Can technology relieve the UK pathology services staffing pressures?

The COVID-19 pandemic catapulted the important work of pathology and the clinical laboratory into the spotlight, but recent studies show the pandemic did little to ease the long-standing staffing pressures in the sector. In fact, the pandemic hastened retirements and spurred medical laboratory professionals to pursue other career interests.

In 2020, as part of The National Pathology Workforce Rapid Intervention Plan, new pathology practice educator (PE) roles were introduced on a regional basis. The aim of the roles was to support the increase of pathology laboratory scientific and support workforce delivering COVID-19 testing in response to the continuing global pandemic and beyond into recovery. Each region took a different approach to the design and remit of the role, with the introduction of PEs, apprentice leads and strategic workforce leads. In total, 18 PEs were appointed across NHS England on a one-year fixed-term contract connecting hospital trust pathology networks and regions across England. Although providing essential support and enabling a vital sharing of good practice and innovation, this framework can only go so far if tackling staffing pressures in the immediate and near future.

The Health and Social Care Select Committee published a report on “Workforce: recruitment, training and retention in health and social care” last year. The Committee’s assessment was that the NHS and the social care sector are facing the greatest workforce crisis in their history and proposed 73 recommendations covering areas such as workforce planning, recruitment, retention and working culture. The role of technology was also considered.

In order to alleviate the workforce crisis in healthcare laboratories, the NHS needs to make rapid progress to train more biomedical scientists and ensure the necessary support is in place for patient care.

The RCPath carries out annual workforce surveys across multiple pathology discipline to identify and put a figure on the crisis. For example, their findings have shown that only 3% of histopathology departments said they had enough staff to meet clinical demand, and this demand continues to grow.

Although laboratories do a near miraculous job in reassigning staff to manage the increases in testing and attempting to fill vacancies and open shifts, they are continuously being asked to do more with less.

Laboratories need to address these shortfalls from all directions and with help from all stakeholders – including from your lab technology partners.

Technology to relieve the strain on existing lab staff

To drive recruitment and retention, many experts are sharing ideas and adopted practices. But, have you explored how lab technology can make your existing staff more productive? Even more to the point, have you constructed technology solutions that free up staff to do the tasks needed most? A seasoned laboratory technology partner has proven solutions that reduce manual and labour-intensive administrative tasks, enabling laboratory professionals to focus more on diagnostics and improved outcomes. As noted in a recent Medical Laboratory Observer article:

“A decade ago, a good portion of a laboratorian’s day was dedicated to necessary, manual tasks, such as sample archiving and system maintenance. But students don’t invest years learning the complexities of pathology to then sort thousands of tubes or troubleshoot equipment … Technology partners owe it to laboratory professionals to help them focus their expertise on what ignited their passion for the profession in the first place – the diagnostic part of their work.”

At Clinisys, we couldn’t agree more. The systems you choose for laboratory operations should streamline processes across the diagnostic continuum, so laboratory staff can accomplish more without sacrificing quality, safety or job satisfaction. To illustrate, let’s look at some of the challenges that can be addressed with technology that enables the lab to do more with less.

• Incomplete, duplicate or incorrect orders (manual or electronic)
• Inefficient instrument / test routing
• Test sharing inhibitors
• Disjointed pathology workflow
• Patient safety and lean lab processes

Incomplete, duplicate or incorrect orders (manual or electronic)

Challenges: Manual order processing and sample accessioning occupies staff time. Orders coming into the lab from disparate systems (EPRs, referral labs, external ordering systems) often require additional manual processes before the lab can route, perform and result the tests. Incomplete orders also may require lab personnel to intervene to complete missing information. This impacts turnaround time as well as lab productivity.

Solution: From the clinician’s office to the lab and back again, Clinisys solutions can fully automate lab testing, completing orders at accessioning. They enable your healthcare organisation to develop multi-site laboratory partnerships and to extend services to GPs, nursing homes, patient service centres, reference labs and more. Powerful multi-staged order workflow automation rules orchestrate clean order capture to improve lab staff productivity by reducing time spent manually resolving missing or incomplete orders. Those same workflow automation rules accommodate varying user preferences for electronic orders and results delivery and allow labs to report partial results and critical or abnormal results per the preferences of individual clinicians.

Inefficient instrument / test routing

Challenges: Lab personnel spend time duplicating data entry into separate LIMS, blood bank and electronic patient record (EPR) systems. These activities do not add value and can actually increase the potential for confusion with test routing, tracking and turnaround. Mislabelling of specimens at order intake can cause incorrect resulting and possible patient misdiagnosis. Auto verification of results may also not be possible, as some technology does not accommodate unsolicited or repeat orders.

Solution: Use Clinisys orders and results management solutions to label samples at the point of collection and route them automatically to the correct analysers without manual handling by staff. Clinisys solutions expedite collection, support draw order compliance, and prevent mislabelling through PPID and instrument-ready barcode labels. Automatic data review provides historical views, delta checks and validation, while customisable rules for auto verification eliminate staff processing.

Tools, such as Clinisys WinPath Auto-Reg, alleviate the bottleneck of specimen reception by leveraging the lab’s investment in automation and freeing up skilled BMSs.

These leaner workflows enable higher throughput and productivity despite staffing challenges.

Test sharing inhibitors

Challenges: Cooperating with other labs to share or batch tests is complex and work-intensive to manage. The efficiencies of overcoming staffing shortages through sharing seem obvious, but the ROI (in a merger or consolidation) isn’t there to reconfigure or replace existing systems. Specimens continue to be processed at a less efficient laboratory location.

Solution: A networked Pathology service can leverage each hospital / Trust’s core competencies and benefit from efficiencies of scale while continuing to operate independently. Clinisys solutions enable multiple labs to share tests, batch and route samples, and consolidate reports for ordering clinicians. All participating labs utilise a shared barcode labelling scheme across their various points of collection, enabling sample routing between the labs. Lab cooperation initiatives made possible by Clinisys solutions reduce staff time and reference lab costs and create new opportunities for insourcing, all without disrupting the labs’ existing IT investments.

Disjointed pathology workflow

Challenges: Any delay in the pathology laboratory inevitably results in more clinicians calling to ask for status. Meanwhile, lab staff is tied up with processing samples at accessioning, manually entering data, coordinating secondary consults, locating and attaching ancillary reports, and reporting out in multiple directions.

Solution: Technology can digitise many processes in the laboratory by linking systems, data, tools and devices into a single interface. Clinisys WinPath unites the pathology workflow and makes it configurable for the team’s specific needs. They eliminate relabelling at accessioning, display case-centric daily worklists by pathologist or by specialty, integrate with dictation and image capture tools, and deliver the complete, synoptic case report to the ordering clinician. Clinisys solutions free up lab staff to work on diagnostics, eliminate manual tasks, reduce turnaround time, enable holistic analyses, and deliver better service to clinicians.

Patient safety and lean lab processes

Challenges: Human error is still the leading cause of pre- and post-analytic laboratory mistakes, like incorrect patient, incorrect test, misidentified patient, misrouted test and incorrect collection container. Outside of the laboratory, siloed lab results, paired with limited information about the patient, can result in clinical errors that impact both cost and patient safety.

Solution: Adoption of LEAN processes, freeing up staff to focus on higher value tasks. Automation from the point of collection to the recording of results in the EPR constitutes an end-to-end, electronic chain of custody for samples. Clinisys solutions unite lab disciplines to create a closed-loop, enterprise-level system that links the entire continuum of care. Clinicians get a full view of the patient’s medical record plus test results for truly integrated care. The results are leaner processes, faster turnaround times, less cost, and a holistic, patient-centred view of laboratory results and care history.

Next steps

Although the core responsibilities of medical laboratories changed little in the pandemic, many lab staff experienced big changes in short amounts of time. Hiring barely kept pace, while people took on different assignments and levels of responsibility to help fill in gaps. Now it’s time to lean on technology. Evaluate where inefficiencies still exist, where leaner processes are needed, and where lab staff derives the least contentment.

Engage Clinisys and your other partners to ease the ongoing staffing strain by using technology to improve the efficiency in your day-to-day laboratory operations. Request a meeting to start to put our technology to work for your team.