Plan puts phlebotomists on professional-development track

March 1, 2010

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

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

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

“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

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.