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Interdepartmental cross-training: perils and pitfalls.

Q Our laboratory believes in cross-training. This can get complicated when it involves personnel from other hospital departments. For example, how should we train people going from x-ray to the lab, or vice versa, within the scope and competencies allowed? Are there legal ramifications to consider? How much of the process is driven by state regulations?

A Cross-training will become increasingly important as multidisciplinary approaches to patient care are implemented more broadly and more frequently. Such an approach can give the laboratory a better understanding of how other departments in the hospital operate. Having a few individuals available who can step in to help out can be highly beneficial, especially in a small institution. The potential pitfalls, however, are many. Interdepartmental cross-training above the clerical level can be costly, dangerous, and unsuccessful unless it is planned exceptionally well.

* Planning. All relevant department heads must take part in developing objectives and goals for training. It would be extremely wise to invite several employees who are slated for cross-training to participate in planning activities.

* Legal issues. The extent of training necessary will of course depend on the level of work to be performed. Investigate your hospital's policies regarding the certification of technical workers. Ask your hospital attorney to check applicable Federal, state, and local statutes concerning the licensure of laboratory and x-ray personnel and such additional factors as responsibility levels. Cross-training across hospital departments is unlikely to be acceptable where clinical lab personnel must be licensed by the state (or by the city, in New York City). A rare exception might be personnel from other departments who happen to hold a valid license to work in the laboratory.

Fully explore potential problems. Dangers would certainly beckon if test results were reported by workers lacking legally mandated qualifications, for example, or by qualified lab professionals lacking proper supervision.

When the attorney is satisfied, obtain the blessing of your administration and human resources department before implementing the program. Cover yourself at each step.

* Defining duties. Cross-training among individuals with different amounts of education, formal training, or both can involve many problems. Among your concerns must be the depth of responsibility in each position, risk of decrease in expertise when an outsider is brought in, and the need to review and perhaps restrict the functions performed in the position. An individual moving from area to area will probably not be able to maintain the same level of expertise as employees who work in one area continually.

Review your operation to identify specific functions that could be handled by someone who is not entirely familiar with laboratory work. In most settings, cross-trained individuals tend to cover functions that can be performed at an acceptable level even when they are not performed continually.

* Information and support. Anyone who feels uncomfortable or unsure about a job won't perform it very well. Write protocol manuals describing the required education and responsibilities of all jobs to be performed by cross-trained individuals. Provide ample refresher information. Hold in-service meetings. Make sure that these individuals work in an atmosphere where they are treated as part of the team.

For cross-trained personnel, it is crucial to have backup systems available. Make sure these individuals know to whom they should report. Give them access to someone who can answer their questions at all times.
COPYRIGHT 1992 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1992 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Management Q & A; medical laboratories
Publication:Medical Laboratory Observer
Date:Sep 1, 1992
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