The Ever-Evolving Lab Management Space
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The Ever-Evolving Lab Management Space

By Soobia Ashraf , Director of Laboratory Services, Advocate Christ Medical Center

1. In the light of your experience what are the trends and challenges you’ve witnessed happening with respect to the Lab Management?

There are several trends that are not unique only to the lab industry, rather are a more multiple industry-wide issue.

a. Aging workforce: We have many of our technologists and management team that are approaching or have surpassed the age of retirement. Also, the influx of the new talent does not amount to the rate of retirement. This is compounded with the decrease in Medical Laboratory Science programs. Labs are having to think outside the box and get creative with recruitment and training. Some labs have home-grown programs and have recruited individuals with the science background and not necessarily lab background. Others have turned to foreign medical technologists or created step programs within their lab to grow entry level staff.

b. Technology vs. Technologist: The enhancements in technology have changed the laboratory world. For example, the molecular platform has developed table top tests that can be brought in house and produce results in a rapid fashion rather than waiting for the conventional methods of certain tests like growing a culture. Automation is an avenue that is increasingly being adopted by labs. This reduces steps and the need for hands in the process. From loading to storing, manufacturers of such products are providing solutions that can help curb the decrease in labor concerns.

c. Driving Quality and Benefits: Laboratory has served as a foundation to the prognosis and diagnosis of the patient. As we fill more medical charts with at least 70% with labs, we have become an essential part of the patient’s journey. Therefore, this drives the need for lab to viewed as a value partner in the hospital, community, and medical community. Reviewing budgets, labs have generally had flat budgets and margins. However, now you will see the benefits when lab has been invested in. What if we had automation, cutting edge instrumentation, Laboratory information systems that have logic built in, report delivery, etc.? From a consumer standpoint and provider standpoint, this will drive the growing necessity to have lab included as a stakeholder on multiple medical/ community initiatives.

2. Could you elaborate on some interesting and impactful project/initiatives that you’re currently overseeing?

a. Sepsis Protocols-Lab provides real time results for several tests vital for this protocol. We have wedged ourselves into the team to teach, review, and consult on collections, products, and timeliness of testing. As we took on the consultation role, we immediately noticed variations in blood culture collections and products (using alcohol to cleanse the site vs. using cholorprep as prescribed). Recently, we approached a manufacturer to assemble a collection kit that will include lactic acid tubes, blood culture collections times, and required material. This will make a user-friendly complete kit that will help avoid inappropriate techniques or missing labs.

b. Stroke Alerts-Through collaboration, we reduced our turnaround times for PTINRs. We used Lean Concepts to reduce steps involved and visual cues that knocked our scores out of the park. One major driver for this was to include our frontline team at the table. When presented with the request to bring our turnaround times down, they brought diversity and creativity to their thinking. Now our hospital is pitching to become a comprehensive stroke center. All of these efforts are not going unnoticed.

c. Collaboration with ED nursing and lab (focus on collections)-ED has been a major contender with the number of rejected specimens and had obstacles in creating efficient flows that would help with turnaround times. As we partnered to help with throughput, we developed a team to review the basics with the ED department. Like the Stroke team, we developed visual cues, introduced evidence-based practices to reduce rejected specimens (i.e. hemolysis, clotted), and drive turnaround times down. Being a level one trauma center, we have reduced hemolysis alone by 50% and reduced our urinalysis turnarounds by 2-fold. We have been 2 years into this partnership. The metrics are advancing positively.

d. Developing simulation lab for phlebotomy collections-With the traction from the above ED Lab partnership, lab pitched a joint proposition with our simulation lab team. We requested an array of training material (training collection arms and vein blocks) for developing a phlebotomy skills program. With proficient technique, we can drive down turnaround times, improve quality, and improve the experience for the patient. We recently received word that we have indeed won the award and our project will move forward. We are excited to partner with our hospital team.

e. Lab information System conversion (Sunquest to EPIC Beaker) This is a major conversion and will tie the hospital, ambulatory, lab, and all service lines together. For the first time, we will be all on one platform. For those who know, different IS systems hooked into each other have their nuances. This is going to be a game changer in our field and industry. It will give our organization an advantage over our competitors.

f. Mentorship-Like discussed previously about the aging workforces, it is vital for us to develop our pipeline of talent. It has been in my person experience, once you can shift the mindset of your team from renter to owner, your metrics, quality, engagement, etc. will flourish. I am part of a workforce initiative team that take our aspiring team members and provide soft skill training. In addition, we map out a career chart. I currently am mentoring 2 team members formally and several informally. Through inspiration, motivation, and partnership, you will have tomorrow defined. If we as leaders do not take the necessary time to span who is around us and pull out the wall flowers that have the mystical talent hidden, then we are disserving ourselves and our industry. We hear about many industries and service lines pay close attention to succession. For year, laboratory succession has been built on tenure and seniority. However, my goal is to challenge that thinking. Med techs with MBAs, phlebotomy supervisors with technical background, emotional intelligence exposure to leaders, etc. are all ways to rethink our teams. As a leader, you are always recruiting. Who is the next in line to take that program or who can we send for a seminar, who would benefit from a formal meet and greet with a senior leader, are all examples of what I am piloting and instilling into the team I lead.

"Lab management will not only be managing the human resources part of the job. As our industry dives into bioinformatics, different platforms, new technology; it will be about managing the whole"

g. Increasing our visibility-As many labs that I have been a part of, we typically wait for the direction we must go. It is either a memo or a strategic plan. Either way, it becomes a task. In the lab world, we are notorious for tasks. It is in our programming (pending logs, QA reports, QC reports, etc.). Not for me; I feel like we are in a long chess game. The matter of fact here is that change is the only constant. To stay ahead of such industry threats, we must be looking to ways to increase our likability, reliability, dependability, and security. Instead of veering away from the, “We are too busy…” attitude, we should wait to see how we can do something or do it better than all. For the phlebotomist who is upset because of the multiple request for collections, shift their thinking to you want them to call us. For the supervisor who wants to know why we must take on this project, say why not? Why not us? It is surprising to me that there are many projects that lab is not invited to. However, they should be at the party. In a poetic way, it is a ‘Revenge of the Nerds,’ so to speak. We can provide clues and definitive results to help achieve the common goal. The idea to keep in mind is that to be invited, you have to be willing to expand and expend yourself.

3. Can you draw an analogy between your personality traits, hobbies and how they reflect on your leadership strategy?

I am not your average Laboratory Director. The road map to my career is very non-linear. I am a biologist who went on to an MBA. While doing that, I was promoted in my lab assistant role to manage the team I worked with. As I explored the world of laboratory that was filled with what ifs and how about we try this because of its intertwining workflows and need for efficiency, I went on to attaining a Medical Laboratory Science degree. That is when the senior leaders took me seriously and promoted me into my Director role. Yes, theory is important as the person who possess it. I surround myself with the smartest and most willing of members. From lab assistants, my former team grew to be the next molecular tech, genetics tech, supervisor, phlebotomy teachers, etc. That is when I knew that this is what it is all about. The road to success in the lab is like a forever moving escalator. You cannot stall or it will consume you. I feel like I am a conductor of a bus and I am finding the best way to get to the destination. However, alone, I cannot find the best way because I am unaware of what is around me. The terrain, the geography; all is beside me. That is when you ask for who you are transporting for the directions. Collectively, we can get there faster. I love meeting, encouraging, supporting, mentoring, and inspiring people. Diversity is important to me. Not by origin only. I believe if you bring technology (millennials) and the technologists (baby boomers) together, you can figure out anything!

4. How do you see the evolution of the Lab Management arena a few years from now with regard to some of its potential disruptions and transformations?

Lab management will not only be managing the human resources part of the job. As our industry dives into bioinformatics, different platforms, new technology; it will be about managing the whole. How does one manage man and machine? We must be prepared. Mentoring, staff development, and transparency are all ways to make sure that who you lead know what to expect, when to expect it, and what is required of them to meet expectations. I don’t make this up. Rather, I deliver on it. It is how you say it that will matter as the industry trends transform us.

5. What would be the single piece of advice that you could impart to a fellow or aspiring professional in your field, looking to embark on a similar venture or professional journey along the lines of your service and area of expertise?

Be creative. Have you thought to yourself how you would have said something or done something given the chance? Then, that is the seedling of a leader. Just by saying hi and by every day to your team drive productivity? Yes. If you put on a lab coat and knock out some work, make you less of a leader? No. See the change in your mind and be it. The heart of it all are the people. Enchant your first follower and keeping going. In a world of work horses, be their unicorn. There is not a day that goes by that I don’t think about the first recruit I had or the first termination I had to do. We learn every day. I was not this leader yesterday, not the same today, and will not be the same tomorrow. The only thing that will remain the same is in a time that our industry needs us the most, I want to lead.

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