I’m concerned about the shortage of medical laboratory professionals. Is this a regional or national issue?
Yes. There are regional differences but the big picture is that the wave of new hires in the sixties and seventies, a period of extraordinary growth in laboratory services, are now approaching retirement. It will be painful once they start to retire because there simply won't be enough new graduates to fill their positions.
How can a hospital protect itself against a shortage of qualified laboratory staff?
The easy answer is that you should make sure that you pay competitive wages and benefits to increase retention of current employees and to recruit new staff.
You should, also consider hosting medical technology students in training. An essential part of a medical technology program is real world experience in a hospital lab as part of a supervised practicum. These programs last for a number of months and are a great way to connect with students who are about to graduate and look for work. The immediate disadvantage is that it takes a little more time for your lab staff to supervise the students but the advantages far outweigh the disadvantages. The students learn about you and you learn about the students and there is nothing like teaching students to keep your staff sharp on up to date.
With the shortage of laboratory professionals, I have heard that some institutions hire biology/chemistry graduates and train them on-the-job. Could this work for our institution?
While graduation from a National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) accredited clinical laboratory science (CLS) program and certification do not ensure quality results, these graduates have demonstrated entry-level competency at a specific level of practice that generally allows more rapid integration and successful contribution to patient testing. The same type of competency cannot be achieved through on-the-job training (OJT).
There are also other issues to consider with OJT individuals. Risk management and patient safety are just two of them. OJT individuals potentially expose the laboratory to more liability because of less clinical laboratory testing education and knowledge. OJT individuals can be more expensive to organizations in many ways. Training time is longer and generally requires more time from certified staff to train them. Clinical laboratory professionals from accredited educational programs enter the practice field equpped with critical thinking skills that enhance problem-solving necessary to resolve issues encountered that may be specific to clinical laboratories.
A facility would not hire an OJT individual into a registered nurse position. Qualified and competent nurses require specific education and training from an accredited program along with registration and certification in order to ensure that standards of practice are met and that persons engaged in the practice of nursing are competent. A healthcare facility should expect no less of laboratory professionals who perform complex testing that impact over 70% of clinical decisions for their patients.
What qualifications and competencies should laboratory personnel have to ensure good quality and cost-effective care for our patients?
Clinical laboratory testing plays an essential part in the delivery of quality health care. Laboratory tests provide physicians with objective data needed to promptly diagnose and effectively treat and monitor disease. It is estimated that lab testing has an impact on over 70 percent of medical decisions, yet laboratory services account for only three percent of health care spending (and two percent of Medicare expenditures). By equipping physicians with critical information, laboratory tests ultimately save lives and reduce overall health care costs.
Why is it so important to have such specifically educated, well-trained individuals to work in a laboratory? Isn't much of what they do performed by instruments and machines that do most of the work?
For the last decade, laboratories have dealt with increased demands and reduced resources by acquiring more advanced technology. Increased automation and computerization has allowed more and more testing with fewer and fewer analysts. Those analysts may also have less training and experience since staffing strategies have targeted lower-cost personnel. "The danger is that the advanced technology and automation also makes it easier to produce more bad results faster than ever before." (Westgard, J. Six Sigma Staffing Strategies)
Though complex technology has made testing more automated, problems with that technology will occur. Those problems that can arise anytime during the day or night and can be increasingly complex. A laboratory requires a skilled professional to recognize and correct problems with complex methods or technology before results are released and harm can come to a patient.
What potential risks does my facility and my patients face in having insufficient numbers of qualified laboratory staff?
Increased errors that can impact the source of patient treatment and care due to understaff labs providing hurried or rushed services.
Missed or incorrect diagnoses due to incorrect???
Increased delays in availability of test results that translate into increased delays in treatment and care.
Increased cost due to laboratory rework of mistakes.
Significantly increased downstream cost in the provision of routine or emergency care, for example:
Delays that keep a bed from opening up faster
Delays that may keep ER patients from flowing through quickly
An incorrect result that causes a patient to unnecessarily undergo a procedure