Thursday, September 22, 2011

Burning Issues in the Medical Laboratory

I have been joining a number of groups of laboratory professionals on Linked in.  It is something like Facebook but a lot less about pictures and pals and a lot more about professional interest.   I think it is worth a look.

I posed a question to some of the medical laboratory oriented groups about topics relevant to medical laboratories.  I presented them with 6 issues (so called Burning Issues) and asked the group to rank them 1 (not very important) to 6 (very important).
Response to the question was designed to be anonymous, without name or demographic, and with a short turnaround.  The results represent a single moment in time opinion.  I had no influence over any of the responders other than they are users of professional social media and prepared to put forward opinion. 

In 24 hours I got back about 1.5 percent response; certainly not overwhelming, but with a reasonable range of repeatability.  The graphic of the results of the ranked averages is seen below.

Without being too over-reaching, the results fell into 2 general groups.  The first group was the three issues of reducing the incidence of laboratory error, human resources hiring and retention of staff, and the meeting requirements for regulation and accreditation.  The second group is has a more quality/business focus and included semi-quality semi-business reduction of costs of poor quality along with the distinctly business oriented issue of changing technologies and changing demographics impacting on the business side of medical laboratories. 

The order may reflect that group participants are more operational (and maybe quality) oriented than business oriented.  That would account for the the business oriented issues – cost and new technologies and changing demographics  being lower ranked.   

Actually the two least ranked are critically important to the business of medical laboratories.  Today’s laboratories are in perhaps one of the most vulnerable transition periods because technology and patients are changing more significantly than at perhaps any other time.  A few years ago microbiologists used to say that if Robert Koch showed up in a modern microbiology laboratory today he might be intrigued by the equipment, but he would certainly understand all the sugar reactions upon which we still predicate many of our test results. Today as we move to more and more molecular Robert would be blown away.   That also means that what few medical technologist training programs there are would be similarly left in the dark.

North American demographics are also impacting on laboratories in a big way.  We old folks may see ourselves as the drivers of laboratory activity, but we would be wrong.  We may have more visits to the laboratory but we get fewer tests per visit and tend to have less intensive investigations.  Laboratory activity is more intense about the very young and middle age.  We require more time and generate fewer tests (and dollars).  Let’s face it we are very inefficient.  Reduced testing means lower revenues and lower interest from institutional administrative forces. That is a not a good thing.

The second question in the survey was a write-in section.  In the first part I had offered the 6 choices.  In the second participants offered one of two issues that they thought should have been included as burning issues.

Here is a partial  list of issues deemed as burning by a group of laboratory professionals participating in Linked in interest groups:
  1. Increasing, often confusing, and frequently contradictory regulations
  2. Increasingly complex and ever-changing billing standards
  3. Continually improve quality in order to reduce cost
  4. Effective communication skills and  open dialogue with upper and middle management.
  5. Focus on safety in the workplace.
  6. Retaining qualified staff; a meaningful career (ladder) for technologists.
  7. Technologists dumbed down by outsourcing.
  8. Quality Management
  9. Decentralized specimen collection.
  10. Quality management.
  11. Make sure that the results of laboratory tests reflect current research and that the end users understand what the results mean.
  12. Doing more with less!  implementing Lean tools for efficiencies
  13. Functionality of information systems and smooth implementation of same.
  14. Decreasing number of Medical Technology and Cytology Programs.
  15. Continuing education on the topics of Lean/Process Improvement and Effective Management/Leadership.
  16. Decrease in MT programs and graduates as current workforce retires.

I am going to let this survey run a little longer to allow the numbers to gel.  If MMLQR readers would like to participate, they can at:

Much more on this to follow.

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