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Aaron Harding worked in healthcare for 30 years, from a teenager organizing procedure films in a radiology room, to a Navy Corpsman, to his current role running one of the largest, integrated hospital labs at Sharp Healthcare in San Diego, CA. Entering civilian life only a few years ago, HPI connected with Aaron to discuss the differences in healthcare environments. Surely, they’re very different . . . right? Aaron thoughtfully paints a picture for us, noting specifically how his military training has prepared him similarly during war times in Southeast Asia and the current healthcare crisis, how he is applying those learnings every day in the clinical laboratory at SHARP.

From a sense of the pace every single day, it’s a war-like situation. There’s a similar operational tempo for the front line – from the medical staff to the nursing staff to support staff, and from a logistics perspective. I’ve talked to colleagues across the country and it’s the same everywhere.

In the Navy Aaron was a corpsman, worked in medical-surgical care in a hospital setting before being  stationed on a ship performing sick call caring and treating its crew. Following his initial enlistment, he returned to college and returned to naval service upon graduating from Arizona State University.  Passionate about transfusion medicine, he earned a degree in Immunohematology from George Washington University and  worked with the Armed Services Blood Program. These experiences gave him appreciation for the delivery of healthcare from both a clinical and medical perspective, which motivating him to provide the best care possible laboratory services. This appreciation has impacted his leadership throughout the current healthcare crisis in two specific ways.

1. The opportunity that I have in a leadership position is to ensure the staff have the resources they need and to help get rid of barriers that impede their success.
2. As a laboratory officer in the Navy, specializing in transfusion medicine, I had the privilege of deploying twice with the U.S. Central Command to manage blood operations across Afghanistan and Iraq. That administrative oversight, working with teams through crisis events occurring within those areas, has allowed me to effectively look at how to develop processes and systems that ensure success with only the resources on hand and the end user in mind.

Aaron transitions to discuss how COVID testing and the pandemic worldwide has put a spotlight on laboratory medicine. The lab has come to the forefront because testing is critical to understanding the prevalence of COVID-19. Lab is now an essential player, from a healthcare perspective and from an epidemiological and a community health standpoint. You have a very technical solution, PCR testing, in order to provide a diagnosis result. People outside the lab are learning more about the technical nature of this test. It’s not a simple test, like a chemistry or hematology test. It’s very technical, very complex, and it takes time and energy to get a result. Considering that this is the centerpiece of diagnosis in a healthcare crisis is of course continued cause for concern. And while tests with faster turnaround times are available, you give up sensitivity and specificity strength, which can negatively impact the accuracy of result reporting.

When asked about his work at SHARP Healthcare throughout the pandemic, Aaron notes that SHARP is operating in wave two of the virus and shares his key reflections.

• The shutdown of the economy allowed a focus on isolation and control of the virus, preparing to not overwhelm healthcare systems. We could really focus on those who were the most critical, conserve on PPE and other resources, ICU beds. I think the country did an amazing job at it.

• The challenge for the clinical lab continues to be the ability to mass produce a very technical test result. When we ramped up testing initially, the Roche instrument had the fastest turnaround times, best detection, sensitivity, and specificity. We fortunately had this instrument already but have had to go through phases of trying to acquire the testing reagents and supplies needed to meet testing demands. We had to work closely with vendors on supply issues. In our community support came quickly and we were able to meet testing demands as early as late March. It truly was only able to happen because of the incredible staff who are dedicated to working tirelessly.
• We are grateful to the laboratory and medical supply industry providing the testing resources, they too are a critical part of the story. Each has accelerated the production of critical supplies, yet it isn’t enough to meet the global demand.  We are all learning about the complexity of supply chain systems, including the availability of raw materials.

As the economy opened up, testing demands increased dramatically. SHARP is seeing 1600-1800 samples a day with a reagent allocation that supports 1100 a day. To meet the need, we put workflows in place to offer 24-7 operations. The difference in this shift for us versus what I’ve seen in other parts of the country is that we started to plan for this in March, including how we would manage workflows, re-operationalizing PM staff to process the increase in molecular testing, re-programming routing between locations, maximizing our throughput on the Abbott, identifying our limitations on reagents – all at once. We came together as a team through these activities and have been able to deliver COVID testing results in less than twenty-four hours (sometimes less than six!).

• Laboratory services are returning to normal with a significantly fast pace, exhausting staff. We have definitely focused on putting strategies in place to minimize that stress on the staff. I think our services have been probably the best of anybody that I know right now. We’ve gotten a lot of positive feedback on service and turnaround times.

Aaron Harding is clearly focused on teamwork and outcomes. He can’t hide it, and it’s refreshing.

As a nation I think we’ve learned a tremendous amount about ourselves. I think there are so many warriors out there that don’t get a lot of recognition. Whether they’re a respiratory therapist or technician or logisticians (the individuals who are helping us manage the biohazard trash), informatics, we have quickly learned how important every member of the healthcare team is to deliver medicine. I think we have a lot to be proud of as a healthcare industry, working together across community boundaries. I’m proud to be in San Diego and a part of the SHARP Team during this time as I truly believe there’s no better place to work, to practice medicine and to receive care, pre-COVID, today or 6 months from now or, infinitely. We’re prepared and we care.

Thank you, Aaron, for your perspective – and your service. We’re grateful for experienced, focused, and passionate healthcare leaders like you throughout this unprecedented period of time. You truly are profoundly impacting healthcare.