ascls_logo-300x199Being patient-centered, one of the Institute of Medicine’s 6 Quality Aims, is defined as respecting the patient’s culture, social context and specific needs as well as involving the patient in decision making about their care1. Becoming patient-centered is a current focus in healthcare. For a laboratory to achieve this IOM aim, obvious things come to mind such as making patients feel comfortable during phlebotomy, educating them about their testing, and providing direct, easy access to lab results2. There are fundamental, and perhaps less obvious, shifts that need to occur to facilitate this movement towards becoming patient-centric.

As clinical laboratory professionals, we are often far removed from our patients. Some of us work for reference laboratories where patients never step foot. It is easy to stop envisioning people and start seeing a sea of accession numbers. To become patient-centric, laboratorians must never lose sight that we do not test specimens, mere numbers, but instead we test patients. All too often, laboratory scientists and technicians  declare that there is nothing that they can do about an issue that occurs before a specimen arrives in the laboratory or after results are issued. Egregious errors in ordering or improperly submitted specimens may be noticed by lab staff with no feedback given to the providers. How often have you heard, “That’s the doctor’s fault” or “Not our problem”?

Laboratory professionals  can no longer limit their participation in patient care to inside the boundaries of the lab.  Laboratory scientists and technicians have an obligation to their patients to communicate information about the quality of activities that occur before the specimen arrives in the laboratory (e.g. Was the correct test ordered?) and those that occur after results are reported ( e.g. Was the patient informed of the laboratory test results and their meaning?). It is time for laboratorians to assume their place on the patient-centered care team; taking ownership  for each stage in the total testing process. Although laboratory professionals might not have direct control, we  will certainly have influence just by initiating a feedback loop to the rest of the patient care team.   Collaboration and open dialogue with other providers in the care of our patients is key3.

Becoming patient-centered will require laboratorians to stay oriented to our true north of thinking of  the patient first and stepping out of our comfort zones in order to collaborate with other providers.

  1. Committee on Quality of Health Care in America. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, D.C.: National Academy Press; 2001
  2. 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.
  3. Knutsen RM. Patient Centered Care and the Laboratory. Advance for Laboratory Administrators. July Retrieved from http://laboratory-manager.advanceweb.com/Features/Articles/Patient-Centered-Care-and-the-Laboratory.aspx

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.