On a previous post I discussed my thoughts on the interactions between Clinical Laboratorians and Clinicians. Today I will be following that post up with this one on my thoughts and experiences with interacting with departmental and hospital administration.
The relationship between the clinical laboratorian and administration is of course going to differ between each and every institution but I feel that the same basic concepts would apply to all. In my experience I have found that by and large the administration and the laboratorian will be on the same page. We are concerned with human health and our goals are to providing expedient service, accurate answers and we seek to do that as efficiently as possible.
There can be some difference in opinion however on how we should attain those goals. For instance, if in the process of replacing an aging immunoassay analyzer that among other testing is used for immunosuppressant drug quantification you may seek to make a capital investment to purchase an LC-MS/MS to more accurately quantify these compounds. However, replacing this one analyzer with a replacement immunoassay analyzer AND a mass spectrometer would obviously add significant cost. This added cost in the setting of decreasing reimbursement for testing may be an obvious problem. In a situation such as this it is incumbent for the clinical laboratorian to frame the discussion not only on the improvement in accuracy but also the flexible nature of mass spectrometry and how this investment can pay dividends in the future.
Frequent and open discussions regarding short and long term plans for the laboratory are a must. And of course these discussion need to be reciprocated by both parties. In order to foster these discussions I’ve found that you need to express your interest in knowing what plans are taking place. Of course there are going to be meetings and plans that you will not be privy to but if you do not express an interest in knowing the administration plans you run the risk of being left out of decisions that may affect your laboratory in the future. Going back to our example of purchasing a replacement analyzer it would be crucial for your planning process to know if your administration is planning a new outreach strategy that would increase your test volumes 20 – 30%! While new volume in the current fee-for-service environment is a win for the department the new volume could exceed the throughput capacity of your instrument. Knowing this in advance could affect your decision as to which instrument you choose.
In these two small examples you can see that the underlying theme in all interactions with administration is open communication. I have been fortunate thus far in my career to work with a departmental administration that for the most part began their careers at the bench. This has been a tremendous help as my departmental administration understands the needs of a laboratory and can convey these needs to hospital administration.
Of course, I should state that all my above advice is based on my interactions with one department and hospital administration at an academic medical center. There of course are going to be specific policies and procedures for each employer that you should get to know as well. I have no doubt that if I were employed at a large hospital system or at a reference laboratory that the interaction would be much more prescribed. In other situations you may not have the same level of access to administration that I have thus far experienced. Regardless, establishing open communication with your administrative colleagues is necessary in order to achieve your goals and succeed as a clinical laboratorian.