Abstract
BackgroundThe clinical laboratory services, as an essential part of health care, require appropriate staff capacity to assure satisfaction and improve outcomes for both patients and clinical staff. This study aimed to apply the Workload Indicators of Staffing Need (WISN) method for estimating required laboratory staff requirements for the high-volume clinical biochemical laboratories.MethodsIn 2019, we applied the WISN method in all 13 laboratories within the Center for Medical Biochemistry of the University Clinical Centre of Serbia (CMB UCCS). A review of annual routinely collected statistics, laboratory processes observations, and structured interviews with lab staff helped identify their health service and additional activities and duration of these activities. The study outcomes were WISN-based staff requirements, WISN ratio and difference, and a recommendation on the new staffing standards for two priority laboratory workers (medical biochemists and medical laboratory technicians).ResultsMedical biochemists’ and laboratory technicians’ annual available working time in 2019 was 1508 and 1347 working hours, respectively, for the workload of 1,848,889 samples. In general, the staff has four health service, eight support, and 15 additional individual activities. Health service activities per sample can take from 1.2 to 12.6 min. Medical biochemists and medical laboratory technicians spend almost 70% and more than 80% of their available working time, undertaking health service activities. The WISN method revealed laboratory workforce shortages in the CMB (i.e. current 40 medical biochemists and 180 medical laboratory technicians as opposed to required 48 medical biochemists and 206 medical laboratory technicians). 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.ConclusionsThe WISN method showed mainly a laboratory workforce shortages and workload pressure in the CMB UCCS. WISN is a simple, easy-to-use method that can help decision-makers and policymakers prioritize the recruitment and equitable allocation of laboratory workers, optimize their utilization, and develop normative guidelines in the field of clinical laboratory diagnostics. WISN estimates require periodic reviews.
Highlights
The clinical laboratory services, as an essential part of health care, require appropriate staff capacity to assure satisfaction and improve outcomes for both patients and clinical staff
In Serbia, the laboratory staffing is based on the current regulations of the Republic of Serbia [8, 9], which determine the norm for the number of necessary health workers in laboratory diagnostics on the scope of work of 120,000 tests per year
The study population consists of 220 health laboratory workers full-time equivalents (FTEs), including medical biochemists and medical laboratory technicians employed in all 13 Center for Medical Biochemistry (CMB) University Clinical Centre of Serbia (UCCS) laboratories, who were functionally organized to provide services in 13 separate UCCS clinics (Additional file 1)
Summary
The clinical laboratory services, as an essential part of health care, require appropriate staff capacity to assure satisfaction and improve outcomes for both patients and clinical staff. Medical laboratories have been afflicted with shortages and skill-mix adequacy of laboratory professionals for many decades [3] Still, their capacity and equitable distribution have been a rare focus of the research for many decades despite the workplace’s technology progress [4, 5] before the COVID-19 pandemic, during which rapid and accurate testing of large number of samples is necessary. Laboratory managers have long struggled with staffing formula due to the complex nature of laboratory activities [7]. In many countries, they traditionally rely on simple methods for determining the staff number and composition using the density rate (i.e. the ratio of staff to population method). The use of uniform staffing standards regardless of the type of laboratory work can create real problems in providing some laboratory services, as laboratories vary widely in many respects, including the level of healthcare in which they are integrated, their size, complexity of operations, working hours, laboratory staff qualifications, and activities
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