Volume 37 Number 6 | December 2023
Catherine Otto, PhD, MBA, MLS(ASCP)CM, SHCMDLMCM, ASCLS Patient Safety Committee Member
Ethical clinical laboratory science practice improves patient safety. Ensuring and improving patient safety requires following ethical principles of practice in order to provide safe clinical laboratory services. Although the term, “patient safety,” was not used when our profession was in its infancy, as our profession developed and created a code of ethics, its principles were identified and adopted for the sole purpose of ensuring that our patients received the highest level of care. Patient safety is defined as providing health care that is safe, effective, timely, efficient, patient-centered, and equitable.1
The ASCLS Code of Ethics describes how we practice our profession and how we perform our daily work, whether as a medical laboratory professional in a hospital, medical office setting, or independent laboratory; or as an educator in a medical laboratory technician (MLT) or medical laboratory scientist (MLS) program; or as a sales or technical service representative from an analyzer manufacturer. The ASCLS Code of Ethics includes three duties: duty to patient, duty to colleagues and the profession, and duty to society.2 One can also place these duties within concentric circles, with the patient as the center circle (the focus of our profession), followed by the members of the profession (those who perform their duties for the patient), and finally the outer circle our role as members of the society we live in (our role in influencing the delivery of healthcare).
Although it seems obvious, it is worth stating that without patients there would be no need for our profession or our work. Patients are at the center of our work. The ASCLS Code of Ethics, “Duty to the Patient,” (listed first) incorporates the definition of patient safety into the definition of our services, “High quality laboratory services are safe, effective, efficient, timely, equitable, and patient-centered.”2 Considering one dimension of patient safety—providing patient-centered laboratory services—how can we, as laboratory professionals, ensure that we are providing patient-centered care in an ethical manner?
“Although it seems obvious, it is worth stating that without patients there would be no need for our profession or our work. Patients are at the center of our work.”
One of the first methods to focus on delivering patient-centered care is to change the words that we use when we talk about our daily duties. How many times do we say to ourselves or our colleagues, “I have collected 25 specimens today,” or, “I have 100 specimens to analyze”? Certainly, these are true statements. However, a patient-centered thinking is, “I collected specimens for 25 patients today,” or, “I analyzed specimens for 100 patients today.” Replacing the word “specimen” with “patient” is the first step to changing our frame of reference on the journey to improving patient-centered laboratory services.
The first sentence under, “Duty to Colleagues and the Profession,” identify vital characteristics of ethical clinical laboratory science practice: “Medical Laboratory Professionals uphold the dignity and respect of the profession and maintain a reputation of honesty, integrity, competence, and reliability.” How do these individual characteristics improve patient safety? Improving patient safety requires honesty when a near miss or error occurs while performing our duties. Identifying problems or defects in our procedures allows us to improve the processes within our delivery systems and demonstrates our integrity to our colleagues and other health professionals and, most importantly, to improving the care our patients receive. Improving patient safety requires professional competence in all aspects of our duties: enrolling students in our programs, hiring individuals to fill vacancies in job openings, and promoting individuals to supervisory and managerial positions.
Within our “Duty to Society,” we serve our patients by considering how laws or regulations impact the clinical laboratory testing they receive, and we advocate for appropriate changes to alleviate and ameliorate disparities in that care. Advocating includes writing letters to our representatives in our state legislatures supporting personnel standards and licensure of medical laboratory professionals to ensure that those who enter and practice our profession have met established qualifications. We also advocate for patients when we write letters to our representatives and senators in Congress supporting eliminating cuts to the Medicare Part B clinical laboratory fee schedule to ensure that our patients have access to clinical laboratory testing in their communities.
Patient safety is a complex subject, composed of six dimensions. The ASCLS Code of Ethics is also multi-faceted. Improving patient safety requires more than ensuring that our quality control procedures meet appropriate standards. It requires examining each of our processes from the perspective of each of the six dimensions of patient safety (safe, effective, efficient, timely, patient-centered, and equitable) to identify opportunities for improvement. Support for our improvement processes can be found in our Code of Ethics, which identifies the principles to incorporate into our daily practice to serve our patients and improve patient safety.
- Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. 2001. Washington, DC: National Academy Press. pp. 39-40.
- ASCLS. Code of Ethics. https://ascls.org/code-of-ethics/ accessed September 12, 2023.
Catherine Otto is a Professor of Medical Laboratory Science (Retired) in Tigard, Oregon.