| Monday, January 01, 0001
Building the Right Team: Staffing the Physician Office Laboratory
By Irwin Z. Rothenberg, MBA, MS, M.T. (ASCP),Technical Writer /Quality Advisor, COLA Resources, Inc.
Physician Office Laboratories were created because, as clinical medicine became more complex and treatments more sophisticated, physicians needed a way to test patients at the actual point of care to diagnose patients expeditiously; POLs also exist because the profession was looking for a more economical way to test.
While the reasons why Physician Office Laboratories evolved are varied, their central purpose is the same: to provide quality diagnoses, treatment, and care to patients in the healthcare system; and, to do this as rapidly as possible[i]. The ultimate success of the laboratory in achieving this goal comes down to the quality of the laboratory staff and the management skills applied by the physician laboratory director and supervisors of the laboratory.
Staff Development and Support
A well-trained, competent, and dedicated laboratory staff will provide comprehensive and meaningful feedback to the management team; identify laboratory errors and potential risks, recommend improvements to the laboratory operation, as well as perform 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.
In order for your staff to perform as expected, they must be supported by having the appropriate 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 management, quality control, record keeping and documentation capacity, incident reporting and investigation, quality assessment, as well as facility and safety procedures.[ii] If some of these are not yet complete, by all means, involve your staff members in this process.
Once you have the staff you want in place, it is important to identify your best employees, and appreciate and recognize their work, as good employees are hard to find, and even harder to replace. It is through the application of management skills that you gain the confidence and loyalty of your staff, build a culture of teamwork, trust and quality, and implement the (sometimes painful) changes necessary for the survival of the laboratory.
High staff morale will be the inevitable payoff 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 become increasingly important for clinical laboratory managers, since low morale can 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[iii].
Key personnel management strategies to keep in mind include:
- The laboratory manager provides the staff with key information about future plans for the development of the laboratory, involving the staff when possible.
- The lab manager determines how the laboratory work gets done through job assignments; staffing levels; policies and procedures; management of timelines and budgets, and keeps current with changes in laboratory technology and regulation as it affects the laboratory operation. Complete and updated job descriptions, as well as a personnel manual should be available to every employee as well.
Leadership. This goes beyond staff management, as it often sets the environment (culture) and pace of the lab. Good leadership can inspire lab members toward greater productivity and creativity, teamwork and trust, and encourage feedback.
Creating a Culture of Continuous Quality
1. Talk to your employees. Meet with new employees briefly and find out a little about them. In addition, make sure your office manager is readily available to talk to staff, particularly when they have an issue or new ideas[iv].
2. Recognize achievement. Celebrate successes due to combined efforts of staff; thank people for doing a job well; publicly recognize hard work; praise staff commitment during difficult times.[v]
3. Help your employees 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.
4. Use employee satisfaction surveys to empower employees.
Large and small practices 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 a practice’s needs and strengths.[vi]
5. Provide continuing staff 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 environment; the best preparation should include information about legislation (such as the Affordable Care Act; how Accountable Care Organizations might affect private practices and hospitals; issues of privacy related to Electronic Health Records; FDA and OSHA decisions; and future trends. This will prepare your staff for the inevitable changes coming to every POL operation.
Staff members respond well to physicians’ high expectations. Since physicians clearly rely on each staff member, this makes all employees feel valued and appreciated. When physicians are open with their staff, and proactively share information, they gain the trust and loyalty of their staff. When staff are supported and recognized, higher morale is achieved. That is the recipe for a quality laboratory operation.
[i] L ll: The Practical Guide to the U.S. Physician Office Laboratory. Rebecca A. Fein, M.S.A.H.I., M.B.A.. May 2014 Pg.6
[ii] COLA White Paper: Integrating Laboratories Into The PCMH Model of Health Care Delivery. Pg.7
[iii] 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.
[iv] Five Ways To Retain Good Staff. Roger Shenkel MD, and Cathy Gardner. Fam. Pract. Manag. 2004 Nov-Dec; 11(10) 57-62.
[v] Five Ways To Retain Good Staff. Roger Shenkel MD, and Cathy Gardner. Fam. Pract. Manag. 2004 Nov-Dec; 11(10) 57-62
[vi] COLA White Paper: Integrating Laboratories Into The PCMH Model of Health Care Delivery. Pg 5
Irwin Z. Rothenbergis a Technical Writer/Quality Advisor for COLA’s Educational subsidiary, COLA Resources, Inc. (CRI), a leader in online continuing education for physicians, laboratory personnel, and allied health professionals. CRI offers continuing education through online courses, informational products in both electronic and hard copy form, webinars on cutting-edge technology and regulatory issues, and CRI on-site Symposia for Clinical Laboratories, providing live educational sessions and interactive workshops with leading industry organizations. For more information, visit their website at www.criedu.org or call 1-800-981-9883.