We all understand how important good management is to the overall success of a laboratory in providing quality patient care, but the defining components of quality care are not static.  Whether we are discussing test accuracy, turnaround time, specimen acquisition, or result reporting;  the technologies, the regulations , the compensation,  and the  treatment protocols, are constantly changing.

These have been characterized in Dickensian terms as “the best of times and the worst of times” in an article on leadership in a recent issue of Dark Daily:

The “best of times” describes the flood of new diagnostic technologies that make it possible for clinical laboratories to detect many diseases earlier and more accurately than ever before. How increasing knowledge of the human genome, proteome, and microbiome generates new ways that pathologists, clinical chemists, and laboratory scientists can help physicians and patients.

The “worst of times” relates to the steady erosion in the prices for lab tests, and the shrinking budgets seen at many labs today. Other negative forces include the shrinking of the most experienced laboratory workforce through retirement, labor shortages;  the dislocations experienced through changes in healthcare delivery settings, hospital closures  and organizational mergers.

These times call for more than good management, they call for good leadership, but leadership .that is more adaptive and agile than ever before—resilient leadership!  . Leadership that understands change, and can adapt  through creating an organizational  culture of  resilience; enabling their laboratory operation to not only survive but prosper and grow.

What is a culture of resilience?

The properties necessary for resilient  organizations include::

Top-level commitment: Top management recognizes performance concerns and addresses them with continuous and extensive follow-through.

Just culture: Reporting of issues, problems, events, and errors throughout the organization is supported, but culpable behaviors are not tolerated.

Learning culture: Issues, problems, events, and errors are handled with an eye toward repair and true reform, not denial.

Opacity: Management is aware of how close they are to having serious problems and events due to weaknesses inherent in their operation

Awareness: Management collects ongoing data to gather insight into quality of performance, problems, and the state of safety defenses.

Preparedness: Management actively anticipates problems and prepares for them.

Flexibility: New or complex problems are handled in a way that maximizes the ability to solve the problem without disrupting overall work.

Out of this develops a resilient testing process, a process capable of adaptively learning to correct errors and to take advantage of new opportunities (e.g., information technology) to improve quality.

The end result is the leveling of silos, enhancing communication,  creating a workforce that is not hesitant to innovate and adapt to change; feels appreciated and experiences less stress when change is needed.

Originally published in ADVANCE for Administrators of the Laboraory, Lab Quality Advisor Blog

[i] Does Your Clinical Laboratory or Pathology Group Have the Effective Leaders It Needs During These Challenging Times?  March 16, 2015
 Dark Daily http://www.darkdaily.com/does-your-clinical-laboratory-or-pathology-group-have-the-effective-leaders-it-needs-during-these-challenging-times-31615#ixzz3tISKg0VS
[ii]  Elder N, McEwen T, Flach J, Gallimore J.  Creating Safety in the Testing Process in Primary Care Offices. http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Elder_18.pdf

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