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A career ladder for MT growth.

Salary and promotion incentives encouraged technologists in this laboratory to cross-train and take part in more continuing education. If help-wanted ads were to reflect what medical technologists think about their jobs, many would read: "dead end," "no room for advancement,"lack of motivation," and "boring." We overcame such perceptions in our laboratory by creating a voluntary career ladder that enables technical staff members to move up and encourages cross-training and continuing education.

Turnover among our 30 technologists has been small for the most part. Nevertheless, we would like to retain all of them because departures create turmoil. Whenever someone leaves, others have to work overtime until we find a replacement. And it's no easy feat to fill a job these days, even though our well-equipped, CAP-approved lab is set in a beautiful mid-size community with many big-city amenities. Declining enrollment in our school of medical technology and the nationwide shortage of technologists have made recruitment increasingly difficult and costly.

In the fall of 1987, the section supervisors and I took a hard look at our technologists' salary scales and career opportunities. (We already had a successful career ladder program in place for phlebotomists.') We learned that advancement was more of a staff concern than money. It was obvious that we needed an incentive for technologists to grow and improve themselves and to become more involved in laboratory activities. Participation in cross-training was especially important to help us cope with staffing emergencies.

With these basic goals decided, the next step wag to see what other laboratories were doing. We randomly selected 12 cities of varying sizes-such as Tucson, Chicago, and Charlotte, N.C.-and focused on one hospital in each. We chose Institutions of different sizes, hoping this would give us a wider range of options and a better chance of finding a workable plan.

I called the hospitals' laboratory directors or managers and asked about technologists' salary levels and how their career ladder was structured if they had one. Most of the individuals surveyed were very receptive. I discovered that our salaries were highly competitive and that career ladders were a popular strategy. I also realized that no one program at another hospital met our specific needs-we would have to design our own.

So the supervisors and I sat down to develop a plan that would meet our goals and gain hospital administration approval. After several drafts, the program began to take shape. We settled on a step system and spelled out the requirements that had to be met to climb the ladder (Figure 1).

Since many of our technologists come from our own medical technology school, we made graduate technologist the first rung of the career ladder. Technologists who are certified but have less than two years of professional experience are classified as medical technologist 1. They must have 12 hours of continuing education annually. A medical technologist II must have at least two years' experience, be crosstrained in another laboratory section, and have 12 hours of continuing education annually. The senior technologist designation recognizes a technologist's overall expertise, accomplishments, and long-standing contributions to the lab and carries the basic job responsibilities of an assistant supervisor. Four years of experience are required along with cross-training in another section and 18 hours of continuing education annually. Because the lab's technical sections are small, each is allowed only one senior technologist.

Section supervisor, chief technologist, and laboratory manager are the final rungs on the ladder.

Though experience is important, it is not the main criterion for promotion. We established minimum ratings on performance evaluations as well as the crosstraining and CE standards. For example, advancement to medical technologist II requires at least 300 points in an evaluation out of a possible 400. Those aspiring to the senior technologist level must score at least 325 points.

We also made use of the salary data amassed from our survey of hospitals to create a pay scale that was competitive on a national basis. When we announced the career ladder option to technologists in the summer of 1988, the were pleased at the prospect of professional growth, not to mention the chance to climb into new pay grades. Under the old system, there were separate salary ranges for technologists, supervisors, and higher management, with no means of earning more once you reached the maximum pay in your grade; all you could do then was to wait for the hospital to adjust salary ranges.

We established a six-month phase-in period to give technolo gists time to meet the cross -train: ing and continuing education requirements. As Figure 11 shows, technologists had to cross-train initially for two consecutive weeks in another section, then maintain their skills with two consecutive days of work per month in the section.

One problem that surfaced was that the chemistry technologists all wanted to cross-train in hematology, and the hematology technologists wanted to cross-train in chemistry, leaving microbiology and the blood bank out in the cold.

We solved this problem by limiting the number of cross-training positions in each section. If all five positions are filled in chemistry, a hematology technologist can either wait for someone to leave or else cross-train in another section. This has channeled some technologists into training for microbiology and the blood bank, and they have done well after overcoming initial fears.

Technologists also became enthusiastic about continuing education. Suddenly we saw stacks of completed exams turned in and a flurry of staff members checking their personnel files to find out how many CE credits they had accumulated. Our hospital offers teleconferences and satellite conferences throughout the year, and we also subscribe to a monthly CE program with an audiotape and exam.

Beyond these educational programs, we grant CE credit for a wide range of activities (see Figure III). For example, a technologist could have earned six credit hours for writing this article. Membership on our quality assurance committee, service as lab safety officer or CE coordinator, taking part in workshops and professional society meetings, and presenting lectures to medical technology students are some of the other ways to earn CE credit.

Participation in our program is not mandatory, and a couple of our technologists have decided not to climb the career ladder. They did cross-train to help the laboratory but are not interested in attending the continuing education programs. These technologists will continue to receive their annual evaluations and corresponding pay raises. However, they are not eligible to move up the career ladder to higher pay grades.

The program has been fully operational since the end of 1988, and we have spent the last few months fine-tuning it. For example, the plan did not recognize specialty certification. We corrected this oversight by instituting a one-time $500 bonus for technologists who already had or subsequently attained specialty status. The lab currently has three specialists-in blood banking, microbiology, and cytotechnology-and two more technologists recently took the SBB exam.

We now have three senior technologists (plus two openings), 10 technologists at the MT II level, and seven technologists at the MT I level. Two of the MT IIs are about to meet the four-year work experience requirement and will probably move into the vacant senior technologist slots. There is still a promotion bottleneck-a senior technologist cannot go any further unless a supervisor resigns-but we have been able to give most of the staff an avenue of upward mobility.

Administration has found the cost of the program acceptable. It raised the laboratory budget for salaries by I per cent in the first year.

The career ladder has not eliminated turnover, but it has boosted morale and enthusiasm, and a fully cross-trained staff makes periodic staffing shortages easier to bear. What's more, the career ladder is a powerful recruitment tool when we have to fill a job.
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Title Annotation:medical technologists
Author:Stevenson, John W.
Publication:Medical Laboratory Observer
Date:Jun 1, 1989
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