Do we need new staffing norms at high-volume clinical-biochemical laboratories in Serbia?

Abstract

Background: Laboratory management has long struggled with staffing challenges, and a uniform staffing formula for medical laboratories remains elusive because of the varied and complex nature of the tasks that laboratory professionals perform, laboratory staff qualifications, skills, competencies, and additional activities. In Serbia, the laboratory staffing norm is based on the scope of work of 120,000 tests per year. Methods and Objectives: This study aimed to determine optimal staff requirements and staffing norms for two priority laboratory workers (medical biochemists and medical laboratory technicians) in 13 laboratories of the Center for Medical Biochemistry of the University Clinical Centre of Serbia (CMB/UCCS), the leading reference institution in Serbia in the field of laboratory diagnostics in 2018/19. In a cross-sectional study design, we applied the Workload Indicators of Staffing Needs (WISN) mixed-method approach, which included a qualitative review of regulations, quantitative analysis of annual routinely collected staffing and performance statistics, narrative reports of the observed laboratory processes, and structured interviews with lab staff. The WISN indicators for their core health care services and additional activities were identified, and staffing requirements and norms were evaluated. Results: The WISN method revealed laboratory workforce shortages in the CMB UCCS. Workforce maldistribution regarding the laboratory workload contributes to a moderate-high workload pressure of medical biochemists in five and medical laboratory technicians in nine organizational units. A modern, well-equipped, and accredited referent medical biochemical laboratory requires 1 medical biochemist and 4 medical laboratory technicians on the scope of 240,000 tests per year for each, that is, 6 medical biochemists and 23 medical laboratory technicians per 100,000 patient population. Conclusions: This study provides evidence to prompt a revisit of the staffing policies and the adoption of better workload-based norms for more efficient utilization of the existing workforce, which will provide quality laboratory services for all.