A New York City Lab Leader Shares Hard-Won Lessons from COVID-19

Pierre Mouawad, MBA, is the laboratory director at Lenox Hill Hospital in New York, NY, part of Northwell Health. He has been a lab leader for the past 8 years and is now the Laboratory Director of Lenox Hill Hospital. Healthcare Performance Insider caught up with Pierre recently to learn about how service-line lab leaders are defining pandemic response and making a dramatic impact.

Attracted to science from a young age, Pierre envisioned himself working behind a microscope and wearing a lab coat. After completing school and becoming a laboratorian, he came to the realization that he can have the greatest impact on his work by adopting a commitment to continuous learning and to surrounding himself with valued mentors and colleagues. The bulk of his career has been at Northwell Health, with the past 11 years at Lenox Hill Hospital. Northwell Health is comprised of 23 hospitals and more than 800 care centers. The hospital is among New York’s largest employers, with 74,000 employees and 3,300 physicians. The health system serves Long Island to Manhattan, Staten Island, the New York City Boroughs, up to Westchester.

Lenox Hill Hospital, a 650-bed facility located in Manhattan, has a rapid response lab on the hospital level, a brand-new core lab based in Long Island, and a busy lab outreach program. We do all sorts of testing here on site at the hospital. We have a chemistry laboratory, hematology, microbiology, pathology, blood bank, phlebotomy, and point-of-care testing, among others.  

Importance of patient blood management

After starting as a blood bank technologist, Pierre’s first leadership role was as Lenox Hill’s transfusion safety officer, a new role at the hospital. Its focus was on choosing the right product for the patient and avoiding unnecessary transfusions. A key part of Pierre’s success in this role derived from using data to investigate current practices and discover solutions to problems.

Patient blood management is very important because you are helping the clinician make a better decision to help the patient. You help the community better distribute blood products to all patients, making sure that we are not wasting blood donations. And you know, the healthcare cost also is significant when it comes to blood products and blood transfusions. So, the role ties into quality, to patient care, and at the end of the day, saving money and allocating the right resources in the right places.

Among his career highlights, Pierre names changing the hospital’s culture of transfusion at the top of the list. Educating teams about evidence-based best practices for transfusion, supporting less transfusion in general and only when necessary, had a significant impact on patient safety and care quality, which was led in conjunction with the Blood Bank Medical Director, Dr. Randy Levine.

COVID-19’s impact on the lab

COVID-19 has been the most difficult challenge of the past year. COVID-19 presented itself as a shock to all of us across the world, and not just in New York and the nation. We were not aware of what we would be facing every day coming into work. We didn’t know what to expect. We were in the unknown for a long period of time. Even now, we still don’t know a lot of things about it.

Among the challenges was the fast pace of change – situations were changing by the minute. Testing capacity was another big issue initially. Testing platforms were limited in the first few months of the pandemic, causing further struggles in supply and demand.

The flipside of those challenges, according to Pierre, was that they served as a catalyst for growth. It kind of expedites the way you learn things, because you have to respond and you have to be in emergency mode every day. And I think that prepared me to be a lab director, facing this difficult situation.

Communication and teamwork formed the cornerstone of the Lenox Hill lab’s success. My team here at Lenox Hill Hospital, the leaders in the laboratory, the team members, our senior executives of the hospital, and also at the service-line level, all were instrumental. Their support was so important for us during this pandemic. As a team, we come together to fix things, and if you don’t have that team spirit where everybody chips in, I think success would be impossible.

Northwell Health: Responding to COVID-19 in New York

We were on a mission at Northwell to roll out diagnostic polymerase chain reaction (PCR) testing. On March 9, 2020, Northwell Health Laboratory was the first health system private laboratory that was approved to perform COVID-19 PCR testing. At that time, the capacity was 100 tests per day at the system’s core laboratory. Today, the lab is doing 13,000 each day. Lenox Hill is performing about 300 COVID-19 PCR tests per day on site.

The health system also innovated in response to the crisis. It created a triage system to prioritize COVID-19 PCR tests based on certain criteria. It used 3-D printing technology to produce its own supply of nasal swabs for PCR tests. The system also bought high-throughput instruments to handle increased loads. All of these changes necessitated extreme flexibility on the part of the lab staff and leaders. We had to quickly adapt to new procedures and instructions. We had to change the workflows in the lab every day.

We also did COVID-19 antibody testing, and we partnered with local governments to provide those antibody testing to over 8,500 first responders. We provided thousands of free community COVID-19 PCR and antibody tests to churches and other community-based organizations. We also partnered with the New York City health and hospitals to create a temporary field hospital site for COVID-19 in Manhattan. At the peak of the pandemic, the lab was receiving and processing up to 7,000 COVID-19 PCR tests and 4,000 antibody tests per day.

Lenox Hill implemented six or seven testing platforms to facilitate this testing for all patients onsite. It was among the first in New York State to implement sample pooling to combat this shortage in the reagent and the supply chain. This could not have been accomplished without our Clinical Pathology Medical Director Dr. Oana Vele and our Microbiology experts in the lab.

Demonstrating the lab’s profound impact

This high-pressure transformation was not without benefits, Pierre said. The laboratory became more visible throughout the hospital, which is great, and we developed relationships, which are so important. Our workflows were able to come together over the course of hours. Projects that usually take weeks or months, we were able to accomplish within six hours, sometimes 24 hours: opening up new units in the hospital, coming up with new workflows, and always thinking outside the box.

The most rewarding part of his work involves people: Working with hardworking and dedicated individuals, mentoring them, coaching them, and seeing the fruit of your investment right before your eyes. And, at the same time, passing on information that you know, that you learned from your mentors and passing it on to the next generation of leaders. You work hard, but then you see the hard work pays off.

I think the more you learn and the more you know about the laboratory in general, and you become part of the bigger picture, I think you can become someone who makes an impact. COVID-19 testing definitely showed everybody that the lab is important, and that the lab must be visible.

Pierre Mouawad

Pierre Mouawad

Laboratory Director, Lenox Hill Hospital

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