FAQs for Administrators

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. In general, about 10,000 baby boomers are retiring each day for the next decade. The laboratory profession is no exception and it will be painful as more leave because there simply won't be enough new graduates to fill their positions. The American Society for Clinical Pathology (ASCP) offers several additional workforce concerns to consider.
www.ascp.org/content/docs/default-source/policy-statements/ascp-pdft-pp-med-lab-personnel-short.pdf?sfvrsn=2
https://www.ascls.org/images/Government_AffairsGAC/Symposium/Caldwell_ASCPStudies_2019.pdf

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 entice/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 laboratory 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 time it takes to supervise students far outweighs the disadvantages. The students learn about you and you learn about the students making recruitment a more fluid process. Besides, there is nothing like teaching students to keep your staff sharp and 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. The cost of employing OJT candidates can be expensive due to extensive training time and requires more time from certified staff to train them. Clinical laboratory professionals from accredited educational programs enter the practice field equipped 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 accepted 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 directly impact clinical decisions in patient care.

What qualifications and competencies should laboratory personnel have to ensure good quality and cost-effective care for our patients?

www.degruyter.com/view/journals/cclm/54/7/article-p1117.xmlClinical 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.

Sources: https://www.degruyter.com/view/journals/cclm/54/7/article-p1117.xml
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049056/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759162/

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. Enhanced automation and computerization have allowed for a greater array of testing modalities. Utilizing poorly or minimally trained staff who have had less training and experience have often been targeted as '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)

The complex technology behind automation can be fraught with technical problems if not overseen by competent laboratory professionals. The more complex the technology, the more opportunities for problems can occur. A laboratory requires a skilled professional to recognize and correct problems in a timely and accurate manner 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?

Laboratory errors due to under-staffed and/or under-qualified personnel can directly impact the quality of patient care.
Unnecessary delays in reporting test results frequently delays treatment and care.
Increased cost in personnel time, reagents, and delayed reporting can occur due to repeating and confirming laboratory results.
Significantly increased downstream costs in the provision of routine or emergency care, for example:
- In-patients are generally allowed to be discharged until the latest laboratory results are reviewed.
- Delays that keep a bed from being available results in delays in admitting a new patient.
- Delays that may keep Emergency Department patients from prompt treatment and release, or acutely ill patients that need to be admitted and treated immediately.
- An incorrect result that causes a patient to undergo an unnecessary surgical procedure, receive potentially dangerous unneeded medications, and/or undergo further expensive testing, scans, or other treatments.

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