Volume 35 Number 6 | December 2021

Rick Panning, MBA, MLS(ASCP)CM

Rick PanningAs a professional organization, ASCLS is well known for its advocacy efforts for the profession with state and federal regulators and legislators. Equally as important is advocacy efforts in the workplace with the executive decision-makers, the C-Suite. One of the expectations of laboratory leaders should be their ongoing efforts to represent their department and professionals with executive leaders. I would also broaden those advocacy efforts to include all levels of the organization “above their position” and starting with their boss. I take a broad view of C-Suite, and there are many individuals and decision-making groups within a hospital, clinic, or integrated health system. Many of them should have laboratory representation.

As an essential element of any healthcare provider organization’s core business, the laboratory is a key contributor to patient safety and quality and optimal patient outcomes. The core competency of the clinical and anatomic pathology laboratory is the provision of quality, timely, and accessible laboratory testing. We need to build on that core competency and advocate for the reality that the laboratory contributes to the quality and financial performance of a healthcare organization and plays a key role in optimizing patient outcomes.

Unfortunately, the laboratory is often viewed as a commodity, a “black box,” and therefore is a service that can be easily outsourced and minimized. The ability for our laboratory leaders and each one of us to consistently be present to “tell our story” and advocate for the important role we play is essential.

“The ability for our laboratory leaders and each one of us to consistently be present to ‘tell our story’ and advocate for the important role we play is essential.”

The majority of my full-time career has been in the role of laboratory leadership (manager, director, senior administrative director, or vice president) in healthcare provider organizations in the Minnesota and western Wisconsin area. For 36 years, I was able to build on the skills gained from my ASCLS membership and become a strong internal advocate, as well as an advocate in the regulatory and legislative arena. I was able to see the results of being strongly connected with my organizational leaders and how it created benefits for the laboratories in terms of resources and support and how it also benefited the wider organization in terms of optimized quality, financial, and patient outcomes.

Be a Trusted Source of Laboratory Information

Some aspects of this advocacy, which are essential, are to be proactive and not reactive; to play offense versus defense; and to become a trusted source of laboratory information. It is important for the leaders of your organization to know that you, and the laboratory leadership team, are the source of truth related to the laboratory. No decisions related to the laboratory should be made without you in the room. I am aware of too many circumstances where strategic decisions related to the laboratory have been made at the highest level of an organization and the laboratory leader was brought in too late in the process or after the fact.

One specific area where I have seen this occur, and which I have become keenly aware of, is when an organization makes decisions to outsource all or part of laboratory services to a national provider of laboratory services. I have personally run into that twice during my career, but I believe due to my relationship with hospital leaders, have been able to be involved at the beginning of those discussions and therefore convince the organization that the laboratory brings significant value to a healthcare organization. While there might be a short-term infusion of cash related to outsourcing, in the long term there are often consequences related to quality, service levels, provider satisfaction, and financial effectiveness. I understand the financial pressures on organizations during times of declining reimbursement and when there is a need for an infusion of cash to support capital acquisition. This is shortsighted and ignores the understanding of how the laboratory contributes to system performance outside the four walls of the laboratory.

Another example, from my career, is related to the ambulatory services in my last organization at HealthPartners. My boss was the vice president of ambulatory services, and her leadership team of regional clinic administrators and medical directors met weekly, with each week focused on one of the strategic pillars of the organization—health, patient satisfaction, people, and stewardship. I was occasionally invited to these meetings, but eventually I requested that I be a regular part of that group along with my counterpart in imaging. While not every topic, every week applied directly to the laboratory, I became aware of the larger picture of providing care in an ambulatory setting, and it provided context for me to bring back to my team so that we could optimize our contributions to patient care. It was also helpful to be at the table, consistently, so that laboratory issues could be addressed in a timely manner with the larger group. The value of this became clearly evident in 2020 as the COVID-19 pandemic began and laboratory needed to be totally integrated in the process for collecting and testing COVID samples, at one point 2,500 tests per day. The laboratory became essential and part of our system-wide command center structure.

Be a Leader for the Laboratory

The laboratory plays a key contributor role outside of the laboratory. The laboratory can influence reportable CMS quality measures in the inpatient and ambulatory environment (hospital acquired conditions, sepsis, diabetes, etc.), can contribute to reduction in length of stay, and can prevent considerable downstream costs if utilized appropriately.

One other benefit of having your leader be an effective advocate is the impact on improving the engagement of your laboratory professionals when they feel represented. This can result in higher morale, improved customer service, improved recruitment and retention, and can aid in the development of laboratory leaders.

In order to be an effective advocate, it is important for you to understand what resonates in your organization. Make sure that laboratory goals and strategies are aligned with that of the broader organization. Always be prepared with ideas and solutions and back up your ideas with data. Always focus on how the laboratory can contribute to improved quality, service, and patient outcomes, but do not forget to be prepared to understand how the laboratory contributes to financial effectiveness. Never forget that “cash is oxygen” to an organization.

The value of your C-suite relationships can be summarized as follows.

  • The laboratory is part of the healthcare organization’s core business, and the laboratory’s value is intrinsic and growing.
  • We must consistently be telling our story. Do not allow the laboratory to be a victim. Consistent advocacy prevents the laboratory being brought into lab-related strategy discussions too late.
  • Being a strong advocate allows for proactive versus reactive decision-making.
  • The value of the laboratory can be strengthened within the organization.

Rick Panning is a Senior Healthcare Consultant with ARUP Laboratories in Salt Lake City, Utah.