Communication is a long-standing issue in every field. This becomes apparent in clinical pathology laboratories where medical directors and administrators not only have different reporting structures but also separate and sometimes different primary goals. These differences play out in practice through issues such as hospital network standardization, instrument procurement, test stewardship, and daily operational concerns. The consequences of misunderstandings in these areas span the gamut from patient redraws to life-threatening errors.
AACC’s Society for Young Clinical Laboratorians (SYCL) hosted a workshop Saturday, “Partners in Patient Care: A Prescription for a Strong Laboratory Administrator-Medical Director Working Relationship,” to explore some of the communication challenges in labs. Speakers for this much-anticipated session included Joshua Nielson, Steve Manzella, PhD, Allison Woodworth, PhD, and Elsie Yu, PhD. They represent academic and multi-hospital systems.
Nielson, a Lab Operations Director, presented his perspective in his talk “How the Other Side Lives,” focusing on communication and collaboration between lab medical directors and administrators. A truly functional laboratory operation will only be achieved with open communication channels, he emphasized. Cases Nielson presented highlighted the impact of both good and poor communication on immediate outcomes and on long-term laboratory operations. Laboratories tend to be siloed which enables communication problems to be ignored to the detriment of laboratory operations and the profession on whole. “Face-to-face communication is quickest to understanding,” he said.
Manzella’s presentation, “Who’s Lab Is It Anyway: How to Manage Parallel Reporting Structures,” focused on how to stymie miscommunication. He identified major reasons for miscommunication in a highly matrixed institution, which included misunderstanding of roles and responsibilities, ambiguity of authority, and lack of a guardian. To deal with these issues, he recommended tools such as Gantt charts and the communication format known as Situation, Background, Assessment, and Recommendation, more commonly known as SBARs. “Communication is how we get things done,” he said.
Woodward’s presentation, “A Seat at the Table: Raising the Profile of the Lab Professional on The Healthcare Team,” focused outside the laboratory silo. Laboratorians are essential members of patient care teams, she stressed, and need to engage with clinical teams to determine their laboratory testing needs. She encouraged attendees to “seize opportunities to build relationships with clinical partners.”
While labs often are siloed, hospital consolidations force them to communicate across healthcare systems. Yu presented “The Health System Growth Spurt: Ensuring Uniform Lab Services Across Multiple Hospitals and Clinics.” There are many approaches to fold a new hospital into a healthcare system, including consolidation, standardization, or doing nothing. While system-level executives make decisions about buying hospitals, laboratory administrators and medical directors combine the laboratories. Yu outlined pros and cons of different management strategies and how to develop plans to operationalize these strategies. Preparing medical directors to manage conflicting priorities that arise when institutional cultures clash, and to change management strategies, helps them win their staff’s trust. Echoing the theme of other presenters, she said that communication is the key to staff buy-in.