The primary raison d’etre for any clinical laboratory is to provide quality diagnoses, monitor treatment, and enable effective care for patients in the healthcare system; and to do this as expeditiously as possible.

The ultimate success of the laboratory in achieving these goals comes down to the quality of the laboratory staff and the management skills applied by the laboratory director and supervisors of the laboratory.

Staff Development and Support

Whether highly trained laboratory professionals, or medical assistants and nurses, (who may have work responsibilities in the lab), your staff are the backbone of the laboratory.  In order to perform as expected, they must be supported by having the laboratory structure and operating systems in place.  These include policy and procedure manuals, personnel standards; training and competency protocols, procedures for equipment validation and maintenance, supplier and inventory management, quality control, record keeping and documentation capacity, incident reporting and investigation, quality assessment, as well as facility and safety procedures.

A well-trained, competent, and dedicated laboratory staff will provide comprehensive and meaningful feedback to the management team; identifying laboratory errors and potential risks, recommending improvements to the laboratory operation, as well as performing all the tasks needed to achieve the highest level of quality for the laboratory.  It is the responsibility of the management to hire, train, and keep good staff, and create a sense of shared teamwork, commitment, and competency.

Once the staff you want is in place, it is important to show appreciation for their work, since good employees are hard to find, and even harder to replace. It is through the application of management skills that you achieve the confidence and loyalty of your staff, build a culture of open communication, teamwork, trust and quality, which allows the ongoing implementation of changes necessary for the survival of the laboratory.

High staff morale will be the consequence of these approaches as well. Workplace morale plays an important role in productivity and job satisfaction, making it a key determinant in an organization’s success. As such, it has assumed increasing importance for clinical laboratory managers, since low morale has been shown to have significant implications for patient safety. Low morale can lead to a dangerous disconnect between employees and their jobs that may cause them to cut corners, not pay attention to details, or simply not care whether or not they do the right thing. Monitoring and proactively dealing with low morale in the clinical laboratory not only avoids considerable downstream costs associated with absenteeism, re-hiring, and training, but also contributes to a better and safer workplace.

Effective personnel management practices include:

    1. Demonstrated Leadership: this goes beyond routine staff management, as it often sets the environment (culture) and pace of the lab. Good leadership can inspire the laboratory staff toward greater productivity and creativity, teamwork and trust; and encourage feedback.  This includes short and long-term planning, goal setting and even creating a mission statement as a guiding light for all that the lab stands for.
    2. Structured Organization: the laboratory manager determines how the laboratory work gets done through job assignments, staffing levels, policies and procedures; management of timelines and budgets; keeping current with  changes in laboratory technology  and regulation as it affects the laboratory operation.  Complete and updated job descriptions, on-going training and competency assessments, and current personnel manuals that are available to every employee are critical components of a structured organization.
    3. Ready Accessibility: ready access to management whenever needed builds a sense of stability, consistency and support. It builds confidence among staff, while encouraging additional direct communications.
    4. Deliberate Transparency: the laboratory manager  provides the staff with key information about future plans for the development of the laboratory; involving the staff when possible.  Regular staff meetings are an important tool to keep staff informed, provide opportunities for participation, and allow for immediate feedback.

Steps to creating a culture of continuous improvement

    1. Communicate with your employees: Make a point of meeting with all new employees, and get acquainted. In addition, make sure all staff can feel free to discuss any issue or new ideas.
    2. Recognize their achievements: Celebrate successes due to the team efforts of staff ; thank people for doing a job well; publicly recognize hard work;  praise staff commitment during difficult times.
    3. Provide diversity training: Teaching cultural competence, i.e. appreciating and understanding of the diverse social and cultural beliefs of coworkers as well as patients, strengthens the trust, dignity, effective communication and quality of care provided by the laboratory.
    4. Help your employees to succeed:. Provide employees with the resources and support to do their work, and as they show signs of readiness, be willing to entrust them with new tasks and greater responsibility.
    5. Use employee satisfaction surveys to empower employees and gain honest insights: Large and small laboratories alike can benefit from asking employees about their level of satisfaction on many different topics by simply using an employee satisfaction survey. Better-performing practices conduct employee satisfaction surveys at least once per year. This anonymous approach to asking about the organization, customer service, compensation, benefits, working environment, professional growth, communication, and employee attitude toward supervisors and physicians can provide vital information to everyone involved. Results of the survey can provide a picture of an organization’s needs and strengths.
    6. Provide continuing education: this should include a formal orientation program, cross-functional training, maintenance of professional skills, coaching, career development, and personal development. Continuing education should go beyond the immediate laboratory (technical) environment. The best preparation should include information about legislation (such as the Affordable Care Act;  how Accountable Care Organizations (ACOs) might affect private practices and hospitals;  issues of privacy related to Electronic Medical Records (EMR) ;  FDA and OSHA decisions) and future trends.  This will prepare your staff for the inevitable changes coming to every laboratory operation.

In Conclusion

Staff respond well to high expectations, since this makes all employees feel valued and appreciated by their supervisors.  When there is a culture of transparency, and information is shared proactively, they gain the trust and loyalty of their staff.  When staff are supported and recognized for their work, higher morale is achieved.  That is the recipe for a quality laboratory operation.

I Rothenberg.  “ Building The Right Team – Staffing A Physician Office Laboratory”  LabOratory. Physician Office Resources May 2015
COLA White Paper:  Integrating Laboratories Into The PCMH Model of Health Care Delivery.  Pg.5-7
The High Cost of Low Morale in the Clinical Laboratory: How Workplace Environment Impacts Patient Safety, Tabitha Barker MLT, and Jaime Noquez, PhD.  AACC Clinical Laboratory News. January 2015.
Five Ways To Retain Good Staff.  Roger Shenkel MD, and Cathy Gardner.  Fam. Pract. Manag. 2004 Nov-Dec; 11(10) 57-62.
Five Ways To Retain Good Staff.  Roger Shenkel MD, and Cathy Gardner.  Fam. Pract. Manag. 2004 Nov-Dec; 11(10) 57-62

About The Author

Kathy Nucifora oversees all facets of COLA's accreditation program on behalf of the firm's nearly 8,000 client laboratories. Before joining COLA as Accreditation Manager, Kathy was the Laboratory Administrator at Maryland General Hospital in Baltimore. In addition to managing quality processes and the day to day operations of the lab, she developed and led a multidisciplinary task force to implement molecular testing for MRSA; she implemented a positive patient identification system via handheld computers; and helped lead the Laboratory and Nursing Process Improvement Committee.

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