Hospital lab management faces a number of challenges, often including key planning and design decisions as well as the complex challenges associated with attracting and retaining staff in a historically tight labor market.
Hospital labs face challenging time and quality constraints. To contribute meaningfully to hospital health services, labs must run multiple processes simultaneously without compromising the scientific validity of their findings. Both international quality standards and business needs challenge labs to operate efficiently day in and day out. This makes lab management of vital importance. Whether the lab specializes in biochemistry, histopathology, microbiology, or immunology, the need for cutting-edge diagnostic care demands careful stewardship from hospital laboratory managers.
Luckily, hospital lab management is a well-established field. Experts draw on years of experience to recommend a number of processes and tools for the best hospital lab consulting results. While some are confined to particular domains, such as molecular biology, most apply broadly to lab management as a whole. These best practices help hospital lab directors take account of the scientific, medical, and business aspects of running a successful laboratory.
Below are some of the proven tools and methods being used to enhance hospital lab management today. While some deal with lab planning and design, others tackle the complicated challenges associated with attracting and retaining staff in a historically tight labor market.
Read on for our hospital lab management recommendations:
When it comes to hospital workflow efficiency, design is key. The first step to improved hospital lab operations is workflow mapping. First, map all the different workflows that occur in the lab. Then, rank them by how much money they generate. Use that metric to prioritize resources, including both financial funding and things like space, equipment, and expertise. Collate activities next to each other that string together, then work with a team of people who will work in that layout. Finally, design alternatives.
There are four different workflows that must be mapped if a holistic overview of the lab is to emerge:
Every laboratory has distinct workflows for each of these factors. If you want to improve patient care, you need to know how these aspects of your lab interact. Specimens may flow in a far more straightforward manner than information does, for example. Data management may even be necessary to properly track the information workflow in your lab. Knowing how these factors flow is the first step toward enhancing the efficiency of your lab.
It’s also important to review your workflows in terms of flexibility. Here are some questions that can help you fine-tune your approach:
Finally, it’s important to balance workloads as evenly as possible to keep your staff satisfied. Though it is likely impossible to completely smooth out the peak rush, spread it out a bit and increase staffing to take pressure off technicians and assistants. Be especially mindful of the likely workflow that night staff will have. Since it is more difficult to find qualified technicians willing to work nights, it’s essential to keep your night staff satisfied.
Like many industries, health care is suffering from a talent shortage. That means that efficient health systems are going to have a huge advantage over their inefficient competitors. In the lab setting, efficiency allows an operation to do more with less. With a dearth of qualified technicians, now is the time to improve lab efficiency, and there are a number of efficiency improvements hospital lab managers can turn to.
One way to maximize the impact of limited staff is to let lab assistants step up and do more. Many lab assistants are entirely capable of handling processes on their own, or at least with minimal supervision. Care management should be about the final result, not about micromanaging each person in the lab. With the right quality equipment and control processes in place, there is no reason not to let lab assistants work to their full capacity. They can do more than data entry.
Another way to improve efficiency is to eliminate process silos. Let’s say that your lab runs chemistry, hematology, and coagulatory processes at 40, 50, or 60 percent. There’s no reason not to run some or all of that together to ensure that everyone is being as productive as possible. Flexibility and balance are key. At peak hours, the lab may run most efficiently with more people, and the workload can be distributed among fewer staff during off hours. No matter when they work, every individual should be at the same level of busyness throughout day and night.
For a list a of frequently asked questions about efficiency improvements, click below.
Though hospital management faces a number of challenges, there is no doubt that quality is key. Health care professionals have a sworn obligation to put patients first. This isn’t only a matter of values: it is a legal responsibility. Everything from state health codes to IFU FDA required processes guide and constrain laboratory quality efforts. There are a number of best practices for quality control hospital lab managers need to implement to ensure they fulfill their ethical and legal obligations.
Statistical tools like the Levey-Jennings chart can help ensure that laboratories are using accurate test methods. By comparing control values against actual results, the chart offers a clear indication of the accuracy of lab operations. In addition, the Westgard rules, a set of statistical patterns that indicate faulty precision or accuracy, can be plotted on Levey-Jennings charts and compared against test results. It is absolutely vital that these tools are used regularly to pick up on any systemic inaccuracies present in lab testing methods.
In addition to statistical controls, hospital labs regularly employ positive procedural controls to ensure the validity of lab methods. For example, CD-Chex Plus tests help hospital laboratory technicians monitor immunophenotyping by flow cytometry. With control values across thirty assayed parameters, they are an important component of quality control. Control samples help labs identify the difference between random error and systemic error and safeguard patient care.
Performance measurement is not only important in business. It’s also vital in the hospital laboratory environment. If you’re looking to improve laboratory services, benchmarks are an absolute must. Benchmarking can help across dimensions such as time, quality, and staff efficiency. Setting up a time equivalent for tasks will give your staff something to shoot for. Using Q-Probes is a simple way to get data on quality performance, both at your lab and across the industry. Having staff trained on MeSH terms can also help lab members navigate data registries. Once you have data, you can target quality improvement.
Another helpful metric is the request ratio. The request ratio tracks the number of projects, such as lab tests or pathology reports, against available resources, which include staff, equipment, and skills. Increasing the ratio is all about enhancing staff capacity. That may be a result of extending working hours, improving equipment, or both.
When it comes to outpatient test services, benchmarking hospital labs can also have a more tangible business impact. A hospital lab that can quantify its performance can make a more compelling sales proposition to a potential client than a lab with little insight into operations. As major health systems look to maximize efficiency and reduce cost, performance metrics can also help during the internal conversations that drive resource allocation and shape strategy. Clinical data and lab tests can provide powerful evidence when hospital system executives are forced to make difficult decisions.
The goal of increasing efficiency has led many hospital system directors to explore new forms of organization. Hospital lab consolidation is one experiment that seems to be working. Higher regulatory burdens are rewarding health system consolidation because larger organizations have a better chance at remaining profitable under an intense burden of paperwork. In fact, industry experts expect that the number of mergers and acquisitions will only increase in the coming years. Unsurprisingly, these broader changes in the health care space are having a profound impact on lab operations.
Consolidation often comes in the form of laboratory integration, which can come in many forms. As health systems grow, standardization becomes necessary as a means of coping with increased complexity. Laboratory consolidation is also to be expected as business needs necessitate that hospitals capitalize on economies of scale whenever possible, shuttering smaller operations. Having larger operations that provide lab tests, clinical testing, and other aspects of laboratory medicine for a number of facilities can often reduce costs. As executives explore solutions, lab managers should take note.
Laboratory integration can also come in the form of IT integration. As labs grow in size, they can utilize more advanced electronic billing tools and onboard cutting-edge data systems. Many organizations are also pursuing laboratory information management system solutions that give directors more control over cycle management across a hospital system. Digital technologies are only expected to grow in prevalence as lab operations are automated and fine-tuned to improve returns.
Hospital lab quality improvement efforts should go hand-in-hand with efficiency improvement activities. A good laboratory manager will be able to engage staff members to continually enhance the patient experience. Experts recommend adopting the PDSA, or Plan-Do-Study-Act, Cycle to improve patient safety. The PDSA Cycle lays out a straightforward method of change and testing that gives everyone insight into what needs to be done to deliver ambulatory care improvement.
When it comes to twenty-first century health care standards, patient-centered care is the name of the game. That is why CAHPS scores are crucial for clinical laboratory improvements. This standardized and publicly-reported survey can give health care organizations an idea of what they need to do in order to delight their patients and earn their trust. Managers should design quality improvement initiatives around patient feedback in order to ensure that no effort goes to waste. When staff members are aligned around patient engagement, a culture of quality improvement is the natural result.
Health care quality assurance is also vital for a successful QI project program. Just as performance measurement is the first step toward performance improvement, quality assurance is the first and most crucial part of any quality improvement project. A good laboratory manager will integrate quality assurance into each step of the health care strategic plan. From monitoring turnaround time to enhancing patient safety, quality assurance serves as the foundation of a professional laboratory practice.
Our partners realized up to a 28% decrease in total lab cost per test
Our partners have realized savings ranging from 15-20% over a 3-year transformation
We have over $1B lab spend under management
Jeff Coker is the Vice President/General Manager of Accumen Technology Solutions, a data exchange company that partners with health systems to establish secure clinical data exchange interfaces such as bi-directional lab testing platforms or health plan quality performance networks. Jeff has over 20 years of experience in leading diverse operations in technology, retail, and manufacturing industries, with a track record of preparing organizations for scale by improving product quality, customer service and operational productivity. Previously, Jeff served as the vice president of Client Execution Excellence at Accumen. Before joining Accumen, Jeff held several leadership positions in Amazon.com’s Global Fulfillment and Supply Chain organizations as well as a software development leader for CGI. Jeff holds a BSc., Civil Engineering, from Purdue University and an MBA, Operations and Supply Chain Management from the MIT Sloan School of Management.
Kelly is a Client Account Lead responsible for working with laboratory clients to identify opportunities that optimize operations and deliver savings against commitments. She brings over 30 years of experience in clinical laboratory operations with multi-facility healthcare organizations. She has a solid understanding of the challenges faced by healthcare clinicians and administrators to deliver high quality patient care while simultaneously meeting regulatory and business demands. Kelly strives to provide innovative and meaningful information to our clients that drive optimization of operational efficiencies and bring value to the client. She has a proven track record of driving consensus among diverse stakeholders, cultivating and maintaining strong relationships. She has developed strategies for core lab optimization, consolidation/centralization, and supply chain improvements. Kelly earned her BS degree in Medical Technology from Mississippi State University, and her Master’s degree in Management with Healthcare Concentration from Kaplan University.
Ahmed Kishta is the Vice President of Client Technology at Accumen, a company that partners with health systems to drive performance improvement and operational efficiency. Ahmed has over 20 years of experience in healthcare, with a focus on laboratory technology. He has experience in leading diverse teams in executing initiatives including product development, outreach program creation & growth, technology assessment/enhancement, laboratory information system evaluation and implementation, system centralization and consolidation, data warehouse development, and strategic analysis and planning. Ahmed leads the Client Implementation and Technology Consulting Teams. Ahmed earned a BS, Computer Science degree from Governors State University, and a MS, Health Informatics degree from the University of Illinois at Chicago.
Jeff Myers, CPA, is the Vice President of Strategic Advisory Services for Accumen and provides expertise on Lab Operations, Consolidation, Strategy, Outreach, and Performance Improvement. Jeff has over 20 years experience in health care finance, focusing on financial analysis, decision support, strategic guidance, and operational improvement analysis. His industry experience includes physician practice management, health insurance, commercial laboratory, and academic health care systems. A Certified Public Accountant (CPA), Mr. Myers graduated with honors from the University of Tennessee with a Bachelor of Science degree in Accounting and Business Law.
Kim brings over 10 years of laboratory experience as both technician and leader in military and civilian clinics and hospitals. Prior to joining Accumen, Ms. Zunker worked as a Medical Technologist and later, Supervisor of the growing laboratory at Soin Medical Center, part of the Kettering Health Network, where she led day-to-day operations as well as multiple process improvement initiatives.Prior to Kettering Health Network, Ms. Zunker served as a Laboratory Officer in the Biomedical Sciences Corp of the United States Air Force. She managed two Air Force Laboratories, winning multiple awards and earning several military decorations. Ms. Zunker earned a Bachelor of Science in Clinical Laboratory Science from Midwestern State University and a Master in Business Administration from the University of Dayton. She is a nationally certified Medical Laboratory Scientist by the American Society of Clinical Pathologists and holds a CAPM certification (Certified Associate in Project Management) from the Project Management Institute.