Canadian Public Health Laboratory Network Strategic Plan 2016-2020

Table of Contents

• Vision, Mission, Mandate
• Message from the Executive
• Message from the Secretariat
• Executive Summary
• Priority 1: Advance Evaluation, Implementation, and Use of Diagnostic Technologies, Practices, and Standards
  • Objective 1: Develop Guidance on Public Health Laboratory Test Choice, Test Use, and Data Interpretation
  • Objective 2: Coordinate Integration of Bioinformatics and Whole Genome Sequencing Laboratory Processes and Procedures between the National Microbiology Laboratory and Partnering Provincial Public Health Laboratories.
  • Objective 3: Enhance Inter-Laboratory Integration of Electronic Laboratory Information Management Systems.
  • Objective 4: Develop Antimicrobial Resistance Guidance Documents to Improve Inter-Laboratory Data Sharing and Comparability.
  • Objective 5: Review National Surveillance Processes and Participate in the Nationally Notifiable Diseases Revision Process.
• Priority 2: Strengthen Coordinated Response Capacity to Address Established, Emerging, and Re-emerging Infectious Disease Pathogens and Public Health Threats
  • Objective 1: Develop CPHLN Emergency Response Protocols
  • Objective 2: Facilitate Business Continuity Efforts to Support Potential Surge Assistance Between Member Laboratories.
• Priority 3: Strengthen Public Health Laboratory Network Capacity and Member Continuity
  • Objective 1: Develop a Succession Plan Support Process for Future CPHLN Membership
  • Objective 2: Champion an Awareness of Public Health Laboratory Science and Services through Accredited Professional Training Programs.
  • Objective 3: Facilitate Expansion and Integration of CPHLN Liaising Opportunities
  • Objective 4: Explore Opportunities and Niches where Public Health Laboratories and the CPHLN can play a Role in One-Health
• Priority 4: Enhance Visibility, Communication and Collaboration Within the Public Health Laboratory System.
  • Objective 1: Enhance Communication Tools and Products
  • Objective 2: Highlight CPHLN’S Unique Role in the Broader Public Health System
  • Objective 3: Promote Relationships among Public Health Partners
• Acronyms

Vision, Mission, Mandate

Vision

A healthier Canada through connected public health laboratories.

Mission

To strengthen Canada’s public health system through coordinated laboratory services and leadership.

Mandate

To assure an integrated public health laboratory network response to infectious diseases that encompasses One-Health.

Message from the Executive

We are pleased to present the Canadian Public Health Laboratory Network (CPHLN) Strategic Plan 2016-2010.

CPHLN is a network that enables the collaboration and connectivity of federal and all provincial public health laboratories (PPHL) with multiple disciplines impacting human, animal and environmental health, to positively improve the lives of Canadians. Since the inception of CPHLN in 2001, we have leveraged the combined strengths, expertise and knowledge of our provincial, federal and greater public health community partners to become a robust network that is a recognized and respected voice for public health.

This growth has led to the evolution of our vision, mission and mandate statements:

Vision: A healthier Canada through connected public health laboratories.

Mission: Strengthening Canada’s public health system through coordinated laboratory services and leadership.

Mandate: To assure an integrated public health laboratory network response to infectious diseases that encompasses One Health.

The CPHLN Strategic Plan 2016-2020 is the result of an intensive two-day planning meeting and a year of dedicated development by our Laboratory Directors Council (LDC). With a focus on the future, the CPHLN is committed to accomplishing four strategic objectives over the next five years:

• Advance Evaluation, Implementation, and Use of Diagnostic Technologies, Practices, and Standards
• Strengthen Coordinated Response Capacity to Address Established, Emerging and Re-emerging Infectious Disease Pathogens and Public Health Threats
• Strengthen Public Health Laboratory Network Capacity and Member Continuity
• Enhance Visibility, Communication and Collaboration Within the Public Health Laboratory System

We look forward to working with all of you in fulfilling these goals and continuing to strengthen the responsiveness and preparedness of our public health system.

Matthew W. Gilmour, PhD FCCM ARMCCM
Federal Chairperson,
Canadian Public Health Laboratory Network

Frances Jamieson, MD, FRCPC
Provincial Chairperson,
Canadian Public Health Laboratory Network

Message from the Secretariat

Through implementation of the CPHLN Strategic Plan 2010-2015, the CPHLN continues its strong tradition of providing significant contributions to the public health system in Canada. As a network, CPHLN has enhanced public health laboratory response to established, emerging, and re-emerging infectious disease threats. CPHLN has become a recognized model for resiliency and cooperation, and it has continually spearheaded work on emerging public health challenges facing the Canadian public health community and people of Canada.

This strategic plan articulates specific priorities, objectives and goals to be achieved in order to realize our public health objectives for a community of healthy people living in Canada. We are confident that as we work to achieve our goals, CPHLN will continue to be a respected leader in the broader public health system and a source of pride for our members.

The Secretariat is grateful and thanks all CPHLN members who have contributed to the development of this plan, as well as those who will be engaged to execute these objectives. We appreciate all of our members’ meaningful dedication to the CPHLN and look forward to your continued commitment as we pursue our strategic goals in the next five years and beyond.

Theodore I. Kuschak
Director of Networks and Resilience Development
Canadian Public Health Laboratory Network

Dionne Marcino
Information and Preparedness Coordinator,
Canadian Public Health Laboratory Network

Sandra Radons Arneson
Standards Development Officer
Canadian Public Health Laboratory Network

Melinda Patterson
Laboratory Network Coordinator
Canadian Public Health Laboratory Network

Executive Summary

Public health laboratories (PHLs) are essential partners that operate within the broader public health system. The scope of work entrusted to laboratories is constantly expanding, as is the depth and breadth of our partnerships with national and international public health stakeholders. This significant public health laboratory evolution and the critical need for enhanced integration have informed the development of four strategic priorities of the CPHLN Strategic Plan 2016-2020:

• Advance Evaluation, Implementation, and Use of Diagnostic Technologies, Practices, and Standards
• Strengthen Coordinated Response Capacity to Address Established, Emerging and Re-emerging Infectious Disease Pathogens and Public Health Threats
• Strengthen Public Health Laboratory Network Capacity and Member Continuity
• Enhance Visibility, Communication and Collaboration Within the Public Health Laboratory System

The priorities identified highlight the CPHLN’s dedication to its vision, mission, and mandate by proactively working toward strengthening Canada’s public health system and forming strong and cooperative linkages with other programs and disciplines that align within the One-Healthcontext^{Footnote 1}.

Over the next five years, the CPHLN will strive to strengthen national laboratory capacity, advance diagnostic capability and capacity, enhance laboratory diagnostic standards and preparedness to emerging threats across Canada. The CPHLN will also work to prepare the next generation of public health laboratory professionals to assume leadership roles within CPHLN and foster collaborative partnerships. Finally, the CPHLN will endeavor to provide the larger global health community with clear and succinct knowledge of the critical role played by public health laboratories in combating infectious diseases in our communities.

Priority 1: Advance Evaluation, Implementation, and Use of Diagnostic Technologies, Practices, and Standards

Accurate, reliable, and timely laboratory diagnostic technologies, practices, and standards are used to establish the microbial causes of illness required to inform on patient care and to guide broader public health responses. Advancements in technologies, practices, and standards will improve clinical care, inform disease outbreak investigations, and guide the responsible use of antimicrobial agents.  

Objective 1: Develop Guidance on Public Health Laboratory Test Choice, Test Use, and Data Interpretation

Goal 1: Draft the CPHLN Gold Standards of Laboratory Tests (GSLT) that includes guidance for clinicians and public health professionals.

The Laboratory Directors Council (LDC) will establish a working group to develop the GSLT, and specify an annual mandate to address gaps in programs areas and provision of proficiency panels, and develop specific testing recommendations. CPHLN Executive will monitor working group progress and facilitate linkages with subject matter experts.

The advancement of new technologies requires the CPHLN to address this priority in a timely manner to meet the evolving landscape of public health laboratory science.

Objective 2: Coordinate Integration of Bioinformatics and Whole Genome Sequencing Laboratory Processes and Procedures between the National Microbiology Laboratory and Partnering Provincial Public Health Laboratories.

Goal 1: Improve the processes and procedures of integrated federal, provincial, and territorial (FPT) public health programs.  

Goal 2: Conduct a gap analysis of advanced technologies exclusive of “–omics”.

Goal 3: Develop approaches to address training, capacity, and data analysis gaps related to whole genome sequencing (WGS) and advanced technologies analyzed as part of goal 2.

Goal 4: Support the development of “-omics” technologies within PPHLs (e.g. PulseNet+, genomics, proteomics) in both clinical and research settings.

Goal 5: Support and assist the standardization of matrix-assisted laser desorption/ionization (MALDI) technologies in Canada, for PPHLs.

The National Microbiology Laboratory (NML) is a leader in the implementation of WGS in Canada. Implementation challenges at the provincial level need to be addressed in order to meet the evolving landscape of public health standards world-wide.

Coordinating the integration of bioinformatics in PPHLs is necessary to enhance the diagnostic assistance they provide to front-line laboratories. The NML will support the CPHLN through the transfer of technology and training to help the PPHLs advance in this area. Current projects such as the distribution of the MiSeq sequencers to PPHLs will facilitate the availability of WGS capabilities across Canada.

The CPHLN will assist the NML in developing a national database of unique or rare Canadian organisms that is translatable between commercial systems. The NML will also work to develop a customized bioterror database for MALDI that will be accessible by CPHLN member laboratories.

These goals will be achieved by continued collaboration with partner organizations (e.g.National Molecular Diagnostic Users Group) to improve new technology uptake, and the development of a clear road-map for PulseNet WGS implementation and use.

The completed road-map for PulseNet WGS will include stakeholder work plans and will address training, technology, and capacity gaps. The laboratories will focus on microbial preparation, processing, and data quality to outputting (e.g.quality assurance protocols, data interpretation and development of standards). The NML and PPHLs, in conjunction with federal and provincial epidemiology partners, will also develop interpretation and metadata criteria for WGS.

Objective 3: Enhance Inter-Laboratory Integration of Electronic Laboratory Information Management Systems.

Goal 1: Improve methods for the sharing of electronic laboratory information.

Improving the fluidity of electronic information sharing reduces the burden on the public health system. Preliminary development of eRequisitions and local laboratory information systems (LIS) has highlighted the need to establish in silico systems’ abilities to communicate.

Progress in completing this goal will be measured through the implementation and roll-out of eRequisitions at the NML and the development of provincial and federal data linkages. The CPHLN Laboratory Information Management System working group has developed a detailed work plan that focuses on all elements of LIS, from requisitions to reporting.

Information Management/Information Technology projects can be demanding and complex. The CPHLN considers this goal achievable provided the project is well-defined, and tasks and resources are appropriately distributed among all partners.

The CPHLN recognizes there are complex interrelated issues to be addressed during the course of this project. The completion of this objective is time sensitive because it is intimately linked to national priorities relating to privacy as well as federal and provincial public health information acts.

Objective 4: Develop Antimicrobial Resistance Guidance Documents to Improve Inter-Laboratory Data Sharing and Comparability.

Goal 1: Develop a working group comprised of community, hospital, and public health microbiologists with front line infectious disease clinician partnerships.

Goal 2: Create and distribute interim recommendations for isolate sharing and the testing and analysis of multi-drug resistant organisms (MDRO) and eXtensive drug resistant organisms (XDRO).

Goal 3: Incorporate MDRO and XDRO recommendations that will be reviewed longitudinally at specified intervals.

Goal 4: Support and engage AMRNet^{Footnote 2} pilot projects and activities, including the development of an AMRNet task group as part of the Antimicrobial Resistance Working Group (AMR WG). This task group will champion national Antimicrobial Resistance (AMR) laboratory surveillance to support coordinated public health actions.

Goal 5: Develop a common data set for antibiograms with special attention to community microbiology.

Goal 6: Discuss data sharing and public health reporting of potential AMR public health threats with other partners.

The CPHLN AMR WG will be comprised of microbiologists and infectious disease physicians from public health, hospitals, and community-based laboratories. The group will be mandated to provide guidance to harmonize AMR laboratory definitions and partner with the broad spectrum of AMR stakeholders.

The mandate of this working group will be the provision of interim recommendations for labeling multi- and extensively drug resistant gram negative organisms adapted to the Canadian context.

The AMR WG will develop a task group to champion AMRnet and develop a common minimal dataset for use across all jurisdictions. This data set will provide consistency in the creation of antibiograms, especially for smaller laboratories.

The AMR WG will also discuss data sharing and public health reporting of potential public health threats (specifically for XDRO or carbapenemase-producing Enterobacteriaceae) with AMR partners.

Objective 5: Review National Surveillance Processes and Participate in the Nationally Notifiable Diseases Revision Process.

Goal 1: Support the Pan-Canadian Public Health Network (PHN) in their review of current practices for Nationally Notifiable Diseases (NND) development and the revision of laboratory case definitions as required.

To ensure a holistic and collaborative approach to the NND processes, the CPHLN will work with the Communicable Infectious Disease Steering Committee^{Footnote 3} to revise the process for NND review and updates, and to define roles and responsibilities in the NND process. It will also review the process for FPT epidemiologist participation and develop an algorithm for laboratory evaluation.

Priority 2: Strengthen Coordinated Response Capacity to Address Established, Emerging, and Re-emerging Infectious Disease Pathogens and Public Health Threats

The twenty-first century has experienced an escalation of globalization. As societies become more interwoven, public health incidents of national and international concern are increasing in both magnitude and frequency. Pathogens that were not endemic to an area now migrate easily with international travelers and have the potential to become established in new regions; those that were eliminated are now re-emerging or becoming drug resistant; still others are evolving to become infectious to humans. These challenges are being exacerbated by significant changes in global climate patterns and human behaviours.

Objective 1: Develop CPHLN Emergency Response Protocols

Goal 1: Develop an all-hazards plan that outlines CPHLN response protocols for both emerging^{Footnote 4} and unknown^{Footnote 5} pathogens.

Since its inception, the CPHLN has engaged in preparedness activities that address current and anticipated needs of the public health community in Canada. For example, the CPHLN Bioterrorism Response Subcommittee built laboratory response capabilities for bioterror events in Canada and was a forerunner to the Canadian Laboratory Response Network. Similarly, the efforts of the Pandemic Influenza Laboratory Preparedness Network guided laboratory response during the H1N1 pandemic.

The CPHLN will develop a Network all-hazards plan based on an extensive hazard-risk-vulnerability assessment and experience with prior public health responses. The all-hazards plan will encompass the five pillars of emergency response^{Footnote 6}, but will focus on preparedness and response. The plan will be considered a living document and will be revised based on lessons learnt from table-top exercises and future responses.

Development of this plan will be led by the Emerging Pathogens Working Group^{Footnote 7} which will conduct strategic consultations with other CPHLN working groups (e.g. the Biosafety Officers Network) and external partners (e.g. the Centre for Biosecurity).

The all-hazards plan will incorporate NML protocols^{Footnote 8} that are fundamental to a nation-wide laboratory response, and guidance for topics such as shipping, Emergency Response Action Plan activation, and decentralization of diagnostic testing in Canada.

It is prudent to address this objective in a timely manner in order to capture and formalize plans and response protocols utilized during recent outbreak events.

Objective 2: Facilitate Business Continuity Efforts to Support Potential Surge Assistance Between Member Laboratories.

Goal 1: Create a CPHLN process to initiate and address urgent assistance requests.

Goal 2: Share best-practices to assist with the development or augmentation of laboratory-specific business continuity plans.

Goal 3: Create a process to enable the CPHLN to continue to function at optimal or close-to-optimal capacity during public health events of national or international concern.

Achieving these goals will assist CPHLN members in developing protocols that will strengthen response capacity during periods of service disruption. This will include: sharing of existing business continuity protocols; developing measures to facilitate cohesive Network functionality during times of regional, national or international crisis; and creating protocols to conduct emergency surveys to identify bodies able to assist facilities in times of crisis.

Similar to the all-hazards plan outlined in objective 1, these activities will be led by the Emerging Pathogens Working Group which will conduct environmental scans and strategic consultations with other CPHLN working groups (e.g. Biosafety Officers Network) to ensure that emergency response messaging is consistent.

This plan will be considered a living document and will be revised based on lessons learnt from table-top exercises and future responses. This objective will be addressed immediately following the completion of the all-hazards plan.

Priority 3: Strengthen Public Health Laboratory Network Capacity and Member Continuity

Public health laboratories (PHLs) are critical partners within Canada’s public health system. They provide services that are essential to keeping Canada’s population safe and healthy, while contributing significantly to public health policy decisions that guide public health action. Strong, dedicated leadership within and relationships among these laboratory facilities are essential to the continued success of Canada’s public health system. As such, enhancing the networking experience of incumbent and potential members of CPHLN is a priority.

Objective 1: Develop a Succession Plan Support Process for Future CPHLN Membership

Goal 1: Create a process that facilitates succession planning within CPHLN by developing information resources that incumbents can use to orientate their successors.

Succession planning and support is an essential part of every organization. Good succession planning helps to build consensus, strengthens relationships, and assists in ensuring continuity of operations. CPHLN will develop an orientation program that assists experienced Network members with integrating their successors and facilitating their ability to quickly take an active role in the Network.

The resources within the orientation program should expedite the development of a concrete understanding of the CPHLN culture and introduce successors to their roles and responsibilities; these resources will also communicate the CPHLN’s history, structure, and priorities. By providing a realistic representation of CPHLN and the successors’ roles within it, new members will be able to quickly engage in CPHLN activities.

The orientation program will remain focused on succession planning and will be developed as part of a larger Toolbox of communications tools, as outlined in Strategic Priority 4: Enhancing Visibility, Communication and Collaboration Within the Public Health Laboratory System.

This program will be reviewed regularly by surveying new members on their experience integrating into the CPHLN. Due to the significant number of pending changes to the current membership, it is imperative to develop the orientation program expeditiously. This approach will enhance smooth integration of successors into the CPHLN.

Objective 2: Champion an Awareness of Public Health Laboratory Science and Services through Accredited Professional Training Programs.

Goal 1: Work with accredited professional training programs to enhance awareness of the importance of public health laboratory science and services.

There is a need to improve knowledge of the unique role of PHLs and the intricacies of laboratory diagnostics among medical professionals. Enhancing the knowledge of public health laboratory science and services is critical for maintaining a skilled, resilient PHL workforce. The CPHLN will work with accredited professional training organizations such as the Royal College of Physicians and Surgeons of Canada and the Canadian College of Microbiologists to incorporate or enhance a PHL component into their training programs. This component will include a competency report that will be submitted to the accreditation body for consideration.

Successful completion of this work will depend on close collaboration and the opportunity to adapt and schedule implementation of these activities in both colleges.

Objective 3: Facilitate Expansion and Integration of CPHLN Liaising Opportunities

Goal 1: Maintain, expand, and integrate existing laboratory and networking activities and programs more formally into collaboration with the CPHLN.

CPHLN has many current activities that would benefit from enhanced alignment in order to exploit already developed products, opportunities, and tools, and to ensure duplicate processes/activities can be identified and addressed.   

Goal 2: Create new liaising opportunities to develop decentralized capacity and support for response to emerging pathogens.

The CPHLN is a collaborative partner within national and international public health communities. The CPHLN has successfully established relationships and bridged gaps within the PHL community, among laboratories, and other sectors of public health. This outreach has enabled the CPHLN to contribute to the development of integrated programs within Canada, and work with international groups so as to remain at the forefront of a dynamic public health environment. The CPHLN will work with external program leaders to determine where and how to further integrate their representatives into CPHLN activities.

The CPHLN will strive to develop new liaising opportunities that will assist in the development of technical capacity to support rapidly evolving technologies such as bioinformatics and whole genome sequencing in Canada. Together with Strategic Priority 3: Strengthen Response to Emerging Pathogens and Public Health Threats, CPHLN will also work to create new partnerships that will focus on developing decentralized capacity and supporting the response to public health threats facing Canada as well as Public Health Events of International Concern.

Successful completion of this objective will be dependent on external programs (e.g. the Laboratory Liaison Technical Officer program) being more closely aligned with formal CPHLN work plans and on developing novel liaising opportunities to support the development of novel scientific advancements (e.g. bioinformatics, whole genome sequencing).

CPHLN’s imperative is to address this objective in a timely manner in order to build upon recent informal collaborations.

Objective 4: Explore Opportunities and Niches where Public Health Laboratories and the CPHLN can play a Role in One-Health

Goal 1: Identify the role that PHLs have in One-Health, and how the CPHLN will contribute.

Human, animal, and environmental health challenges are intimately linked. The One-Health initiative

“...seeks to promote, improve, and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals and by promoting strengths in leadership and management to achieve these goals.”^{Footnote 9}

In collaboration with the Pan-Canadian Public Health Network, the CPHLN will identify the role that Canadian PHLs play in this initiative and determine how the CPHLN and its member facilities can contribute to the success of One-Health objectives. Within the context of CPHLN’s current understanding of the One-Health initiative, the Network will establish functional and productive collaborations, networks, and working groups with One-Health partners.

While it is critical that CPHLN participate in this work, it is understood that completion of this objective will be a lengthy process.

Priority 4: Enhance Visibility, Communication and Collaboration Within the Public Health Laboratory System.

Visibility, communication, and collaboration are vital elements of any network. The CPHLN’s ability to communicate effectively allows the Network to facilitate decision-making with external stakeholders. CPHLN’s visibility enables it to develop new collaborative public health opportunities and to refine existing relationships.

Objective 1: Enhance Communication Tools and Products

Goal 1: Develop an electronic Toolbox of communication products to enhance the profile of public health laboratories.

Goal 2: Create and maintain a web presence that meets CPHLN’s emergency response and communication requirements.

Goal 3: Develop communication products for distribution that accompany electronic tools.

The overarching ambition of this objective is to re-establish the CPHLN’s web presence so that information can be shared efficiently with internal and external stakeholders. To achieve this, the CPHLN will develop an electronicToolbox of communication products that will be available for download by the public health community and the general public.

The electronic communication products will: provide a robust description of the Network and its capabilities; highlight the benefits of engaging with both the CPHLN and PHLs; provide educational opportunities; and provide protocols for emerging or emergent pathogens^{Footnote 10} as they relate to the public health laboratory community.

CPHLN has had a strong and successful history of creating awareness by developing and sharing non-electronic messaging such as brochures, pamphlets, hosting of booths, and sharing of media-relations tools. CPHLN will resume development and use of these awareness opportunities in the future.

It is prudent that this issue be undertaken expeditiously in order to address Priority 3:Strengthen Public Health Laboratory Network Capacity and Member Continuity.

Objective 2: Highlight CPHLN'S Unique Role in the Broader Public Health System

Goal 1: Capitalize on CPHLN’s accomplishments to illustrate the Network’s established utility and long-standing value to FPT and international decision makers.

Since the first CPHLN strategic plan was drafted in 2002, the CPHLN has successfully fulfilled a significant number of strategic objectives that promote and enhance public health in Canada. High profile CPHLN projects, such as laboratory case definitions for Nationally Notifiable Diseases, the Laboratory Annex for the Canadian Pandemic Influenza Plan and others are easily identified by decision-makers. To ensure that equally important projects that have a lower profile are recognized, the CPHLN is committed to developing communications products that capture the CPHLN’s accomplishments and highlight the valuable role that the Network and its member facilities play within the public health system. These products will be key components of a broader communications Toolbox and will be developed specifically for decision-makers.

This objective should be achieved within the five-year strategic plan.

Objective 3: Promote Relationships among Public Health Partners

Goal 1: Build upon existing relationships through enhanced integration and communications. CPHLN has established many formal and informal relationships in Canada and in the international community. These relationships need to be more fully engaged.

Goal 2: Increase the frequency of face-to-face CPHLN meetings.

The effectiveness of the CPHLN has been diminished by financial constraints that limited its face-to-face meeting opportunities to discuss challenges that are difficult to resolve on short teleconferences or by email. Face-to-face meetings offer a unique opportunity to enrich meeting participants’ dedicated focus on CPHLN challenges that are not well served by other mechanisms, as well as facilitate and encourage informal discussion and networking amongst members on issues pertinent to CPHLN and its partners.

Goal 3: Identify and create new strategic relationships with particular attention paid to those serving indigenous groups and populations.

Since 2001, the CPHLN has worked diligently to foster and maintain strong relationships and communication within the laboratory community, and between this community and the greater public health system. CPHLN’s successes in these collaborative opportunities have been reinforced by robust face-to-face meetings among jurisdictional and subject matter representation.

The CPHLN will strengthen existing and build new relationships with the public health community by working with professional associations to expand collaborative opportunities.

Achieving these goals and increasing the frequency of face-to-face meetings will position the CPHLN as the preeminent organization for public health laboratory related issues in Canada.

This objective should be achieved within the five-year strategic plan.

Acronyms

AMR

Antimicrobial Resistance

AMR WG

Antimicrobial Resistance Working Group

CPHLN

Canadian Public Health Laboratory Network

FPT

Federal/Provincial/Territorial

GSLT

Gold Standards Of Laboratory Tests

LDC

Laboratory Directors Council

LIS

Laboratory Information Systems

MALDI

Matrix-Assisted Laser Desorption/Ionization

MDRO

Multi-Drug Resistant Organisms

NML

National Microbiology Laboratory

NND

Nationally Notifiable Diseases

PHL

Public Health Laboratories

PPHL

Provincial Public Health Laboratories

PHN

Public Health Network

WG

Working Group

WGS

Whole Genome Sequencing

XDRO

Extensive Drug Resistant Organisms