Laboratory Workforce Research Articles

Tuberculosis remains a challenge despite economic growth in Panama [Notes from the field

Tuberculosis (TB) is a disease associated with inequality, and wise investment of economic resources is considered critical to its control. Panama has recently secured its status as an upper-middle-income country with robust economic growth. However, the prioritisation of resources for TB control remains a major challenge. In this article, we highlight areas that urgently require action to effectively reduce TB burden to minimal levels. Our conclusions suggest the need for fund allocation and a multidisciplinary approach to ensure prompt laboratory diagnosis, treatment assurance and workforce reinforcement, complemented by applied and operational research, development and innovation.

Strengthening national health laboratories in sub‐Saharan Africa: a decade of remarkable progress

Efforts to combat the HIV/AIDS pandemic have underscored the fragile and neglected nature of some national health laboratories in Africa. In response, national and international partners and various governments have worked collaboratively over the last several years to build sustainable laboratory capacities within the continent. Key accomplishments reflecting this successful partnership include the establishment of the African-based World Health Organization Regional Office for Africa (WHO-AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA); development of the Strengthening Laboratory Management Toward Accreditation (SLMTA) training programme; and launching of a Pan African-based institution, the African Society for Laboratory Medicine (ASLM). These platforms continue to serve as the foundations for national health laboratory infrastructure enhancement, capacity development and overall quality system improvement. Further targeted interventions should encourage countries to aim at integrated tiered referral networks, promote quality system improvement and accreditation, develop laboratory policies and strategic plans, enhance training and laboratory workforce development and a retention strategy, create career paths for laboratory professionals and establish public-private partnerships. Maintaining the gains and ensuring sustainability will require concerted action by all stakeholders with strong leadership and funding from African governments and from the African Union.

Building a Laboratory Workforce to Meet the Future

To analyze the demand for services from the nation's medical laboratories, which is predicted to dramatically increase as our citizens age and millions receive insurance coverage through the Affordable Care Act. A systematic review of relevant publications and databases was conducted to assess the current state of the nation's medical laboratory workforce and to examine the impact of population demographics and health reform on workforce development to address the future demand for laboratory services. Building a Laboratory Workforce to Meet the Future, a new report from the American Society for Clinical Pathology (ASCP), provides a comprehensive strategy to address the future workforce needs of the nation's medical laboratories to meet this demand to provide timely, accurate, and safe patient care and to fully realize the benefits of personalized medicine. The report, from the ASCP Task Force on the Laboratory Professionals Workforce, is a comprehensive review of the myriad of factors affecting recruitment and retention of qualified laboratory professionals and provides a set of thoughtful recommendations outlining a multifaceted approach to bolster the pipeline of potential candidates for the profession as well as leadership in health care.

Quality Assurance for African Laboratories: How Soon can this be Accomplished?

Quality Assurance for African Laboratories: How Soon can this be Accomplished?

Preservice laboratory education strengthening enhances sustainable laboratory workforce in Ethiopia

BackgroundThere is a severe healthcare workforce shortage in sub Saharan Africa, which threatens achieving the Millennium Development Goals and attaining an AIDS-free generation. The strength of a healthcare system depends on the skills, competencies, values and availability of its workforce. A well-trained and competent laboratory technologist ensures accurate and reliable results for use in prevention, diagnosis, care and treatment of diseases.MethodsAn assessment of existing preservice education of five medical laboratory schools, followed by remedial intervention and monitoring was conducted. The remedial interventions included 1) standardizing curriculum and implementation; 2) training faculty staff on pedagogical methods and quality management systems; 3) providing teaching materials; and 4) procuring equipment for teaching laboratories to provide practical skills to complement didactic education.ResultsA total of 2,230 undergraduate students from the five universities benefitted from the standardized curriculum. University of Gondar accounted for 252 of 2,230 (11.3%) of the students, Addis Ababa University for 663 (29.7%), Jimma University for 649 (29.1%), Haramaya University for 429 (19.2%) and Hawassa University for 237 (10.6%) of the students. Together the universities graduated 388 and 312 laboratory technologists in 2010/2011 and 2011/2012 academic year, respectively. Practical hands-on training and experience with well-equipped laboratories enhanced and ensured skilled, confident and competent laboratory technologists upon graduation.ConclusionsStrengthening preservice laboratory education is feasible in resource-limited settings, and emphasizing its merits (ample local capacity, country ownership and sustainability) provides a valuable source of competent laboratory technologists to relieve an overstretched healthcare system.

Salaries and Compensation Practices in Public Health, Environmental, and Agricultural Laboratories

The public health, environmental, and agricultural laboratory (PHEAL) workforce is a key component of the public health infrastructure. The national laboratory workforce faces an ongoing challenge of recruitment and retention of workers often related to pay and other compensation issues. To collect information on laboratory salaries and laboratory compensation practices using a national compensation survey targeting the PHEAL workforce. Seventy-three of 109 (67%) PHEAL directors in the 50 states and District of Columbia collectively employ 3723/4830 (77%) PHEAL employees in the United States. A standardized survey was developed and administered in 2010. Compensation data were compiled by job classification, geographic region, laboratory gross operating budget size, laboratory staff size, and laboratory type. Laboratory staff size ranged from 3 to 327 individuals (mean = 74 and median = 51). Median base salaries were lowest in the Southwest and South and highest in the Mountain and Pacific regions. Mean and median laboratory gross operating budgets for all participating PHEALs were $8 609 238 and $5 671 500, respectively. Extra cash compensation, used by 8 of 60 (13.3%) PHEALs, was more likely to go to a scientist-manager or scientist-supervisor. In 2010, a standardized national compensation survey of technical and scientific public health employees working in 73 PHEALs was effective in collecting previously unavailable data about laboratory salaries, laboratory budgets, and payroll practices. Laboratory salaries varied by geographic region and there was an uneven distribution of extra cash compensation among job classifications. The compensation data collected may be useful in characterizing and improving laboratory salary structures and practices to better support workforce recruitment and retention.

Addressing Laboratory Workforce Issues in Australia

To the Editor: The challenge of training future laboratory directors in a number of countries was discussed by Scott and his contributors in a previous issue (1). In Australia the Pathology Associations Council, made up of representatives of the various national organizations and professions in Australian pathology service delivery, has been addressing similar issues through a number of different initiatives that involve better definition of the role of the scientist compared to the roles of other non–graduate-level professionals in pathology. The first initiative was to update the competency based standards for medical scientists, given that that there is now a requirement for competency evaluations of staff under AS ISO 15189 (5.1.2) and such standards can be used in all laboratories to define minimum standards for practice (2). These standards have been developed to reflect the contribution normally expected from a person with a degree in a relevant area of science or applied science from an Australian (or equivalent) university, together with 2 years …

Strengthening national laboratory health systems in the Caribbean region

The President's Emergency Plan for AIDS Relief (PEPFAR) programme for the Caribbean Region was established in 2008 to address health system challenges, including fragile laboratory services and systems. The laboratory component of this programme consisted of several phases: assessment of laboratory needs of all 12 countries engaged in the programme; addressing gaps identified during the assessment; and monitoring and evaluation of the progress achieved. After one year of PEPFAR collaboration with national governments and other partners, laboratory services and systems greatly improved. Some of the milestones include: (1) the accreditation of a public laboratory; (2) improved access to HIV diagnosis with faster turnaround time; (3) establishment of capacity for platforms for DNA PCR, viral load and HIV drug resistance; (4) development of the laboratory workforce; and (5) establishment of a framework for implementation of sustainable quality management systems for laboratory accreditation. The progress recorded in strengthening laboratory health systems after one year of initiating this collaboration shows that with a rigorous initial assessment, programme design and intervention and strategic partnership, national laboratory health systems can be greatly enhanced to support programme implementation. Continued collaboration and country leadership is critical to create an integrated and sustainable laboratory network in the Caribbean.

The Laboratory Workforce Shortage

Most clinical laboratories in the nation report severe difficulties in recruitment and retention of most types of personnel. Other important factors impacting this problem include work complexities, increased automation, and a graying workforce. As a further challenge, institutional needs for clinical laboratory personnel are expected to grow significantly in the next decade. This article examines the current situation of the clinical laboratory workforce. It analyzes the different types of personnel; the managerial, supervision, and line positions that are key for different types of laboratories; the job outlook and recent projections for different types of staff; and the current issues, trends, and challenges of the laboratory workforce. Laboratory managers need to take action with strategies suggested for overcoming these challenges. Most importantly, they need to become transformational leaders by developing effective staffing models, fostering healthy and productive work environments, and creating value with a strategic management culture and implementation of knowledge management.

American Society for Clinical Pathology’s 2010 Wage Survey of U.S. Clinical Laboratories

Since 1988, the American Society for Clinical Pathology (ASCP) has conducted its Wage and Vacancy Survey to provide the most recent wage data and determine the extent and distribution of shortages within the nation’s clinical laboratory workforce. This confidential survey has been administered every two years and has served as the primary source of information for academic, governmental, and industry labor analysts. While continuity remains a central objective in monitoring trends, the survey has evolved in response to changes within the profession. New questions have been added to the 2010 survey to examine some of the factors affecting wage and vacancy rates. This year, the ASCP Wage and Vacancy Survey has been administered as two separate surveys, beginning with the Wage Survey. The 2010 Wage Survey was conducted through collaboration between the ASCP’s Public Policy Office in Washington, DC and the Society’s Board of Certification (BOC). Electronic invitations were sent on April 1, 2010 via Zarca Interactive (an online survey vendor) to 21,418 laboratory managers, directors, and supervisors across the United States. The majority of these initial recipient email addresses were derived from the ASCP database, with the following partnering societies: American Association of Pathologists’ Assistants (AAPA), American Society of Cytopathology (ASC), American Society for Cytotechnology (ASCT), and National Society for Histotechnology (NSH), contributing to the initial recipient cohort. To maximize survey response, recipients were able to forward the electronic survey invitation to fellow colleagues within the laboratory profession. Due to the recipient’s ability to forward the survey invitations, an accurate rate of responses cannot be calculated. The survey was closed on May 25, 2010. View this table: Table 1 Total Number of Respondents by Occupational Title The 2010 Wage Survey sought to collect staff- and supervisor -level data on the following clinical laboratory occupations:

The Impending Crisis in the Clinical Laboratory Workforce

Imagine going to your doctor for a routine checkup and the phlebotomist takes a few blood samples for lab work. Three days later, the doctor's office calls and asks you to come back because they need to get another sample for testing. Wondering if something is terribly wrong, you ask “why?” since you already gave a blood sample just a few days ago. The person on the phone assures you that nothing is wrong. Imagine, though, that the laboratory that received your blood sample did not have enough clinical laboratory scientists to test your sample upon arrival and now they are out of stability (too old to test).

Coping with Laboratory Workforce Shortages

Thank you for the Forum article by Kaplan and Burgess in February Microbe discussing alarming workforce shortages in the diagnostic laboratories of the United States (Microbe, February 2011, p. 52). The writers are correct—it is critical to improve the visibility of clinical lab careers among teachers, youngsters, and the general public. However, it is disturbing that, were there to be a big influx of potential students, we could not handle them. The laboratory community needs to address the diminished capacity and vibrancy of educational programs, many of which were closed in recent decades.

Basic Personnel Tools to Help Ensure a Future Public Health and Environmental Laboratory Workforce

Competition is growing in the United States for a shrinking national pool of qualified laboratory scientists. Public health and environmental laboratories (PHELs) must address this problem using a range of strategies and tools to ensure that a highly technical workforce of PHEL scientists is available in the future. One of these tools is the use of common personnel standards involving job titles and definitions, job classifications and minimum qualifications, and multi-step career paths. This article explains in detail the need for structure and use of common, basic personnel standards in developing and retaining a national workforce of PHEL scientists.

Knowledge and Perceptions of Quality Systems among Vermont Laboratorians

This article reports on a survey of medical laboratorians' knowledge of quality systems in their workplace and their perceptions about the effect of job function, education and training, professional credentials, and experience on the overall quality of testing and results. The Medical Laboratory Workforce Survey was designed and conducted in Vermont in 2005. Surveys were distributed to all laboratorians working in Clinical Laboratory Improvement Amendments-regulated laboratories throughout Vermont. Results were analyzed for statistical significance using the Fisher's exact test for overall group comparisons. Laboratorians perceived that they were generally knowledgeable about the quality systems in place in their laboratories (96% considered themselves familiar with quality assurance [OA] measures in their laboratory), but meeting quality objectives and perceptions of factors that impact quality measures in the laboratory were variably influenced by the laboratorians' years of experience, professional credentials, organization type, and job title. Almost half (47%) of laboratorians said they did not have a role in deciding the QA measures, whereas 77% felt they had a significant impact on meeting the QA objectives. Not all laboratorians feel that they play a significant role in assuring quality or influencing quality measures used in the laboratory. All laboratorians should be encouraged to take an active approach to influence quality systems in the laboratory to ensure the highest quality health care possible.

The Impact of Clinical Laboratory Improvement Advisory Committee Recommendations on Microbiology Laboratories

The Clinical Laboratory Improvement Advisory Committee (CLIAC) was mandated by the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and established in 1992 to provide advice to the Department of Health and Human Services on regulation of laboratory testing and improving laboratory quality. Since then, CLIAC has met regularly and recommended regulatory changes to CLIA, provided input on good laboratory practices, and discussed critical issues related to clinical and public health testing, the laboratory workforce, and laboratory systems research. The Committee has been effective in driving changes to microbiology quality control, which have led to a decreased burden and lower laboratory costs without sacrificing quality. The issues CLIAC addresses are complex and sometimes controversial, yet members have said their time on the Committee is worthwhile and that CLIAC has a positive influence on laboratory medicine. This Committee will remain a vital resource for providing guidance as laboratory testing continues to evolve.

ASCP Wage and Vacancy Survey of U.S. Medical Laboratories

In 2008, the American Society for Clinical Pathology (ASCP) conducted its eleventh Wage and Vacancy Survey to provide recent wage data and determine the extent and distribution of shortages within the nation’s clinical laboratory workforce. This confidential survey of hospital, reference, and physician office laboratory facilities has been administered every two years since 1988 and serves as the primary source of information for academic, governmental, and industry labor analysts in defining the state of the nation’s clinical laboratory workforce. While continuity remains a central objective in order to monitor trends, the survey has evolved in response to the changes in the profession. New position categories and questions have been added to the 2008 survey to examine some of the factors that are affecting wage and vacancy rates. The survey was conducted by Morpace Research and Consulting (Farmington Hills, MI) under the supervision of Nancie Noie Thompson, ASCP Vice President of Membership and Communications, and The Colette Steward Group, an independent research firm. It was administered in two waves. The first wave ran from November 13, 2007, to January 31, 2008, resulting in 1,321 completed questionnaires for a response rate of 13%. To increase laboratory participation, the ASCP partnered with six other organizations in a second wave, fielded from August 14, 2008, to September 25, 2008, which yielded an additional 273 completed questionnaires. In total, 1,594 interviews were completed. For the first wave of survey recipients, a representative sample of clinical laboratories by facility type was obtained from a list supplied by the Centers for Disease Control (CDC) database of all legally operating licensed clinical laboratories in the United States. Based on the response rates from the ASCP’s 2003 Wage and Vacancy Survey of Medical Laboratories ( Lab Med. 2005;36:149–157), 10,000 laboratories were selected by facility type and region from the 139,789 …

Multi-skilling the non-medical catheter laboratory workforce

Allyson Arnold discusses the changing nature of demands on the cardiac catheter laboratory team and new initiatives to equip non-medical staff to work across disciplines and provide improved patient care

The Laboratory Workforce Shortage

The Laboratory Workforce Shortage

ASCLS continues collaborative efforts to address laboratory reimbursement and workforce issues.

1. Paula Garrott The theme of recent Washington Beat articles has been the Medicare Clinical Laboratory Competitive Bidding Project. This issue continues to “top” the list of legislative and regulatory issues as implementation of the demonstration project in the San Diego Metropolitan Statistical Area continues. Three San Diego-area laboratories have filed a lawsuit seeking to block the demonstration project on the grounds that the US Department of Health and Human Services failed to comply with the federal Administrative Procedure Act, failed to protect small businesses, and established a program that threatened irreparable injury to laboratories in the designated area (Sharp Healthcare v. Leavitt, S.D.Cal. No.08 CV 0170, filed 1/29/08). The American Society for Clinical Laboratory Science (ASCLS), along with the other members of the Clinical Laboratory Coalition (CLC), are supporting this lawsuit. In addition, ASCLS and other CLC member organizations continue to lobby for the passage of HR 3453 and S. 2099, bills that have been introduced to repeal the Medicare competitive bidding project for laboratory services. As efforts continue in Washington DC to address the ongoing threats to appropriate reimbursement for clinical laboratory services, another critical issue is impacting the practice of clinical laboratory science—the increasing shortage of qualified practitioners. Although the criticality of the shortage varies geographically, there is increasing concern among employers, educators, professional associations, and policy makers that the shortage will continue to worsen. The US Bureau of Labor and Statistics projects a need of approximately 150,000 new practitioners per year through 2014. Accredited educational programs are currently graduating…

ASM Participates in Clinical Laboratory Workforce Meeting

ASM Participates in Clinical Laboratory Workforce Meeting