Patient care and the cost of turnover in the clinical laboratory

Businesses of every size and industry are highly sensitive to the impact of staff turnover. For hospitals and health care organizations, navigating the monetary costs and operational effects can be especially challenging, particularly with high-demand, lower-paid positions such as medical technologists in the clinical laboratory.

Staffing and job vacancies are standard costs of doing business. However, in the COVID-19 postpandemic environment, employers across sectors are experiencing unprecedented struggles to build back their workforce. Seemingly no category is exempt. Roles in every area from service occupations to highly compensated medical professionals remain vacant with few prospects for filling the gaps. All this comes at a significant cost — to revenue, to growth, to job satisfaction, to company culture. In the case of health care, at its worst, it can also come at a cost to patient care and the ability to deliver on the mission of the hospital.

Specifically for the role of the medical laboratory technologist, the gap between the need and job vacancies in recent years has widened significantly. This is a residual effect of the pandemic, but it’s also due to several persistent and new challenges, including increasing demand for diagnostics, an aging population, retirements, training and the inability to attract new talent to the laboratory workforce. To better understand the drivers of laboratory staff turnover and its impacts, QuidelOrtho released a report based on findings from its survey of U.S. health care professionals. While the data provide a candid picture of the current situation, they also offer reasons for hope and possible solutions to help mitigate the laboratory staffing crisis.

One of the more alarming findings from our study was that just 12% of laboratory technologists reported they were extremely likely to stay in the diagnostics field. Job dissatisfaction in the lab is driven by low wages, long hours, intense pressure and less respect than their health care peers, among several other factors. The multifactorial nature of the issue is perhaps in part why 65% of all respondents felt that addressing the current diagnostic health care workforce shortage will require a far greater commitment from senior hospital leadership.

Compounding the challenges, health care today is experiencing staffing shortages throughout the system. According to the broader 2024 NSI National Healthcare Retention and RN Staffing Report, the average hospital experienced a 20.7% turnover rate across all positions in 2023. The effect of this is a contributing factor to staffing burnout, from primary care physicians to nursing to administration. The NSI report also found that medical laboratory technologist turnover was among the highest in the hospital at 15.9%. From a monetary standpoint, this translates to a loss of $4.82 million annually for the average hospital due to turnover-related costs, which include recruiting expenses, new hire training, lost productivity and other costs. In an era of higher costs and lower reimbursements, this loss can significantly affect the bottom line for many hospitals. While our study did not directly address the concerns of the primary care physician, a physician sentiment survey by Athenahealth reported in 2024 that 78% of physicians say staff shortages and/or poor health care staff retention are negatively impacting their organization, demonstrating again that the impact is systemic.

What the figures and statistics don’t account for is the human cost that comes with the added pressure and stress of continuously operating short-staffed. Seeking to understand more about the drivers of dissatisfaction in the lab, our study probed into differences in perception between levels of seniority for several workplace challenges and issues. The disparity in reported ratings was often dramatic, including the following:

• 50% of lab techs were somewhat or very satisfied with their jobs overall, compared with 91% and 88% at the two most senior staffing levels.
• 65% of medical directors and vice presidents were satisfied with their workplace environment, compared to 44% of lab techs.
• 35% of lab techs felt respected in their roles, representing a 40- to 55-point gap across the range of titles surveyed, the widest margin of all satisfaction scores.

Another point of distinction and an important factor contributing to turnover in the lab is laboratory technology. While our study found that 73% of upper management feel there is adequate access to up-to-date diagnostic equipment, only 35% of lab technologists share the same sentiment. These discrepancies highlight a concerning trend in the workforce and a growing divide between lab staff and hospital management for key drivers of job satisfaction and retention. The lab team knows that technology like automation, combined with laboratory informatics solutions, can greatly reduce the burden on staff by streamlining workflows, reducing manual processes and improving results quality for better patient care.

Through a process called apheresis, donors can also give specific components of blood such as platelets or plasma. Different from a whole blood donation where the blood is collected directly into a bag, with apheresis, blood is drawn from the donor into a machine that separates and collects the blood components using centrifugation. The remaining blood components are then returned to the donor from the machine.

While the situation is dire, there are several areas of the report that show hospital management and lab techs are more aligned than at odds. These include dedication to the mission of the organization, the impact of the work that they do and their commitment to patient care. Understanding that excellent patient care requires a healthy workplace culture and innovative technologies like automation and informatics that drive efficient workflows can help put some of the potential solutions to the staffing crisis into perspective. And when teams can see eye to eye on the issues, real progress is possible.

Bryan Hanson is the senior vice president of clinical laboratory and transfusion medicine business units at QuidelOrtho.

https://www.medicaleconomics.com/view/patient-care-and-the-cost-of-turnover-in-the-clinical-laboratory