Patient Safety Focus: What Can Laboratory Directors Learn from Baseball?

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What Can Laboratory Directors Learn from Baseball?

By James S. Hernandez, MD, MS

Laboratory leaders face many challenges. But few situations are as trying as receiving unjust criticism for making an unpopular decision, even when that decision meets the needs of patients and staff. As a baseball fan, I think laboratorians can learn some valuable lessons about leadership from the sport.

Major league baseball pitchers are masters at controlling the location of their pitches, and sometimes they throw balls with the intent of intimidating batters. The slang term, “chin music,” refers to a pitch that comes perilously close to the batter’s head, often causing the batter to move away from home plate and even to fall down. When the baseball actually hits the batter, it is called a “bean ball.” Pitchers are often so accurate that they can literally throw at the batter’s chin, causing the batter to jerk back or even fall down before he gets hit. Sometimes the pitcher’s manager or coach even orders the pitcher to throw a bean ball. This can result in both the manager and pitcher being ejected from the game.

Like it or not, chin music and bean balls are part of the game of baseball. They entertain the crowd and boost the pitcher’s ego, especially if the umpire goes easy and lets him off without a warning or ejection.

Lab leaders might do well to think of themselves as batters 
facing a tough pitcher when it comes to patient safety.

Successful Lab Leaders

So how does baseball’s chin music tie into lab leadership? You might ask yourself which type of batters—weak or strong—are the pitcher’s target for this menacing pitch.

In my opinion, lab managers who are not at the receiving end of a few bean balls or a little chin music are like weak batters and probably are not really leading the lab. As management guru John Kotter stated, “Management is about coping with complexity…leadership, by contrast, is about coping with change” (1). True leaders take the laboratory to new heights and guide the lab team through the lowest lows. Getting knocked down a few times in the process or taking it on the chin for an unpopular decision is part of leading.

Patient safety is a non-negotiable matter that demands strong leadership in the lab, especially today. The six Institute of Medicine aims for improving the medical system call for all aspects of healthcare to be safe, effective, patient-centered, timely, efficient, and equitable (2). Even the suspicion of a patient safety issue should cause lab leaders to jump out of their chairs and respond with urgency and concern.

Unfortunately, some laboratorians still seem to be opposed to the concepts of patient safety. As lab leaders, we need to understand why. In my experience, some laboratorians simply don’t understand why they are being asked to change how they process blood samples. Maybe their leaders haven’t effectively communicated or shared the vision of how protecting patients’ safety is at the heart of lab operations.

In other instances, laboratorians might not be properly equipped or trained to respond to the Institute of Medicine’s goals. Maybe there are conflicting goals in the organization or patient safety is not a high priority in the institution. Some may resist because they simply aren’t willing to follow the new direction. They may be comfortable with the status quo, or there may be too much inertia or a lack of trust in the leaders. Lab leaders need to respond to each of these scenarios differently, just as batters respond in various ways to balls thrown by the pitcher.

Charging the Mound

Similar to the crowd at a major league baseball game, lab staff watch how the lab’s leaders respond to bean balls and chin music. While some batters lose control and “charge the mound” after being on the receiving end of an intimidating pitch, we, as lab leaders and professionals, want to avoid coming unglued and attacking when the pressure is on. If we lose control, the results in the laboratory, as in baseball, are often not pleasant and may live on to taint our career.

On the other hand, it is natural to want to be liked and to respond to chin music by backing off—in essence, staying on the ground. True leaders cross the bridge from wanting to be liked to earning the respect of the laboratory staff (3). Patient safety issues require strong and swift action from the lab’s leadership, even if the measures are unpopular.

Loving the Game

In my opinion, William Howard “Willie” Mays, Jr. was one of the best baseball players ever. Famous for his ebullient love of the game, he was known as the “The Say Hey Kid.” Mays got a lot of chin music in his career, particularly in his early days as one of the first African-Americans to play after the major leagues were integrated. He frequently would dust himself off after getting some intimidating chin music, smile, and hit the next pitch.

How we respond as lab leaders to chin music is a matter of what happens in the five-and-a-half inches between our ears. We can lose control and charge the mound, or we can do what Mays did. The choice is ours.


  1. Kotter, John P. What Leaders Really Do. In: Harvard Business Review on Leadership. Boston: Harvard Business School Publishing, 1998: 37.
  2. Institute of Medicine, Crossing the Quality Chasm. Available at, accessed July 21, 2010.
  3. Hernandez JS. Crossing the leadership bridge. Physician Exec 2009 Sep–Oct; 35(5):92–4.
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Patient Safety Focus Editorial Board

Michael Astion, MD, PhD
Department of Laboratory Medicine 
University of Washington, Seattle

Peggy A. Ahlin, BS, MT(ASCP) 
ARUP Laboratories 
Salt Lake City, Utah 
James S. Hernandez, MD, MS 
  Mayo Clinic Arizona 
Scottsdale and Phoenix

Devery Howerton, PhD

Centers for Disease Control and Prevention 
Atlanta, Ga.

Sponsored by ARUP Laboratories, Inc.