Labor accounts for 50% to 70% of direct clinical laboratory cost; thus the management of staffing levels is central to overall laboratory management expenses. With too high a staffing level, laboratory operations are inefficient; too low a staffing level increases the potential for errors or slow throughput. Determining optimum cost-effective staffing levels without compromising quality is a complex process, going beyond the laboratory industry’s benchmarks that measure output per Full Time Employee (FTE).
Other considerations when determining optimum staffing include levels of experience, motivation, and the capabilities of your staff; the amount of labor-saving automation employed; any special labor-intensive testing or other demands not encountered by a “typical” laboratory; and the amount of “nonproductive” work that technical staff are expected to perform, such as ordering supplies or training. Decisions about how many managers to employ reflect many of these same considerations and are also influenced by personnel policies that managers are expected to administer, the amount of technical knowledge managers are expected to possess, and other work managers are expected to do beyond supervision of subordinates 2. A key determinant is the operating budget provided by your institution.
It is also helpful to include direct staff input when staffing levels are under consideration. This provides added insight: ask your staff how they feel about their present workload. Are they sufficiently challenged, but not overworked? How’s your quality? Could you be as close to error-free as possible with fewer people working fewer hours? 3 What suggestions do they have in regard to modifying staffing patterns?
If you determine that you can reduce staffing, first ask yourself what effect downsizing might have on morale, quality and productivity versus reduction by natural attrition. The following recommendations for evaluating your staffing needs were derived from a study conducted by the College of American Pathologists Q-Probes Study of Staffing at 151 Institutions 4:
1. Laboratory staffing should be evaluated in the context of peer-group data. Smaller-volume laboratories should not compare their labor productivity with larger-volume institutions, except in histology.
2. Laboratory departments or specialties with lower labor productivity compared to their peer group generally require management attention. Some staff assigned to these areas might be redeployed elsewhere, or the section might be merged into a larger operation so as to bring laboratory productivity out of the bottom quartile.
3. Laboratory departments with high labor productivity may also require scrutiny. Staff in areas with particularly high productivity may be overworked and prone to error or slow throughput. Alternatively, the laboratory may have more experienced or able staff, may have more streamlined procedures, or may make better use of automation and not have an error rate or turnaround time any higher than that of other laboratories. We suggest that managers of high-productivity laboratory sections critically examine error rates and throughput and also, as an exercise, write down the reasons they believe the section is particularly productive. High error rates, slow throughput, or high productivity with no ready explanation may be a signal that a department is understaffed.
4. There is wide variability among laboratories in the number of staff each manager supervises. Managers who supervise few people might be assigned to perform more technical or “bench” tasks within the laboratory. Alternatively, sections might be combined so that staff operate with fewer total managers. In some cases, administrative tasks may need to be streamlined to allow managers to increase their span of control. Thus, when strategizing how to achieve the most efficient staffing for your laboratory, it is important to go beyond relying on calculated productivity alone, and to take into account particular characteristics of your laboratory operation.
Effective personnel management is pivotal for running an efficient laboratory and producing quality work. You can access additional staffing articles in our Insights publication.
Read more about responding to personnel shortages and how your staff can reduce error.
In our next issue we will explore how to sustain quality in a cost effective laboratory.
RESOURCES:
1. Paul N. Valenstein, Rhona Souers, and David S. Wilkinson (2005) Staffing Benchmarks for Clinical Laboratories: A College of American Pathologists Q-Probes Study of Staffing at 151 Institutions. Archives of Pathology & Laboratory Medicine: April 2005, Vol. 129, No. 4, pp. 467-473.
2. Paul N. Valenstein, Rhona Souers, and David S. Wilkinson (2005) Staffing Benchmarks for Clinical Laboratories: A College of American Pathologists Q-Probes Study of Staffing at 151 Institutions. Archives of Pathology & Laboratory Medicine: April 2005, Vol. 129, No. 4, pp. 467-473.
3. Lab Soft News. March 2015. Advice on Clinical Lab FTEs and Workload Units. Posted by Bruce Friedman.
4. Paul N. Valenstein, Rhona Souers, and David S. Wilkinson (2005) Staffing Benchmarks for Clinical Laboratories: A College of American Pathologists Q-Probes Study of Staffing at 151 Institutions. Archives of Pathology & Laboratory Medicine: April 2005, Vol. 129, No. 4, pp. 467-473.