Creating a Culture of Transparency in the Laboratory: The Laboratory Director’s Role of Leader and Catalyst for Change

LabOratory – Physician Office Resource, March 2016 

Introduction

When the concept of creating cultures of quality and safety are applied to laboratories, they are viewed as an organizational commitment to improving quality patient care. Ensuring the “cultural competency” of all new staff follows closely in importance.   

But when the discussion turns to creating a “culture of transparency” in the laboratory, one may wonder how does this differ?  While it sounds similar to the aforementioned cultural initiatives, transparency involves a more global approach, reflecting all areas of laboratory operations, including external relations and business operations. In fact, it requires commitment to open and honest communication throughout, a supportive and learning work environment, and a respect for staff feedback. This can only come about through the will and leadership of the lab director and the management team.

Defining a culture of transparency

Transparency as behavior implies openness, communication, and accountability. Transparency is operating in such a way that it is easy for others to see what actions are performed. It has been defined as simply "the perceived quality of intentionally shared information from a sender."

However, a culture of transparency is about the entire laboratory operation, since it involves transparency on many levels -- among individuals, groups, and within the corporate structure. On an organizational level, it is both a reflection of values held, as well as managerial leadership.

Creating transparency in a workplace means making changes in the way information is communicated, and how staff is treated.  It affects working relationships internally, as well as relationships with other divisions, and outside customers and agencies.  Thus, instilling a culture of transparency in the lab requires a deliberate decision by the lab director to change the way their laboratory operates. It also necessitates commitment at the supervisory level, as well as the support of the entire staff.

Steps to creating a culture of transparency in the laboratory:

Make sure that the management team is aligned with this goal.  Alignment is most important because of the flow of information. If one supervisor is out of sync with the others, then everyone under them is going to be out of sync.  Put mechanisms in place for aligning frontline (staff) employees with these changes as well.  

Following are the qualities of a transparent laboratory work environment:

  1. Trust: A pre-requisite for transparency is trust. Trust can only be built in an organizational environment conducive to it, including valuing honesty and openness; as the old saying goes, “say what you mean, and mean what you say.”  There is evidence to show that active engagement and an improved employee performance are a function of the relationship between a manager/supervisor and their staff. A laboratory can have all the recognition, celebrations and such it wants, but unless this relationship is a trustworthy one, these activities will be of limited value in increasing engagement and employee performance.
  2. Effective communication all the time at all levels:  The effective way to transparency is through constant communication. It is also important to remember that communication is a two-way street. Treat it as a program of communication in its own right, with the ultimate goal of accuracy, immediacy, and trust.

One of the most effective ways to facilitate open and honest communication is to hold regularly scheduled meetings where detailed, consistent information is provided, and feedback encouraged; where issues can be discussed openly, and opinions respected.

  1. Structure and clarity:   Set clear standards and expectations.  In order for your staff 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 management, quality control, record keeping and documentation capacity, incident reporting and investigation, quality assessment, as well as facility and safety procedures.  Goals that are measurable, quantifiable and objective (instead of subjective) help the performance management process as well. In order to become more transparent, the assessment process should be simple and clear. 
  2. Respect: and recognition: Rewarding people for taking responsibility and recognizing their worth are key. Most people do expect to eventually receive a financial reward, but also trusting them to take work forward without micro management liberates the spirit of the team and shows respect. . 
  3. Creating a supportive work environment:  The hallmark of such an environment is when the reporting of issues, problems, events, and errors throughout the organization are supported, and handled with an eye toward resolution and true reform, not denial.  When honest mistakes are made, and owned up to, these should be viewed as a learning opportunity to improve performance and quality through education, training, and mentoring.  An environment where there is fear of punishment and worse, can lead to efforts to hide these errors, a continued lack of needed training, and perpetuation of lower quality work. Of course, poor performance and disruptive behaviors that are deliberate and culpable should never be tolerated.  Standards should be upheld  in a fair unbiased and equitable manner
  4. Treat staff as adults: informed and respected: When something changes, let everyone know. This builds trust with employees and keeps them connected to the big picture.  Be sure to share any good news you get; when you disseminate positive developments as quickly as you do negative ones, you boost employee morale and reinforce any progress that's being made.  However, if there is bad news, share it with everyone immediately. Don't attempt to hide it.  "Knowing what's happening, and what it means, is always better than not knowing," says Quint Studer, author of the new book Straight a Leadership: Alignment, Action, Accountability. "And often, what people are imagining is worse than what's really happening.”
  5. Feedback and goal guidance provided: Employees work less effectively, and with less enthusiasm, when they’re in the dark about how they are doing. Transparency involves regular and honest feedback about their performance. Providing workers with the tools they need to meet company goals ensures that they have specific actions to take to move themselves and the organization forward. A transparent manager does not keep staff expectations under wraps; a worker knows what needs to be done and where to go for help.
  6. Strong sense of employee ownership:  Sharing information about the laboratory operation with employees increases their sense of shared effort, trust, and involvement, not only with their own work team, but with the entire laboratory organization.  Loyalty also means better retention of your best staff; stability for your operation; support for management initiatives; and higher morale.

Conclusion

It is through the continued support of the laboratory director as well as the management team,   that operational transparency becomes the normative culture of the laboratory. The resulting benefits of increased trust, open communication, a supportive work environment, and increased staff loyalty will also lead to a higher level of quality patient care.


Irwin Z. Rothenberg, MBA, MS, M.T. (ASCP)

Technical Writer/ Quality Advisor, COLA Resources, Inc.