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Management

(P-MG-4) Today, Tomorrow, the Future - Addressing Staffing Shortages

Sunday, October 20, 2024
12:00 PM - 1:00 PM  
Background/Case Studies: Hospital staffing has been in the news for years but recently it has reached a critical state with more Medical Laboratory Scientists (MLS) retiring and fewer individuals entering the field. Laboratory management continues to evaluate and seek solutions. Testing volumes continue to increase with less staff expertise, higher blood product demands despite reduction in donations, more quality initiatives, and numerous tasks, pulling MLS away from focusing on patient care. These trends can especially impact more isolated tertiary care hospitals where staffing resources are limited. This is a 15-year retrospective review comparing testing volumes, staffing, turnaround times (TAT), and the impact of new processes. 

Study

Design/Methods:

We reviewed historical staffing levels, expertise, testing volumes and TAT. We also considered the processes implemented from 2009 to 2023 to determine their overall impact. This included review of time spent training staff, quality initiatives and competency review.

Results/Findings: Our antibody detection increased ~50% and overall testing averaged a 41% increase in 15 years (Table 1).  Our staffing remained the same with ~9 FTE’s/day.  We no longer have our 1 Blood Bank Specialist and now employ 1 MLS in place of a Lab Assistant.  We also staggered our shifts, implemented 8-12 hour shifts, employed foreign graduates, encouraged our Biology Science degree employees to attend online MLS programs and supported them with lab training.  In 2009, we upgraded our LIS to Cerner Millennium (Cerner Corp., Kansas City, MO) and added electronic crossmatching in 2015.  In 2010, we implemented blood bank automation with 2 Echo’s (Werfen, Norcross, GA) which allowed us to incorporate more generalists, decrease our training time by ~40%, and train more staff at one time.  In 2017, we automated more assays (90-95% of all testing) including: cord bloods, eluates, & DAT (IgG). Our average TAT remained constant (< 60 minutes for stats), even though our volumes increased significantly. This year, we implemented a data management system, ImmuLINK (Werfen, Norcross, GA), which has decreased our tech time for antibody identification and simplified our supervisor review process by ~15 minutes.

Conclusions:

Our annual testing volumes increased 41% and continues to trend upward with a more aging population, while our staffing has remained constant over the past 15 years. Staffing continues to be a challenge now and we anticipate it will continue with more MLS retiring. Maintaining operations, turnaround times and retaining staffing will require more creative processes and procedures, including staggered shifts, 10-12 hour shift options, online programs for Biology Majors and incorporating foreign graduates. Automation and data management systems have proven to reduce training and improve workload, maximize quality of the results including better patient care.