Technical Director Midwest Region Advocate Health Northbrook, Illinois, United States
Background/Case Studies: As part of a large Midwest Hospital System the laboratory has worked to standardize process but have lagged on standardization of Transfusion Service (TS) leadership titles and duties.This was identified as part of a reorganization effort and there was a push to move toward standardization and unification. A second big challenge was to streamline communication between smaller hospitals and internal reference lab hospitals. Leadership had been acting as a middleman which resulted in extra phone calls back and forth rather than direct contact between the sending hospital and the internal reference lab making being on call a painful experience.There was also animosity and push back between the internal reference site and the other TS leaders.As the larger groups looked further at procedures there were multiple examples where procedures varied from state to state.
Study
Design/Methods: A new Technical Director position was created to oversee all of technical aspects of the Transfusion Service at 25 hospital locations in 2 states.This allowed one voice to lead toward common expectations.Previously, title overlaps did not match between the 2 states resulting in confusion and difficulty in understanding expectations for the different leaders.Step one was to create new job titles and descriptions.Next steps were to hire for the newly created positions that now aligned between the 2 states. To standardize processes more completely, procedures are being updated with a push toward standardized forms, language, and workflow.
Results/Findings: Several individuals who had been hired under old job titles chose to leave the organization.This led to a bit of scrambling to cover while positions were filled but after 1 year all leadership positions are filled and everyone that has been hired is on board and now part of the larger team. Numerous Lab Directors helped push the job title standardization as well as helping with hiring of the leaders.The on-call situation was resolved by getting the internal reference lab to take the calls directly from the referring location so that the leadership person was no longer the middleman.On call went from 40 to 50 calls in a weekend, down to 5 or 6 calls and vastly improved work life balance.Although the system has been together for over 10 years we continue to find things that are unique to each state and sometimes site. Conclusions: The standardization process was definitely painful at first and several leaders did leave the organization, but the end result has been a huge swing toward the positive.Struggles continue due to the different size of the hospital locations as these range from 700 beds to 10 beds.All sites have learned to compromise in order to make things work in a standardized way.With the help of multiple individuals, leadership has become standardized and the Transfusion Service Team is now working together with shared goals and perspective.
