A team of Saratoga Hospital doctors and laboratory professionals say they have demonstrated that pooled testing for COVID-19 can save time, preserve scarce resources and improve safety for patients and staff.
At a time when hospitals nationwide are hampered by shortages of testing materials, pooled testing has enabled Saratoga Hospital to test all patients before they’re admitted and isolate those who have the novel coronavirus, according to officials.
Pooled testing combines samples from several low-risk people in a single vial. If the test is negative, everyone whose sample was combined has tested negative for COVID-19—using supplies for only a single test. If the test is positive, each person must be retested individually.
The approach was first reported in Germany and the University of Nebraska. Saratoga Hospital started pooled testing in the Capital Region with a pilot program in April.
According to the hospital, since then:
• Saratoga Hospital has conserved over 2,150 test cartridges.
• The state Department of Health granted emergency use authorization for Saratoga Hospital’s protocol, clearing the way for other facilities to adopt Saratoga Hospital’s approach.
• The U.S. Food and Drug Administration issued its first emergency use authorization for sample pooling in diagnostic testing.
Results of Saratoga Hospital’s pilot program were published this month in the Journal of Hospital Medicine, the official peer-reviewed journal of the Society of Hospital Medicine.
“The strategy of pooled testing has allowed us to continue to immediately test all admitted patients, thus improving patient care,” said David Mastrianni, senior vice president of Saratoga Hospital Medical Group and lead author of the journal article, “Pooled Testing for SARS-CoV-2 in Hospitalized Patients.” Contributing authors include Drs. Richard Falivena, Timothy Brooks, Brian McDermott, Josenia Tan, Michael Holland and Administrative Director of Laboratory Services Richard Vandell, all of Saratoga Hospital.
“We believe pooled testing is a valuable tool during a time of limited resources,” Mastrianni added. “This strategy can be used by other community hospitals and may have applications for testing additional low-risk groups, including healthcare workers and clients of occupational medicine services.”
Patients who come to the Saratoga Hospital Emergency Department and need to be admitted for care are immediately assessed for COVID-19. Depending on their symptoms and other medical indications, patients are identified as at low or high risk for the disease, officials said.
Low-risk patients are tested using the pooled approach: Swabs from up to five patients are placed in a single testing vial that can be analyzed in-house by the Saratoga Hospital lab team. Patients that have tested negative are assigned to units with other COVID-free patients.
High-risk patients receive a single send-out test and are considered “persons under investigation” while the hospital awaits their results. Depending on their condition, these patients are admitted either to the intensive care unit or a special COVID unit.
Officials said the two-tiered approach helps ensure that COVID and non-COVID patients are isolated from each other and receive the appropriate care. The strategy also reduces both patient and staff anxiety.
“Like many others, we have observed that public fear of entering the hospital during this pandemic has caused delays in patients seeking care for non-COVID-19 conditions,” he said. “Our impression is that testing all admitted patients has been reassuring to our community and will help reduce those fears.”
