In a recent literature review published in the Journal of the Pediatric Infectious Diseases Society, researchers found no published prospective studies that quantified the effects of outsourcing microbiology services on patient care, patient safety or medical education. What little evidence they did find pointed to some potential disadvantages with outsourcing.
“A growing trend in hospitals worldwide is to outsource microbiology laboratory services as a cost-saving measure,” Manuel E. Penton III, from the department of pediatrics at SUNY Downstate Medical Center, and colleagues wrote. “However, data on the actual impact of outsourcing on patient care, safety and medical education, including costs, are scarce.”
In their search of the literature, the researchers looked to answer two questions:
- “What are the potential benefits of outsourcing core microbiology laboratory testing?”
- “What are the potential harms to patient care and medical education when medical centers outsource essential microbiology services?”
Their search turned up eight articles. The only prospective study in the group investigated the effect of transport time on the detection time of positive blood culture results in both simulated models and clinical scenarios.
“The remaining seven articles were mostly editorials, surveys, and case reports,” the researchers wrote.
According to the Accreditation Council for Graduate Medical Education, pediatric ID fellowship programs should provide access to consultants in mycology, virology, parasitology and clinical pharmacology, and there must also be access to clinical microbiology labs that use techniques to identify bacterial, mycobacterial, fungal, viral and parasitic infections, as well as rickettsiae and chlamydiae.
Penton and colleagues wrote that the articles included in their review “contained opinions mostly about potential disadvantages of outsourcing and detailed a handful of errors and delays in diagnosis and treatment that resulted from outsourced microbiology laboratory studies and poor communication between the off-site laboratories and physicians.”
They noted that these concerns “are real and must be addressed by appropriate studies.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.