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There are a number of staffing issues related to offering microbiology tests. First and foremost, is availability of personnel that meet the qualifications of a CLIA high complexity lab. Assuming the hospital makes the decision to offer microbiology tests, compliance with CLIA high complexity personnel requirements is a necessity.*
The five key positions (director, technical supervisor, clinical consultant, general supervisor and testing personnel) all have highly specific and detailed responsibilities. In most community hospitals, a director presents few if any challenges, whether devoted to the specific institution or shared across the network.
There are specific requirements for the technical supervisor directly related to microbiology testing, including specific training for 6 to 12 months in microbiology unless the technical supervisor is an MD or equivalent with a certification in clinical pathology. This position as well as the clinical consultant can be the most daunting ones to staff in the smaller community.
The mix of tests offered in microbiology should be evaluated from time to time and adjusted based on a number of factors other than staffing alone. The three areas that affect the mix of tests offered are:
What automated methods are available? How will sensitivity and specificity of newer testing methods including molecular improve our process? What is the impact of turnaround?
Look for changes in the community in incidence of important infectious agents including MRSA and C. difficile and emerging infectious agents such as zika virus. What does your facility need to be equipped to test for?
What is the level of focus for improved antibiotic stewardship from administration and medical staff?
“Data released in October show higher vacancy rates as well as higher anticipated retirement rates compared to just 2 years ago […] By department, chemistry had the highest percentage of employees anticipated to retire in the next 5 years, 23.6%, followed by hematology at 19.51%, microbiology at 19.48%, and blood banks at 19.19%.”1
Among all of the traditional lab disciplines, microbiology remains one of the most demanding in terms of skills, experience and professional judgment. Even with the advent of more sophisticated automated equipment, including molecular techniques, microbiology remains one of the areas of the lab where staff skill and experience is key to quality of results. In addition, particularly for culture and sensitivity results, trust and excellent communication between the laboratory and medical staff are important for proper, timely patient care decisions.
There is an important synergy between the needs of the community, the tests the institution offers, the technology it chooses to use and availability of skilled, trained personnel. Oftentimes, the limiting factor is available staff and the tests and technology they have experience with.
Keeping this linkage in mind and being prepared to make and refine value judgments about test menu and turnaround time is important as a facility considers how to deliver results for this important lab specialty.
Get an overview of microbiology, including terminology, types of testing and testing methods.
Learn how improving your microbiology testing turnaround times can impact your community hospital.
Learn about the top four microbiology considerations for managing patient stay, treatment and condition
Our Laboratory Implementation Team helps with initial lab setup and implementation, ensuring you have enough space for lab equipment, verifying hazard protocols, validating and testing equipment and more. This team can help set up single pieces of lab equipment or help build an entire new lab. Email us today to get started.
*(AM J Clin Pathol 2015;144:432-43)
1: Scott, Kimberly. (2015, November 1). The Laboratory Workforce Shortage Demands New Solutions. Clinical Laboratory News. Retrieved from https://www.aacc.org/publications/cln/articles/2015/november/the-laboratory-workforce-shortage-demands-new-solutions