Goodwin Andrew, Wilburn Clayton, Wojewoda Christina, Mesec Jessica, Cacciatore Lori S, Grove Staci-Anne, Hajder Armina, Stowman Anne M
Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA.
University of Vermont Medical Center Jeffords Institute for Quality, Burlington, VT, USA.
Am J Clin Pathol. 2022 May 4;157(5):653-663. doi: 10.1093/ajcp/aqab213.
Our academic health care institution was the victim of a cyberattack that led to a complete shutdown of major patient care, operational, and communication systems, including our electronic health record (EHR), laboratory information system, pharmacy, scheduling, billing and coding, imaging software, internet, hospital shared computer drives, payroll, and digital communications. The EHR remained down for 25 days, significantly affecting our clinical pathology (CP) laboratory operations.
During the downtime, our CP laboratory incorporated manual interventions for patient specimen testing, recruited additional staff for reporting results, and employed multiple communication modalities to support patient care. The crisis required a swift response, employing innovative approaches to mitigate patient harm; regular, multidisciplinary engagement; and consistent, broad-reaching communications. CP leadership worked with hospital administration, staff, and our referral clients to provide the timely laboratory results needed for acute patient care.
During this downtime, the laboratory lacked accurate information about the number of patient samples diverted to other laboratories, the number of specimens processed, and the number of test results reported.
This paper focuses on the approaches the CP division took to develop and maintain downtime operations. Laboratories should consider these strategies in preparation for a prolonged downtime.
我们的学术医疗保健机构成为网络攻击的受害者，导致主要的患者护理、运营和通信系统完全瘫痪，包括我们的电子健康记录（EHR）、实验室信息系统、药房、排班、计费与编码、成像软件、互联网、医院共享计算机驱动器、薪资系统以及数字通信。电子健康记录系统停用了25天，严重影响了我们临床病理（CP）实验室的运作。
在停机期间，我们的临床病理实验室对患者标本检测采用了人工干预措施，增聘了报告结果的工作人员，并采用多种沟通方式来支持患者护理。这场危机需要迅速做出反应，采用创新方法来减轻对患者的伤害；进行定期的多学科参与；以及进行持续、广泛的沟通。临床病理科领导层与医院管理层、工作人员以及我们的转诊客户合作，以提供急性患者护理所需的及时实验室结果。
在这段停机期间，实验室缺乏关于转移到其他实验室的患者样本数量、处理的标本数量以及报告的检测结果数量的准确信息。
本文重点关注临床病理科为制定和维持停机期间的运作所采取的方法。实验室在为长时间停机做准备时应考虑这些策略。
