Suburban Hospital in
Bethesda, MD, is a 238-bed hospital with a fully operational laboratory
department serving the acute-care and outreach-testing environment. The
laboratory, like most across the nation, struggles to maintain adequate
and qualified staffing levels to ensure patient testing remains at
acceptable timely reporting and quality levels.
We first noticed in late 2003 the difficulty in
reaching staffing levels at Suburban when the laboratory was unable to
recruit staffing fast enough to compensate for losses that normally
affect a large metropolitan area such as ours, which is just outside
Washington, DC. In addition, administrators recognized that 17% of the
medical laboratory staff were in the “baby boomer” group and in the next
seven to 10 years would be retiring or working in a reduced capacity.
To cope with the current lack of medical
technologists and the potential staff reduction due to retirement, the
laboratory embarked on a long-range plan to acquire and implement a
laboratory automation system for its core laboratory. The primary areas
to be automated were chemistry and hematology, specifically routine
chemistry, immunochemistry, and complete blood analysis. The objective
was to maintain quality and timely testing while working with less
available staff.
The automated chemistry/immunochemistry and
hematology lines were purchased in June 2004 and implemented over a
six-month period. Although the initial cost of the system was expensive,
the laboratory has raised its productivity per FTE by 34.7% since 2004
and has maintained a staffing level of 23 FTEs for the past five years
while performing 1.5 million billable tests per year. What the automated
lines provided Suburban Hospital was a means to address staff and
recruitment issues through the use of technology and provide
administration some breathing room to address other operational and
staffing issues beyond the core laboratory.
The potential “boomer consumer” effect on the
testing environment at Suburban, in part, led laboratory administrators
to develop operational changes in workflow and physical structure, to
employ middleware to manage patient and instrument data, and to add
strategic administrative staff positions.
While Suburban Hospital’s laboratory has invested
and will continue to invest in technology to aid in meeting testing
demand, administration sees continuous staff development as the next
horizon. As “baby boomers” retire, an experience and knowledge void is
being created. To help fill the voids left by the “boomers,” Suburban
has added two positions to assist in keeping the staff trained on a
continuous basis. The newest administrative positions are the Quality
Coordinator and Educational Trainer/Professional Staff Development
Coordinator. As Suburban experiences new staff and newly graduated
medical technologists, Suburban’s hope is that these new positions will
deliver the education level needed to continue to provide the tech-savvy
technologists that the hospital and lab require as well as retain those
who have already reached that level.
David Hornbeck, MBA, BS, MT(ASCP), is the
division director of Laboratory Services at Suburban Hospital in
Bethesda, MD, where he has served for seven years, with a total history
of 34 years in the medical laboratory field.
Lab retirees now make up a portion of “boomer consumer” statistics
In a recent article in The Wall Street Journal,
Laura Landro of “The Informed Patient” addressed the recent swine flu
outbreak and its impact upon hospitals and patients who face a shortage
of technicians to run critical lab tests. One of her examples of the
pressure on the medical laboratory was Nashville, TN’s Vanderbilt
University Hospital, which had to move staffers from other locations in
the hospital to help, as well as ask medical lab professionals to work
double shifts in order to test incoming patients. And this was not even
a major infectious diseases outbreak.
In her interview with Vanderbilt’s chief pathologist,
Michael Laposata, Landro quotes him as saying that labs in smaller U.S.
hospitals “would never have enough expertise or resources to mount a
response. This is a major patient-safety issue, right behind taking out the
wrong kidney or giving 10 times the dose of a drug.”
While the United States is currently experiencing a
shortage of medical technologists, as well as virtually all other healthcare
professionals, student enrollment in MT programs is steadily declining.
Universities — University of Wisconsin-Madison being the latest — have cut
budgets for Clinical Lab Science programs or closed them.
The disparity in salary compared to other
healthcare workers — only 50% to 70% of that of a registered nurse — is
a major reason for a decline in students entering the medical technology
field. One well-recognized reason for this disparity is lack of
understanding by the public as to the value of the profession. Estimates
range from 80% to 90% of physicians depending on the laboratory’s
findings to diagnose patients — but few people realize this fact.
And the aging workforce not only leaves
laboratories with a gap in experience and knowledge, that group then
becomes part of the “boomer consumer” group that is increasingly making
demands on laboratory services. The average age of the laboratory
professional is between 49 and 50.
For inexperienced incoming medical technicians
and technologists, the workload will increase as the U.S. “boomer”
population ages and becomes more dependent upon healthcare services of
all kinds. It is common knowledge that he number of students currently
in training programs is not sufficient to satisfy future vacancies and
the increasing workload.
Numbers from the U.S. Bureau of Labor Statistics show
167,000 practicing clinical lab technologists in 2006, with a projected need
for 21,000 more by 2016. Programs available for education in this field have
dropped from a little more than 6,000 graduates from some 700 clinical lab
science programs in 1975 to just over 2,000 graduates from the remaining 232
programs in 2005.
“This is a major patient-safety issue, right behind taking out
the wrong kidney or giving 10 times the dose of a drug.”
All U.S. medical laboratory related organizations
have lobbied for improvements in education programs, scholarship, salaries,
and other pertinent areas in attempts to generate interest among college-age
students to enter the field. To date, the dilemma has not been
satisfactorily resolved.
Even medical lab technologists in Canada — that
country’s third largest group of healthcare professionals — have voiced
their concerns over professional “burnout.” An example is available at
www.nape.nf.ca/documents/document_65.pdf, with detailed information
regarding 1999 warning signs about the impending med-tech shortage crisis
that have, thus far, been ignored in a particular region. The impending
crisis is now reality, says the site, despite years of Canadian laboratory
professionals’ lobbying for a national strategy to resolve the situation.
