ascls_logo-300x199Serving the patient has always been at the heart of clinical laboratory medicine, however the Institute of Medicine has identified improving patient-centered care as a key competency to improve healthcare quality.1 For laboratory professionals, providing patient-centered care means identifying, respecting and caring about patients’ values, preferences, differences, needs and expectations. This requires effectively listening to, clearly communicating with and educating our patients about laboratory testing.2   As the laboratory scientists who play a critical role in patients’ care, we have the duty to ensure that our patients and their providers understand preparation requirements for testing, receive information about the meaning of lab tests and our services  meet their needs and expectations. Providing direct access testing and patient access to laboratory test results are other ways we can become more patient focused. These are obvious areas to focus on in order to work towards this goal, however there are critical skills laboratorians can develop to become more patient-centered.

Thinking more holistically about patients’ experiences and patient outcomes is a first step in becoming more patient-centered.   For example, we cannot measure turnaround time as the time when the specimen is received in the laboratory to the time that the result is released.   Would this lab focused definition of  turnaround time matter to the patient if a stat test arrived in the laboratory 3 hours after its collection? Of course not. What really matters to the patient is how much  time it takes from specimen collection to when their care provider can  use the information for clinical decision making. It is often less convenient and “messier” to think outside the boundaries of the laboratory, however developing big picture, patient-centric thinking  enable us to participate on interdisciplinary teams with other care providers, provide feedback and effectively problem solve with non-laboratory providers.  This allows laboratory professionals to truly have an impact on what is important to the patient and their care.

Sharing information about laboratory testing with patients and healthcare providers requires a new set of communication skills. For some of us, effectively communicating with patients and their providers is challenging.  Many of us work in our insulated laboratories with only the occasional phone call from a care provider. Effective consultative communication is a skill that lab professionals need to consciously work to develop. This will allow us to communicate important information to patients and to become valued members of the patient-centered care team.  Although we  may think we don’t have control over a certain aspect of the pre-pre-analytical phase, we certainly have influence. This influence  increases with effective  communication.  Laboratory professionals have valuable information to share with  providers caring for patients. How often do we proactively and strategically communicate our knowledge and concerns? I would argue not often enough.

Clinical laboratories are not a black box where specimens go in and test results come out. Clinical laboratories are the places where scientists with important, often critical, medical information is identified and communicated to patients and their care providers.  We owe it to ourselves and our patients to look for ways to make laboratory service  more patient-centered  and  share our expertise with the rest of the patient care team.

 

  1. Institute for Healthcare Improvement. Across the Chasm Aim #3: Health Care Must Be Patient-Centered. 2015. retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/AcrosstheChasmAim3HealthCareMustBePatientCentered.aspx.
  1. Committee on the Health Professions Education Summit, National Academies Press. Greiner AC, Knebel E. Eds.  Health Professions Education:  A Bridge to Quality. Washington DC:  National Academies Press; 2003. 

About The Author

Jennifer Dawson, MHA, LSSBB, CPHQ, DLM(ASCP)SLS, QIHC, QLC, is Sr. Director, Quality for Human Longevity in San Diego, CA. She sits on the CLSI Quality Management Systems Expert Panel, the ASCLS Patient Safety Committee and the AACC Management Sciences & Patient Safety Division Executive Committee. Jennifer has also recently served on the National Malcolm Baldrige Quality Award Board of Examiners and the CLMA Board of Directors. She is a frequent presenter and publishes articles in trade magazines and journals on the topic of quality in a clinical laboratory. Her areas of interest include ISO 15189 and Baldrige Framework deployment, real-time quality metrics, cost of poor quality, electronic management of non-conformities, creating a culture of quality, and quality in the pre-analytical phase. She’s a Lean Six Sigma Black Belt, a Certified Professional in Healthcare Quality, a Diplomate in Laboratory Management certification from ASCP and is a fellow of the American College of Healthcare Executives. She is also Health Services Administration faculty at Regis University.