Education

Plan puts phlebotomists on professional-development track

By Lisa O. Ballance, BS, MT(ASCP), CLC(AMT)

How does a company with approximately 1,500 employees, 28% of whom are phlebotomists, improve recognition, stability, and job satisfaction rates among its blood-collection personnel? It rolls up its sleeves and draws upon creative thinking.

Alverno Clinical Laboratories (Alverno) is an integrated delivery system of clinical laboratory services to 28 healthcare providers headquartered in Hammond, IN. When an internal report generated by Alverno’s human resources department revealed the need for improvement in job satisfaction and staff turnover rates among 423 phlebotomists distributed across its two-state network, the company did not hesitate to take action.

Recruitment and hiring

Realizing many applicants for phlebotomist positions failed to understand what the job entailed, Alverno made changes to its employee recruitment and selection methods. With input from one of its hospital-based phlebotomy teams, Alverno created a detailed brochure for job-seekers and interested individuals that provided a clear description of the duties of a phlebotomist and requirements of the position. The company also expanded its interview processes to incorporate behavior-based questions after discovering the most desirable applicants were those who best comprehend healthcare as a service profession that calls for both dedication and compassion.

Rewarding from within

Alverno’s approach to elevating the status of its phlebotomists over the past year has been multidimensional. According to Rosemarie Brichta, MT(ASCP), system educational coordinator, seeking assistance from its pastoral care department resulted in the implementation of system-wide ritual known as the "Blessing of the Hands" to honor the phlebotomist’s role in providing quality patient care.

In addition, the company designated 2009 as "The Year of the Phlebotomist," giving special attention to the growth and professional development of its blood-collection personnel. Activities included team-building exercises to improve interdepartmental cooperation among the various healthcare professions as well as implementing an annual "Phlebotomy Day," an educational reward for high-performing phlebotomists. Front-line supervisors also participated in a "Leadership Day," which underscored their role in promoting good communication among employees within their work groups.

Seeking assistance from its pastoral care department resulted in the implementation of system-wide ritual known as the “Blessing of the Hands” to honor the phlebotomist’s role in providing quality patient care.

As a result of the company’s efforts, by the close of 2009 turnover rates among phlebotomy positions stabilized and job satisfaction increased compared to the previous year. Specifically, the number of phlebotomists hired in 2009 decreased to 92 from 172 in 2008, displaying an independence from temporary fills. Satisfaction levels, as measured by the Morehead Employee Satisfaction Survey, increased in 16 of 19 phlebotomy work groups. Six of the 19 groups scored in the top echelon of satisfaction, doubling the number from the previous survey.

Standardization of training

In 2009, Alverno also formed a Phlebotomy Standardization Committee with the objective of creating a standardized training program for new and newly hired phlebotomists. As the Education Coordinator, Brichta collaborated with site supervisors and educators to offer a uniform curriculum of orientation and training throughout the system.

"Standardization of training is an ongoing improvement process for 2010," states Brichta — no small goal for a 28-facility network where phlebotomy services exist within each hospital site, at patient service centers, clinics, and nursing homes. In terms of centralized versus decentralized phlebotomy, Alverno allows each site to select its own phlebotomy model for the delivery of service.

"In the hospital, the most common model is a centralized service under the direction of the laboratory director," explains Brichta. "Standardization and quality measures are part of a system-wide delivery of educational and administrative services that include quality metrics and a scorecard." Within specific patient-care delivery systems, nurses and doctors may also draw blood samples, depending on the emergent needs of the patient. In terms of non-phlebotomists, some hospital sites have specific training in place for nurses to participate and become "phlebotomy approved," according to Brichta.

Certification, advancement encouraged

While highly encouraged, Alverno does not require national certification for phlebotomists due to its extensive network across two states in urban and rural regions.

"Efforts to establish a basic requirement for national certification was stymied by the disparity among residents of certain geographic areas to obtain the needed qualifications," Brichta states. "In response, Alverno has chosen to offer standardized training across the system. Although we have 21 affiliations with MT, MLT, and phlebotomy schools, as of January 2010, we now only have contracts with new schools if they are NAACLS [National Accrediting Agency for Clinical Laboratory Sciences] accredited. We encourage our phlebotomists to seek certification through the following agencies:

• American Certification Agency;
• National Center for Competency Testing;
• American Society for Clinical Pathology;
• National Healthcareer Association; and
• American Medical Technologists.

"We recommend these because they are nationally recognized, are in good standing with the Better Business Bureau, demonstrate ethical business practices, offer examinations reflective of Clinical and Laboratory Standards Institute standards, and require all applicants to take an examination," Brichta explains.

Alverno provides an internal career ladder for its phlebotomists, consisting of three tiers within each of three different pay categories, to allow for the advancement and recognition of various levels of expertise. In addition, up to $5,000 per year in tuition assistance is available to phlebotomists who wish to continue their education with accredited institutions. Alverno also offers its employees a complete benefits package as well as access to a number of optional benefits.

Realizing many applicants for phlebotomist positions failed to understand what the job entailed, Alverno made changes to its employee recruitment and selection methods.

Company history and impact

The Sisters of St. Francis Health System in conjunction with its partner, Provena Health, established Alverno Clinical Laboratories in 2005. Since that time, the corporation has systematized and integrated the clinical laboratories of free-standing hospitals, realizing a savings of $3.4 million in 2006 and $7.1 million in 2007 while increasing the number of jobs in Hammond by 82.53 FTE in 2008. In terms of test volume, the Alverno centralized laboratory performed 3.2 million assays in 2008 and 3.8 million assays in 2009. For former free-standing hospitals, the improvements brought about by Alverno’s integrated laboratory-services model has meant access to better pricing and state-of-the-art information services, allowing for improved turnaround times and quicker diagnoses for patients.

By "rolling up its sleeves" and drawing upon the creative resources within its staff, Alverno has acknowledged the people and processes that infuse quality into every test result. By recognizing that proper blood-sample collection is a critical first step in a laboratory’s path of workflow, Alverno’s response to the needs of its phlebotomists will assure that path also continues to lead to the company’s overall success.

Lisa O. Ballance, BS, MT(ASCP), CLC(AMT), new director of Online Education for the Center for Phlebotomy Education in Corydon, IN, coordinates development of online CE exercises, webinars, and other distance-learning activities as well as serving as managing editor for the Center’s two e-newsletters.