"Boomers" change the medical lab landscape.

Suburban Hospital in Bethesda, MD, is a 238-bed hospital with a fully operational laboratory department serving the acute-care and outreach-testing environment. The laboratory, like most across the nation, struggles to maintain adequate and qualified staffing levels to ensure patient testing remains at acceptable timely reporting and quality levels.

We first noticed in late 2003 the difficulty in reaching staffing levels at Suburban when the laboratory was unable to recruit staffing fast enough to compensate for losses that normally affect a large metropolitan area such as ours, which is just outside Washington, DC. In addition, administrators recognized that 17% of the medical laboratory staff were in the "baby boomer" group and in the next seven to 10 years would be retiring or working in a reduced capacity.

To cope with the current lack of medical technologists and the potential staff reduction due to retirement, the laboratory embarked on a long-range plan to acquire and implement a laboratory automation system for its core laboratory. The primary areas to be automated were chemistry and hematology, specifically routine chemistry, immunochemistry, and complete blood analysis. The objective was to maintain quality and timely testing while working with less available staff.

The automated chemistry/immunochemistry and hematology lines were purchased in June 2004 and implemented over a six-month period. Although the initial cost of the system was expensive, the laboratory has raised its productivity per FTE by 34.7% since 2004 and has maintained a staffing level of 23 FTEs for the past five years while performing 1.5 million billable tests per year. What the automated lines provided Suburban Hospital was a means to address staff and recruitment issues through the use of technology and provide administration some breathing room to address other operational and staffing issues beyond the core laboratory.

The potential "boomer consumer" effect on the testing environment at Suburban, in part, led laboratory administrators to develop operational changes in workflow and physical structure, to employ middleware to manage patient and instrument data, and to add strategic administrative staff positions.

While Suburban Hospital's laboratory has invested and will continue to invest in technology to aid in meeting testing demand, administration sees continuous staff development as the next horizon. As "baby boomers" retire, an experience and knowledge void is being created. To help fill the voids left by the "boomers," Suburban has added two positions to assist in keeping the staff trained on a continuous basis. The newest administrative positions are the Quality Coordinator and Educational Trainer/Professional Staff Development Coordinator. As Suburban experiences new staff and newly graduated medical technologists, Suburban's hope is that these new positions will deliver the education level needed to continue to provide the tech-savvy technologists that the hospital and lab require as well as retain those who have already reached that level.

RELATED ARTICLE: Lab retirees now make up a portion of "boomer consumer" statistics.

In a recent article in The Wall Street Journal, Laura Landro of "The Informed Patient" addressed the recent swine flu outbreak and its impact upon hospitals and patients who face a shortage of technicians to run critical lab tests. One of her examples of the pressure on the medical laboratory was Nashville, TN's Vanderbilt University Hospital, which had to move staffers from other locations in the hospital to help, as well as ask medical lab professionals to work double shifts in order to test incoming patients. And this was not even a major infectious diseases outbreak.

In her interview with Vanderbilt's chief pathologist, Michael Laposata, Landro quotes him as saying that labs in smaller U.S. hospitals "would never have enough expertise or resources to mount a response. This is a major patient-safety issue, right behind taking out the wrong kidney or giving 10 times the dose of a drug."

While the United States is currently experiencing a shortage of medical technologists, as well as virtually all other healthcare professionals, student enrollment in MT programs is steadily declining. Universities--University of Wisconsin-Madison being the latest--have cut budgets for Clinical Lab Science programs or closed them.

The disparity in salary compared to other healthcare workers--only 50% to 70% of that of a registered nurse--is a major reason for a decline in students entering the medical technology field. One well-recognized reason for this disparity is lack of understanding by the public as to the value of the profession. Estimates range from 80% to 90% of physicians depending on the laboratory's findings to diagnose patients--but few people realize this fact.

And the aging workforce not only leaves laboratories with a gap in experience and knowledge, that group then becomes part of the "boomer consumer" group that is increasingly making demands on laboratory services. The average age of the laboratory professional is between 49 and 50.

For inexperienced incoming medical technicians and technologists, the workload will increase as the U.S. "boomer" population ages and becomes more dependent upon healthcare services of all kinds. It is common knowledge that he number of students currently in training programs is not sufficient to satisfy future vacancies and the increasing workload.

Numbers from the U.S. Bureau of Labor Statistics show 167,000 practicing clinical lab technologists in 2006, with a projected need for 21,000 more by 2016. Programs available for education in this field have dropped from a little more than 6,000 graduates from some 700 clinical lab science programs in 1975 to just over 2,000 graduates from the remaining 232 programs in 2005.

All U.S. medical laboratory related organizations have lobbied for improvements in education programs, scholarship, salaries, and other pertinent areas in attempts to generate interest among college-age students to enter the field. To date, the dilemma has not been satisfactorily resolved.

Even medical lab technologists in Canada--that country's third largest group of healthcare professionals--have voiced their concerns over professional "burnout." An example is available at www.nape.nf.ca/documents/document_65.pdf, with detailed information regarding 1999 warning signs about the impending med-tech shortage crisis that have, thus far, been ignored in a particular region. The impending crisis is now reality, says the site, despite years of Canadian laboratory professionals' lobbying for a national strategy to resolve the situation.

By David Hornbeck, MBA, BS, MT(ASCP)

David Hornbeck, MBA, BS, MT(ASCP), is the division director of Laboratory Services at Suburban Hospital in Bethesda, MO, where he has served for seven years, with a total history of 34 years in the medical laboratory field.