There is a growing personnel crisis in the United States' health care systems. This crisis was present way before the COVID-19 pandemic. The medical laboratory professionals know it. The academic programs who train medical laboratory professionals know it. Those in health care leadership roles know it. However, unlike public facing professions (e.g., physicians, nurses, pharmacists, etc.) where the world hears and sees about health care shortage issues on television, news outlets and legislative agendas, the critical shortage of medical laboratory professionals are not always understood or recognized by the public.
Such workforce shortages strain existing professionals in ways that threaten their abilities to provide accurate and efficient laboratory medicine results-work that can be lifesaving and is foundational to the provision of safe, high quality patient care. The American Society for Clinical Laboratory Science (ASCLS) states that "laboratory medicine is a vital component of today's complex health care system, providing users with essential information for the prevention, diagnosis, treatment and management of health and disease. According to the Institute of Medicine, collaboration between physicians, nurses, patients and laboratory medicine professionals can help reduce the current trend in diagnostic errors and potentially prevent unnecessary deaths." According to the U.S. Centers for Disease Control and Prevention (CDC,) medical laboratory professionals conduct approximately 14 billion laboratory medical tests annually, which provide about 2/3 of all the necessary and critical results for physicians and other health care professionals to make accurate medical decisions. Simply put, laboratory testing is the single highest-volume medical activity affecting Americans from cradle to grave.
Building Relationships and Creating Solutions
In the American Society for Clinical Pathology (ASCP) April 2021 publication of "The Clinical Laboratory Workforce: Understanding the Challenges to Meeting Current and Future Needs," results from interviews and focus groups strongly emphasized that, "meeting future workforce needs will require actions by, and collaboration among, education and training programs, employers and professional organizations."
While the scope of this article is not addressing the breadth of issues impacting and contributing to the medical laboratory and public health professional identity and workforce shortages, the focus will be to highlight strategies for hospitals and other medical laboratory entities to establish a new or stronger ongoing relationship with an academic medical laboratory education program. Examples will be provided of how to develop relationships, as well as why this correlates with how a strong relationship can enhance clinical placements, recruitment, retention and leadership development of employees.
Simply put, relationship building is the keystone for success for medical laboratory academic programs and health care, and it must involve reciprocal communication, appreciation, perseverance and respect. From an academic standpoint, relationship building applies soft skills to connect with others to form positive relationships. The same thing is true for building and maintaining a relationship between a hospital and a medical laboratory science education program. As the saying goes, "there's no elevator to success; one needs to take the stairs." And when it comes to relational growth, that stairway is bidirectional (i.e., a 2-way street) and includes multiple behavioral levels.
- Level 1: Make a conscious effort to establish and build rapport with others, including non-task related conversation (e.g., chatting about weather, current events, etc.). Identify areas of mutual interest as a means of establishing a personal relationship without specific objectives. Maintain clear contact with others and initiate opportunities designed to improve the longer-term working relationship with internal contacts.
- Level 2: Call upon established relationships to gain entry to higher levels/decision-makers or to achieve an important goal. At this level, one understands and looks for opportunities to strengthen the relationship.
- Level 3: Identify significant opportunities for contribution, key external contacts and ways to make personal connections. At this level, one nurtures the relationship over time in order to build rapport and trust and develop a basis for future interactions.
- Level 4: Develop and maintain a network of relationships, both internal and external to the organization/entity. At this level, one uses the network to identify opportunities, gather information and seek input to solve problems, with an aim of sustaining excellence.
- Level 5: At this level, one develops partnerships and maintains strategic relationships and partnerships based on an in-depth knowledge and understanding of each other's roles.
Education Programs and the Medical Laboratory Placement Conundrum
What sets the medical laboratory major (and many other health care majors) apart in the field of laboratory science is that, in addition to completing core coursework, medical laboratory students matriculate through clinical placements in fully operational medical labs, sometimes referred to as internships or clinical rotations. The irony of this wonderful experiential learning is that, due to the massive workforce shortages, hospital laboratories are less likely to have the personnel to teach and train students, and as a result, the supply and demand for internships are in direct conflict with one another. When this occurs, hospitals are less likely to be successful at recruiting new graduates if students don't spend time in their workplace environment.
Amplifying this cyclical problem is the fact that, even if/when medical laboratory academic programs receive plenty sufficient numbers of applicants, fewer clinical placement options create a nasty bottleneck that limits enrollment in academic programs. As a result, over time, that academic program may be viewed as too costly for such a low number of college majors and find itself in danger of being ended. The question we must ask is where does it stop?
Examples and Strategies for Building Relationships
Fostering strong relationships between hospitals and medical laboratory education programs is a critical part of the equation. Strong relationships can ensure training partnerships (both in the classroom and in the laboratory) and enhance downstream efforts for workforce recruitment. One of the first steps to build a new relationship is the affiliation agreement between the hospital and academic program. An affiliation agreement is a formal agreement between the 2 institutions that the hospital or other medical laboratory training facility will host students from medical laboratory science programs for internships/rotations. This can take time if an existing affiliation agreement doesn't exist with the umbrella health care entity. Thus, a hospital wanting to establish clinical rotations with an academic program may want to do some research on this to find out if there is already an agreement in place, and if so, if and how they can be added to that agreement. Pro Tip: Legal is involved on both sides, and the affiliation language can be confusing and restrictive, so be proactive and start early.
Outside of the affiliation agreement, there are many additional examples and strategies for building new and existing relationships between hospitals and medical laboratory academic programs, including:
- Alumni Connections-Alumni connections are important because they can maintain a point of contact for each party. To strengthen these relationships, institutions can establish an email mailing list or direct messaging account where alumni and employers can connect.
- The Preceptor/Clinical Educator-Preceptors and clinical educators can help reduce burnout by working with academic programs to set reasonable expectations for staff deadlines, paperwork, etc. (differs for each site). In the interest of developing strong partnerships, setting reasonable expectations is a good way for academic programs to prevent unnecessarily burdening medical laboratory staff. Notably, alumni connections can be a good resource when networking/seeking interested candidates to fill this role.
- The Academic Advisory Board-The Academic Advisory Board provides a unique opportunity for colleagues to meet, share ideas and go over upcoming clinicals, program changes/needs, curriculum information and clinical practice competencies for students, as well as ASCP pass rate data from the past year. Alumni often may be interested in participating on the board at their graduating institution.
- Adjunct Professors-Adjunct professors have academic appointment at an institution but do not work at that establishment full-time. When hospital laboratories have employees who are interested in becoming adjunct professors of an academic program it presents a synergistic opportunity to recruit and build leaders in the workforce. Alumni connections may be a good source of interested candidates when filling the role of adjunct professor.
- Recruiting Visits-Recruiting visits are a win for both the institution and recruits because they offer opportunities for the hospital to meet and hire qualified candidates and introduce student majors to open job opportunities.
- Guest Speaker-Guest lecturers who are engaged in any area of laboratory specialization are of interest to academic programs because they introduce new connections, relationships and networking opportunities for lecturer, students and institution alike.
- Laboratory Tours-Offering (or requesting) a tour of a hospital laboratory, public health laboratory, reference laboratory or other medical/clinic site can help generate interest in the academic program, and more broadly, the profession itself.
- Laboratory Assistants-Laboratory assistants are responsible for helping scientists conduct laboratory experiments. Offering employment opportunities that enable pre-MLS and MLT majors and current majors to work in hospital laboratories prior to their clinical rotations is a great way to build a pipeline for both parties.
- Shadowing-Shadowing is essentially an unpaid laboratory assistant position, which offers on-the-job experience and networking opportunities for pre majors or majors. Shadowing is a great way for facilities to showcase their work and entice new recruits to enter the workforce.
- Summer Undergraduate Research Fellowships (SURFs)-SURFS are common in both MLT and MLS academic university settings. An academic setting or health care/public health setting can set up a SURF site to provide a summer experience that fosters longer-term relationships with students.
- Student Society-Most university and community college medical laboratory programs have a student society. Hospitals and other employers may want to investigate opportunities to establish mentorship opportunities for students, offer to sponsor student events (bake sales, blood drives, bone marrow match, etc.) or be involved with the student society officers.
- Research Projects-Most academic programs have a dedicated course or a research project within core courses. For example, Texas State University students work with hospitals on correlation and validation studies utilizing deidentified data. In this way, students learn everyday critical skills and the hospital can build future employee interest. These dedicated medical laboratory research courses prepare future professionals for conducting real-world laboratory skills to onboard new equipment or assays.
- Professional Organization-A professional organization, exists to advance a particular profession, support the interests of people working in that profession and serve the public good. Hospitals and other entities may want to consider helping employees with membership cost, time off/travel support, and leadership support in professional organizations.
The Payoff: Benefits for All
Employing the above strategies and putting concerted effort into relationship building amongst hospitals, academic programs and students alike produces many benefits to all parties involved. By working together, the ability to build stronger and an ongoing pipeline for college majors and future medical laboratory workforce becomes synergistic. While there are many factors to untangle and improve, the opportunity to build a strong relationship with a medical laboratory academic program is the foundation to success.
Learn. more about workforce shortages in clinical microbiology by exploring key takeaways and highlights from ASM's Clinical Microbiology Workforce Survey 2021.
