FAQ for Administrators
Q: I am a hospital administrator and our lab seems to be doing okay. Should I be concerned about a shortage of medical technologists/ clinical lab scientists?
A: Yes. There are regional differences but the big picture is that the wave of new hires in the
sixties and seventies, a period of extraordinary growth in laboratory services, are now
approaching retirement. It will be painful once they start to retire because there simply won’t
be enough new graduates to fill their positions.
A: The easy answer is that you should make sure that you pay competitive wages and
benefits to increase retention of current employees and to recruit new staff.
A: You should consider hosting medical technology students in training. An essential part
of a medical technology program is real world experience in a hospital lab as part of a
supervised practicum. These programs last for a number of months and are a great way
to connect with students who are about to graduate and look for work. The immediate
disadvantage is that it takes a little more time for your lab staff to supervise the students
but the advantages far outweigh the disadvantages. The students learn about you and
you learn about the students and there is nothing like teaching students to keep your
staff sharp on up to date.
institutions hire bright biology graduates and train them on the job. Could this work
for our institution?
A: While graduation from a National Accrediting Agency for Clinical Laboratory Sciences (NAACLS)
accredited clinical laboratory science (CLS) program and certification do not ensure quality
results, these graduates have demonstrated entry-level competency at a specific level of
practice that generally allows more rapid integration and successful contribution to patient
testing. The same type of competency cannot be achieved through on-the-job training (OJT).
There are also other issues to consider with OJT individuals. Risk management and patient
safety are just two of them. OJT individuals potentially expose the laboratory to more liability
because of less clinical laboratory testing education and knowledge. OJT individuals can be
more expensive to organizations in many ways. Training time is longer and generally requires
more time from certified staff to train them. Clinical laboratory professionals from accredited
educational programs enter the practice field equpped with critical thinking skills that enhance
problem-solving necessary to resolve issues encountered that may be specific to clinical
laboratories.
A facility would not hire an OJT individual into a registered nurse position. Qualified and
competent nurses require specific education and training from an accredited program along
with registration and certification in order to ensure that standards of practice are met and that
persons engaged in the practice of nursing are competent. A healthcare facility should expect
no less of laboratory professionals who perform complex testing that impact over 70% of
clinical decisions for their patients.
Q: How important is the testing performed by qualified and competent laboratory testing to the provision of timely and good quality care to our patients?
A: Clinical laboratory testing plays an essential part in the delivery of quality health care. Laboratory tests provide physicians with objective data needed to promptly diagnose and
effectively treat and monitor disease. It is estimated that lab testing has an impact on over
70 percent of medical decisions, yet laboratory services account for only three percent of
health care spending (and two percent of Medicare expenditures). By equipping physicians
with critical information, laboratory tests ultimately save lives and reduce overall health
care costs. (source: http://www.clinical-labs.org/issues/value/index.shtml)
Q: Why is it so important to have such specifically educated, well-trained individuals to work in a laboratory? Isn't much of what they do performed by instrumetns and machines that do
most of the work?
A: For the last decade, laboratories have dealt with increased demands and reduced resources
by acquiring more advanced technology. Increased automation and computerization has
allowed more and more testing with fewer and fewer analysts. Those analysts may also have
less training and experience since staffing strategies have targeted lower-cost personnel. The
danger is that the advanced technology and automation also makes it easier to produce more
bad results faster than ever before. (Westgard, J. Six Sigma Staffing Strategies)
Though complex technology has made testing more automated, problems with that technology
will occur. Those problems that can arise anytime during the day or night and can be increas-
ingly complex. A laboratory requires a skilled professional to recognize and correct problems
with complex methods or technology before results are released and harm can come to a
patient.
Q: What potential risks does my facility and patients face in h aving insufficient numbers of
qualified laboratory staff?
Increased errors that can impact the source of patient treatment and care due to
understaff labs providing hurried or rushed services.
Missed or incorrect diagnoses due to incorrect???
Increased delays in availability of test results that translate into increased delays
in treatment and care.
Increased cost due to laboratory rework of mistakes.
Significantly increased downstream cost in the provision of routine or emergency
care, for example:
- delays that keep a bed from opening up faster
- delays that may keep ER patients from flowing through quickly
- an incorrect result that causes a patient to unnecessarily undergo a procedure
Q: What are the potential real-life stories or examples that demonstrate the importance and
impact of clinical laboratory staff and the clinical laboratory?
A: There are a number of examples on how lab tests and the people who perform them make
a difference every day in people's lives and care. Some examples include:
Q: What about cytotechnologists? We do not perform Pap tests in our hospital. How
necessary are cytotechnologists to our institution?
A: Although there is a general misperception that cytotechnologists are predominantly Pap
test "screeners," they are extremely valuable in processing and interpreting nongynecologic
cytology specimens as well as fine needle aspirations. They usually work in concert with
pathologists to provide more services.
Q: Are there enough cytotechologists?
A: Cytotechnology is a small specialty compared to other laboratory professions. There are
only 34 active schools in the United States, and many experienced cytotechnologists
are reaching retirement age. A shortage is imminent. Consider hosting cytotechnologists
in training as a way to introduce your institution to potential new cytotechnologists.
Q: Can't other lab professionals screen slides?
A: No. Screening and interpretation of nongynecologic preparations and Pap tests are
regulated by the Clinical Laboratory Improvement Amendment of 1988 (CLIA '88).
Essentially, you must have a trained cytotechnologist to interpret cytologic
preparations.
Q: What about cytotechnologists trained abroad?
A: The cytotechnologist must be trained at a CAAHEP-approved school. While a
cytotechnologist may be adequately trained elsewhere, they must meet the
personnel standards required by CLIA '88.
Q: Right now, my pathologists screen non-gynecologic slides. Why shouldn't
they keep on doing that?
A: A cytotechnologist streamlines the screening process. Cytotechnologists are
trained to detect rare abnormal cells. They are much more accurate at detecting
abnormal cells than pathologists. While cytotechnologists screen, pathologists
can be performing other physician-only tasks.