part of the Food Safety Information Network (FSIN) announced earlier this year. The FSIN will be implemented incrementally over five years, linking federal and provincial food safety authorities and accredited laboratories across the country. The Centre will further enhance Canada's ability to effectively detect viral contaminants in food, such as noroviruses and hepatitis A.

The Food Virology National Reference Centre will:

  • Develop strategies to detect, quantify and characterize foodborne viruses in complex food conditions;
  • Study foodborne, emerging and zoonotic viruses in the food chain;
  • Research viral indicators to assess food and water safety;
  • Evaluate prevention approaches, risk mitigation and analyses; and
  • Provide testing services and scientific advice on potential foodborne contamination.

Did you know?

An estimated 4 million Canadians get sick each year due to foodborne diseases.

bioMérieux’s Industry Unit has a wide range of microbiological control solutions dedicated to food safety and quality. In January 2015, bioMérieux added to its already broad food testing solutions portolio by acquiring CEERAM (European Centre for Expertise and Research on Microbial Agents), an innovative virology laboratory specializing in the detection of foodborne and environmental viruses. CEERAM has developed internationally recognized expertise for the detection of foodborne viruses using molecular biology techniques. The company has a comprehensive range of molecular virology reagents, in particular focused on the identification of noroviruses and hepatitis A and E viruses in foods.

There is still work to be done to prevent and control foodborne illness in Canada, to focus efforts on pathogens that cause the greatest burden, and to better understand foodborne illness without a known cause. bioMérieux hopes to help reduce this burden through its technologies and ongoing research.

References: 
Government of Canada. Backgrounder: Government of Canada establishes centre for food virology: http://www.inspection.gc.ca/food/action-plan/backgrounder/eng/1437602715302/1437602947865.
Government of Canada. Food safety investigations: http://www.inspection.gc.ca/food/information-for-consumers/food-safety-investigations/eng/1332299626115/1332299812611.
Public Health Agency of Canada. Estimates of foodborne illness in Canada: www.phac-aspc.gc.ca/efwd-emoha/efbi-emoa-eng.php
bioMérieux Press Release

Biomérieux Annual Report, 2014.pdf

< Back to all articles
More knowledge, less risk.
Read next article

More knowledge, less risk.

Antimicrobial resistance (AMR) occurs when antibiotics completely lose or have diminished effectiveness to treat infections.
December 16, 2015 - Healthcare

More knowledge, less risk.

Counter the global public health threat of antimicrobial resistance

What is antimicrobial resistance (AMR)? AMR occurs when antibiotics completely lose or have diminished effectiveness to treat infections. This happens because microbes change by mutating or acquiring genetic information from other microbes to develop resistance. Unfortunately, AMR is a natural phenomenon accelerated by the overuse and/or inappropriate use of antimicrobial agents in both people and livestock. As a result, resistant strains survive and aggregate, limiting treatment options for common infections.

Why is AMR a concern? Because the risk of morbidity and mortality is higher in patients infected with resistant strains. And because the overall societal costs associated with the treatment of AMR are staggering. In the US alone, it is estimated that AMR results in up to $20 billion in direct costs and up to $35 billion in indirect costs. 

Antimicrobial resistance is recognized as a global public health priority by healthcare organizations, including the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).

Advanced knowledge of microorganisms is crucial to fight back and bring them under control. The contribution of microbiology is essential at each step in the fight against AMR. With over 40 years of expertise in microbiology, bioMérieux is committed to the fight against AMR and works in close partnership with healthcare professionals to provide the most relevant solutions. One example of the company’s commitment is their funding of the Global Point Prevalence Survey, which was created by a group of worldwide experts at the 4th World Hospital-Acquired Infections (HAI) Forum in 2013. This study, launched in 2014, is designed to provide a global snapshot of antimicrobial resistance and utilization. Unprecedented in scope, it is being coordinated by the University of Antwerp Hospital (Belgium). In 2015, they expect to mobilize more than 700 hospital centres in more than 70 countries across all continents. The information obtained will be used to initiate a global database dedicated to tracking the consumption of antibiotics and antimicrobial resistance in hospital settings.

In June 2015, bioMérieux participated in the United States’ White House Forum on Antibiotic Stewardship to discuss possible ways of implementing changes over the next five years directed at slowing down the emergence of antibiotic-resistant bacteria, preventing the spread of resistant infections and preserving the efficacy of existing antibiotics.

Through measures such as these, bioMérieux hopes to assist hospitals and patients worldwide in combating AMR, improving outcomes and retaining the value of microbial treatment options.

References: 
World Health Organization
Antimicrobial resistance: global report on surveillance, 2014
bioMérieux Press Releases
Global experts engage in the fight against antimicrobial resistance during the World HAI/Resistance Forum organized by bioMérieux.
Biomérieux Annual Report, 2014.pdf

< Back to all articles
How LEAN is your lab?
Read next article

How LEAN is your lab?

Did you know that the vast majority (87%) of process time in the average hospital microbiology laboratory is not spent on “core value” activities?
December 16, 2015 - Healthcare

How LEAN is your lab?

Greater efficiency for better patient care

Did you know that the vast majority (87%) of process time in the average hospital microbiology laboratory is not spent on “core value” activities? This statistic is worrying, as the lab is the linchpin for nearly every treatment decision within the hospital, and the speed and accuracy with which results are provided is critically important to the well-being of patients. 

What contributes to “wasted” time in labs? On average, process time is spent as follows:

  • 5% on backlog requests
  • 23% on extra work performed because of missing information
  • 27% waiting to complete the next “core value” step due to unavailable staffing or equipment
  • 4% on unnecessary motion (e.g., walking to the next task)
  • 12.5% on review and quality assurance
  • 7% on call or log information
  • nearly 10% on correcting quality issues

In our approach, waste actually refers not to the true value proposition offered by the microbiology laboratory: its expertise, time and capital,” said Anne Beal, Manager of the Workflow Optimization Team at bioMérieux. “[The waste] is not a tangible thing, but the relationship of the laboratory as a resource and the members of the laboratory staff. This is not the kind of waste that ends up in a garbage can, but it is in a very real sense a missed opportunity to improve the core value of the microbiology laboratory.

LEAN Lab Design is a service offered by bioMérieux. The service applies LEAN®/Six Sigma® principles to the microbiology lab. This service involves observation of the lab in its current state, such as the physical layout and the manner in which samples are processed. At the end of the process a roadmap is provided, outlining how the lab can improve processes to reduce waste and improve efficiency, while simultaneously increasing the quality of results and reducing errors.

For example, when the LEAN Lab assessment was performed at the Children’s National Medical Center in Washington, DC, it was discovered that approximately 20-25% of their workload was collected during the time of day when the lab had limited staff to process specimens. This issue was illustrated in a “Pareto diagram,” as shown in Figure 1.

Figure 1: Analysis of staffing and specimen volume

As a result of this analysis, the lab adjusted their staffing patterns in an appropriate fashion. Once this and other adjustments were made to the lab after their LEAN assessment, turn-around times (TATs) were compared from identical six month periods, pre- and post-LEAN. The results revealed that there was a significant improvement in TATs, with the Center gaining on average a complete day in their positive culture TATs post-LEAN (see Table 1). 

 

Table 1: Days of the week: pre- and post-LEAN positive culture TATs

LEAN lab assessments can prompt thought evolution among lab technologists, because they are made to be part of the process and are part of the desire to provide better services to their physicians and patients.

References:
Campos J. LEAN Lab Implementation Improves Turnaround Times and Leads to Faster Results and More Confident Clinical Decision Making: http://www.biomerieuxconnection.com/11-15-11-lean-lab-implementation.html.

< Back to all articles
Is antibiotherapy necessary?
Read next article

Is antibiotherapy necessary?

Matrix Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) technology can provide rapid microbiological identification faster than traditional methods at an affordable cost.
December 16, 2015 - Healthcare

Is antibiotherapy necessary?

State-of-the-art technology for your ASP

Matrix Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) technology—better known as Mass Spec—is used for rapid microbial identification. With this technology, organism proteins are analyzed to generate unique fingerprint patterns that are matched against a comprehensive database of relevant organisms.

VITEK® MS technology is providing rapid microbiological identification faster than traditional methods at an affordable cost. Rapid identification is key in enabling physicians to implement the right antibiotherapy. The technology has sped up identification time and it helps to get patients on appropriate antibiotics sooner, when they are needed.

Most larger health institutions in Canada have experience with such systems. One such lab is that of Dr. Victor Leung, the Medical Director of Infection Prevention and Control and the Physician Lead of Antimicrobial Stewardship at Providence Health Care, at St. Paul’s Hospital in Vancouver, British Columbia. Several years ago, his lab began using the Mass Spec technology from bioMérieux (VITEK® MS), and developed a business plan to support the acquisition of this new technology and clinical guidelines for improving patient care. He and his team have been using it clinically for about a year and a half.

Dr. Leung’s centre has developed an impressive, multifaceted Antimicrobial Stewardship Program (ASP) that incorporates technologies, processes and people. The ASP, including VITEK® MS, has significantly decreased the antibiotic spending within the institution. The program involves a team that is very supportive at all levels of the organization and includes physicians, microbiologists and pharmacists who all have a vested interest in microbial utilization in their hospital. There is a clinical working team, which consists of a physician and a pharmacist, who track and review cases of patients on antibiotics and make recommendations on how they should be managed. The bacteremia program incorporates the use of the Mass Spec technology and the test results are texted to the research team. “Our vision is really to ensure people are on appropriate antibiotics at the right time,” says Dr. Leung. He also believes that the technology, in conjunction with his ASP, has improved internal dialogue, enhancing education for both clinicians and the laboratory staff.

But what does all this mean for patients? According to Dr. Leung, “It means that sometimes they are not getting an antibiotic they don’t need. Sometimes they are getting an antibiotic sooner. Sometimes they are getting more comprehensive review from the ASP early on, because the team has more input about the case. This rapid identification can allow them to be on the best antibiotics as soon as possible with a better management strategy review.”