The biggest issues facing lab directors today

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The past two years have caused staffing issues in many areas of healthcare, but medical labs had already been struggling to hire enough people before the COVID-19 pandemic's onset.

Six leaders in the medical lab field spoke with Becker's Hospital Review on staffing and other challenges they're facing today.

Editor's note: These answers have been edited lightly for clarity and brevity. 

Question:  What is the biggest challenge for your lab right now?

Michelle Wiginton, partnership executive at S&P Consultants, on behalf of Pathology Laboratory Associates (Tulsa, Okla.): Our challenges are likely what others are experiencing, with the debate over vaccination status and consequences for employees not willing to get vaccinated. Lab medicine is already in dire need of staffing. We are experiencing the retirement of seasoned staff and an inability to hire staff to meet the demands of increasing ordering patterns. To add fuel to the fire, we insert required vaccination for healthcare workers. We are at risk of more vacating positions where staff already feel overworked, overwhelmed and emotionally drained, causing professional burnout.

Another major factor is payer contracting and reducing reimbursement. As laboratorians, specifically pathology, we are an ancillary service for ordering providers, and the requirement to stay in-network with thousands of carve out payer plans is extremely challenging. Laboratory medicine provides the assistance to the ordering clinician on diagnosis and disease management, which is a critical component of the overall health of the patient, yet the payers see laboratory medicine as a commodity undermining the time and skill it takes to provide the service.

Mike Blitz, senior director of sales at Karius (Los Angeles): Lab personnel are simply tired and exhausted. They have had to validate and implement multiple platforms for COVID-19 testing. Normally a lab will have one platform or test, but with the supply chain issues and demand differences, labs have multiple platforms.

Getting basic supplies for non-COVID-19 testing has been a challenge as manufacturers transition capacity to COVID-19 testing and make less for tests like GI illness.

Finally, basic maintenance has been delayed. It would be hard to do basic upkeep on your house during the middle of a hurricane — and then when Hurricane Ida passed, the next hurricane hit a short time later.

Noel Maring, executive director of health systems at Labcorp (Burlington, N.C.): These comments are not specific to my company, but apply to commercial laboratories and many hospital laboratories.

Both commercial and hospital laboratories have dealt with shortages of trained employees in specific areas of the laboratory for several years (microbiology technologists, histology techs, etc.). However, the pandemic has exacerbated these shortages and created additional shortages.

A shortage of trained phlebotomists has made it difficult for commercial laboratories to consistently maintain regular patient service center hours. Commercial laboratories have the same issue, but for couriers.

Additionally, vaccine requirements further limit the pool of people available for the above two positions. Some hospitals do not allow outside contractors access to the hospital unless they are vaccinated, so for example, only vaccinated couriers can enter some hospitals.

Jonathan Gerber, account executive at Diasorin (San Francisco): Right now, the most challenging thing for my lab director customers is getting testing supplies. Several of the big name diagnostics companies cannot deliver on what they promise.

Thel Grayson, director of laboratory services at JPS Health Network (Fort Worth, Texas): There appears to be a shortage of available medical lab scientists and lab technicians to work in the hospital environment.  

Also, there continues to be a cycle of national supply shortages for laboratory needs. We are spending quite a bit of time stretching allocated supplies or finding alternate products that can be utilized. There are some supplies that are proprietary to the equipment and there are no alternatives other than implementing a new testing platform.

Brandy Gunsolus, director of specimen referral at Augusta University Medical Center (Ga.): A challenge we are facing now that we hadn’t foreseen a year ago: the continual issue with supply chains and the inability to obtain critical supplies, such as blood collection tubes, for lab testing.

A challenge that was present a year ago, but has now reached a critical point is laboratory staffing. We have known for a number of years that we are retiring and losing laboratory staff exponentially faster than we are currently educating and certifying them, but we have now reached a critical point in the profession. This is due to a lack of individuals going into the field and more programs closing due to low enrollment and lack of funding.

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