Experienced and skilled laboratory leaders recognize that we are living through very different times than we did just a few years ago. Yes, the basic principles of quality laboratory management remain the same, but now the context has changed, and if laboratory management is to remain effective and relevant, it must adapt as well. While we all agree that quality laboratory management means providing quality patient care, the emergence of new technologies, new patient expectations and rights, critical staffing needs and fiscal challenges require a new resiliency. Changing times require changes to internal management strategies that includes a greater emphasis on staff support and internal communication, as well as the adoption of new digital technologies, automation and the handling of new forms of external communication.

However, that is not all. Modern management must be uber aware, adapting to the external forces affecting laboratory operations and survival. These challenges include our recent pandemics and responses to public mandates for rapid changes in service. Additional challenges include new rules for compensation of medical services including those of the laboratory, the rapid consolidation of medical practices into larger corporate conglomerates and how laboratories fit into this new dynamic, and finally, the rise of retail medicine and the increased pressure to allow non-laboratory professionals to perform lab work beyond waived testing.

Where do we start?

The basics of quality laboratory management remain the same: in order to manage a laboratory effectively, the laboratory manager must be involved equally with all the work shifts, providing the necessary support for all the staff. This can be achieved through conscientious team building, consistent communication, constantly updated organizational policies and procedures, ensuring continuing education, encouraging shared experiences, and competent leadership. This process can only succeed when there is an awareness that this dynamic must be maintained 24/7. We have just emerged from an extremely stressful time in providing healthcare services where our workforce is stressed, experiencing burnout and giving serious thought to alternative ways to work and live. Our laboratories will not retain or be able to hire sufficient staff if the workplace culture does not effectively address these issues.

Whether you are a new manager of a laboratory, an experienced manager threading their way through the new post pandemic demands and expectations of a lab you have managed for years, or a lab manager looking forward to retirement, these issues must be considered if your lab is to survive. Managers must be up to date, open minded and willing to work even harder to enable staff to succeed in this new age. Resiliency is the name of the game.

The basic principles, but updated for these times:

Provide Strong Staff Development and Support.

Your staff are the backbone of the laboratory. In order to perform optimally, they must be supported by having a solid laboratory structure and having operating systems in place. These include updated policy and procedure manuals, including protocols for training and competency, equipment validation and maintenance, supplier and inventory management, quality control, all record keeping and documentation, incident reporting and investigation, quality assessment, as well as facility and safety procedures.

Encourage Feedback

However, in an era of increased stress and burnout, the laboratory staff should also be encouraged to provide comprehensive and meaningful feedback to the management team; identifying laboratory errors and potential risks, recommending improvements to the laboratory operation, as well as performing all the tasks needed to achieve the highest level of quality for the laboratory. It is the responsibility of the management to create a sense of shared teamwork, commitment, and competency. This increases the opportunity to provide support to staff at critical moments.

Show Appreciation

It is important to show appreciation for your staff’s work and commitment, since good employees are hard to find, and even harder to replace. It is through understanding this dynamic that you achieve the confidence and loyalty of your staff, build a culture of open communication, teamwork, trust and quality, which allows the ongoing implementation of changes necessary for the survival of the laboratory. High staff morale will be the consequence of these approaches as well. Workplace morale plays an important role in productivity and job satisfaction, and employee retention, making it a key determinant in an organization’s success. As such, it has assumed increasing importance for clinical laboratory managers. Another important point is that low morale also has significant implications for patient safety. Low morale can lead to a dangerous disconnect between employees and their jobs that may cause them to cut corners, not pay attention to details, or simply not care whether or not they do the right thing.

Monitoring and proactively dealing with low morale in the clinical laboratory not only avoids considerable downstream costs associated with absenteeism, re-hiring, and training, but also contributes to a better and safer workplace1.

Be Readily Accessible to all Work Shift Staff / Management by Walking Around

Ready access to management whenever needed builds a sense of stability, consistency and support. It builds confidence among staff, while encouraging additional direct communication.

It is very important that the laboratory manager is aware of what is happening on each shift, and this can be achieved directly by personally visiting each shift periodically (if two or more shifts are operating), or by regular, constant communication with each shift supervisor.

Be Transparent

The laboratory manager provides the staff with key information about future plans for the development of the laboratory; involving the staff when possible. Regular staff meetings are an important tool to keep staff informed, provide opportunities for participation, and allow for immediate feedback.

Additional steps to creating a laboratory that will thrive in this era:

Provide Diversity Training

Teaching cultural competence, i.e. appreciating and understanding of the diverse social and cultural beliefs of coworkers as well as patients, strengthens the trust, dignity, effective communication and quality of care provided by the laboratory. This is increasingly important as our laboratory staff represents increasingly diverse backgrounds. It is also important for staff retention.

Use employee satisfaction surveys to empower employees and gain honest insights

Large and small laboratories alike can benefit from asking employees about their level of satisfaction on many different topics by simply using an employee satisfaction survey. Better-performing practices conduct employee satisfaction surveys at least once per year. This anonymous approach to asking about the organization, customer service, compensation, benefits, working environment, professional growth, communication, and employee attitude toward supervisors and physicians can provide vital information to everyone involved. Results of the survey can provide a picture of an organization’s needs and strengths. 2

Provide Continuing Education

This should include a formal orientation program, cross-functional training, maintenance of professional skills, coaching, career development, and personal development. Continuing education should go beyond the immediate internal laboratory environment and address all the changes occurring that affect the laboratory profession.

The best preparation should include information about legislation, issues of privacy related to Electronic Medical Records (EMR), CDC, FDA and OSHA decisions; and future trends that include (for example) telemedicine, retail medicine, and remote monitoring. This will prepare your staff for the inevitable changes coming to every laboratory operation.

In Conclusion

Staff respond well to high expectations, since this makes all employees feel valued and appreciated by their supervisors. When there is a culture of transparency, and information is shared proactively, they gain the trust and loyalty of their staff. When staff are supported and recognized for their work, higher morale is achieved. That is the recipe for a quality laboratory operation. An informed laboratory staff at every level is the result of resilient leadership provided by a management team geared to survive and thrive in this new era.

1 The High Cost of Low Morale in the Clinical Laboratory: How Workplace Environment Impacts Patient Safety, Tabitha Barker MLT, and Jaime Noquez, PhD. AACC Clinical Laboratory News. January 2015.

2 COLA White Paper: Integrating Laboratories into the PCMH Model of Health Care Delivery. Pg. 5