Laboratory testing is a factor in approximately 70% of healthcare decisions, and 10% or more of diagnoses aren’t final until laboratory testing is complete.1 The 320,000 CLIA laboratories in the U.S. conduct 14 billion tests each year. 2 This won’t surprise lab staff. They recognize their significant contribution to the healthcare system and that quality is paramount for accurate test results—and they know more and more tests are being done.
Unfortunately, an estimated 795,000 Americans die or are permanently disabled by diagnostic errors each year. This includes 371,000 deaths and 424,000 permanent disabilities.3 According to an analysis by ECRI, an independent nonprofit patient safety organization, more than 70% of these errors happen within the testing process,4 from ordering tests and collecting samples to processing tests and sharing results.
ECRI’s analysis of patient safety adverse events and near-misses in the U.S. found that one-third are related to diagnosis errors. Technical or processing errors accounted for 23% of the events, and mixed-up samples, mislabeled specimens, and tests performed on the wrong patient represented 20% of testing errors.4
A recent LGC Clinical Diagnostics white paper, Diagnostic Errors: The Laboratory’s Essential
Role in Addressing Today’s Challenges, examines current research on diagnostic errors, the challenges labs face today, their impact on staff, and ways to address these challenges. This article reviews the two most significant issues and the role of quality and safety. An upcoming article will address solutions for these challenges, including automation.
Laboratory staffing crisis
The vacancy rate for laboratory positions is between 7% and 11% (up to 25% in some rural locations).5
Plus, for some time, the number of people entering the clinical laboratory field hasn’t kept up with the number retiring.
The approximately 338,000 laboratory technologists employed in the U.S. today equals one technologist per 1,000 individuals.6 Nearly 25,000 openings are projected for clinical and laboratory technologists annually through 2030.5 Only 5,000 are graduating from academic programs each year, and the number of accredited training programs fell to 482 in 2020.7
A Harris Poll for Siemens, Inc. identified several notable impacts of the staffing shortage, including hampering the ability to provide the highest clinical value and increasing risks for patients and staff. Survey respondents reported that a lack of staff led to lab closings for one or more shifts (5%) and caused overworked/burned-out staff to make a low-risk (2%) or high-risk (14%) error.1
To combat staffing challenges, labs have increased overtime, eliminated non-essential tasks, and redistributed resources, all of which can cause additional stress for staff. Of those surveyed in the Harris Poll, 20% report feeling burned out, and 9% are considering leaving their workplace or the industry.1
Escalating testing needs
Our aging population, increased incidences of chronic disease, and the availability of new tests contribute to growing testing volumes. More than 10 new tests are released daily (including variations of existing tests).8 Adding to approximately 175,000 already in use.8 The relatively recent growth of molecular diagnostics has revolutionized testing and impacted testing demand.
Staying focused on quality and safety
The need for laboratory testing is unlikely to lessen soon and is more likely to grow further. Staffing issues require long-term solutions, but laboratories must ensure that quality doesn’t suffer and that results are accurate now.
What can an individual lab do? Many quality and safety strategies are within a lab manager’s control, including educating providers on laboratory testing, strengthening processes, and establishing a culture of quality that encourages staff to report errors and near-misses to identify opportunities for improvement. See LGC’s 5 Best Practices for Best-in-class Clinical Lab Quality Control for more strategies and practices to implement.
Streamlined processes create greater efficiency and increase confidence in patient results. LGC Clinical Diagnostics' independent quality measurement tools, used with LGC’s automated software, can help. The extensive selection of liquid, ready-to-use solutions supports daily quality control needs in clinical biochemistry, molecular testing, serology, next-generation sequencing, urinalysis, and toxicology. They simplify quality control, calibration verification, and linearity data management and help bolster a culture of quality.
LGC Clinical Diagnostics supports the diagnostic testing industry with biological materials to develop, validate, and challenge today’s most trusted molecular and serological infectious disease assays. We are an elite provider of high-quality third-party controls for the clinical laboratory market, with decades of experience designing and manufacturing effective quality control monitoring tools.
Download the white paper, Diagnostic Errors: The Laboratory’s Essential Role in Addressing Today’s Challenges, for a shocking in-depth look at the industry's current challenges.
References
- Clinical Labs in Critical Condition: What lab professionals reveal about the impact of workforce shortage on patient care
- Clinical Laboratory Improvement Amendments (CLIA) – home page
- Report Highlights Public Health Impact of Serious Harms From Diagnostic Error in U.S.
- Data analysis reveals common errors that prevent patients from getting timely, accurate diagnoses
- S. Bureau of Labor Statistics Clinical Laboratory Technologists and Technicians
- Workforce in the Shadow of Healthcare –An Update on the Survival Status of Laboratory Medicine and Public Health
- Clinical Laboratory Personnel Shortage
- Lab Testing Volume, Spend to Rise
Additional sources
We’re Facing A Critical Shortage Of Medical Laboratory Professionals