NACB - Scientific Shorts
NACB - Scientific Shorts (formerly NACB Blog)
By Christine Snozek, PhD, DABCC, FACB
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Introducing any form of change is challenging:  humans are change-resistant by nature, and this is even more true for those individuals whose personalities are well-suited for the clinical laboratory with its stringent regulations and SOP-driven nature.  That being said, change is inevitable even in the clinical lab, especially as methods like LC-MS/MS and next-gen sequencing become more commonplace.  As scientists, we tend to focus on the technical aspects of validation, and forget the human factors that go along with making any change, particularly one as potentially revolutionary as bringing a cutting-edge platform into a typical lab.  Lab leadership must find ways of easing the pain of change to ensure that new technologies are accepted and used appropriately, rather than becoming a dusty, expensive box sitting idle in the corner.

 
A key factor to consider when planning how to introduce new technology is the demographic profile of the techs who will be using it.  Understanding differences in generations, learning styles, cultures, etc., helps lab leadership understand the fears,  concerns, and motivations of the techs.  For example, individuals near retirement might prefer not to learn a new methodology, whereas younger staff might be more willing.  Conversely, senior techs might embrace the challenge of a different platform as a welcome break to their routine, while newer techs might lack the confidence to try it. 
 
Much of the pain of change comes from lack of knowledge:  What will the change entail?  How difficult is the new process?  Will this disrupt my daily routine, or even threaten my job?  Call me naïve, but I think the best way to deal with uncertainty is to provide open, honest information as it becomes available.  Details of the advantages and disadvantages of the new technology, why the decision was made to bring in a new test or replace an existing one, and other key issues are known by leadership, but are often not shared with the medical technologists who will ultimately be responsible for running the new system.  Education is key, especially when the advantages aren’t obvious, e.g., when an automated platform is replaced by manual extraction and LC-MS/MS detection to eliminate metabolite cross-reactivity.  Also, drawing correlations to existing technologies can help make the unfamiliar less intimidating – comparing peak review on LC-MS/MS with electropherograms for protein electrophoresis, for example. 
 
I’d like to mention one really useful tool developed by the military (no joke) for monitoring the success of education, implementation, or other events.  It’s the after-action review or AAR, which is a factual, blame-free discussion of 3 key points:  1) what went well, 2) what didn’t go well, and 3) what should be done next time a similar event occurs. AARs provide informative feedback and suggestions for any size event or project, whether it’s a single education session on how PCR works, or implementation of an entire molecular diagnostics lab.  Ideally, AARs should include input from everyone involved, even (especially!) those who weren’t part of the planning or design aspects.  Perhaps more importantly, AARs are most useful when the people who are able to set policy and make changes listen to the suggestions raised during the discussion. 
 
Change is difficult, and there are far more aspects to consider than what I’ve mentioned here.  As laboratorians, it’s easy to forget about the human side of the process, but even substantial changes can be smoothed by making the effort to find out what concerns people have, address those concerns with education, and monitor how well individual events were handled. 
 

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