Volume 38 Number 6 | December 2024
Instilling Values that Ensure Patient Safety Every Step of the Way
Larissa Todd, MLS (ASCP)CM, ASCLS Patient Safety Committee
While the workings of the laboratory may seem distant from the patient experience, it’s essential to recognize that patients are ultimately the end users of laboratory services. Ensuring patient safety depends not only on technical accuracy in reporting, but also extends to ensuring competency of laboratory personnel, facilitating environments of collaboration and teamwork, and fostering a culture that puts the patient first.
As healthcare evolves, the laboratory must continue to adapt and embrace innovations that support a culture of safety, diversity, equity, and inclusion. As such, the transmission of knowledge alone in educational programs for clinical laboratory science is insufficient in creating the type of medical laboratory professionals that are needed. It is paramount that clinical laboratory science education programs prioritize patient safety and ethical considerations to instill a commitment to patient safety throughout a graduate’s career. So, how is it that we educate and foster the development of medical laboratory professionals to create an environment focused on patient safety and equitable healthcare?
As a medical laboratory science educator, my favorite question to ask is, “Why?” Why does it matter that the sample for ammonia is placed on ice? Why do you need to read the test at five minutes and not four? Why do you need to call the critical result in under 30 minutes?
Disclaimer: The answer has never been, “Because it says so in the procedure.”
“It’s crucial that medical laboratory professionals understand that the basis of all testing is not the sample, but the patient, and when mistakes happen there needs to be an environment that allows for honesty, accountability, and transparency.”
The basis of these questions applies not only to students, but to all medical laboratory professionals at all stages of their career.Of the laboratory testing you are performing, what are the implications for your patient? What happens once the results are transmitted to the clinician, and how do pre-analytical and analytical variables contribute to the health outcomes for the patient?
Fostering this level of understanding and consideration in our students and ourselves allows for the growth of laboratory professionals into patient-centered careers, where they can advocate for patients and maintain the integrity of the clinical laboratory science profession. Asking the important question of “Why?” also permits students and professionals the opportunity to consider if the current practice is the best practice. After all, innovation and the consistent effort to improve patient safety and laboratory reporting direct us towards a higher standard of care and advancement in the field. This questioning should not only be permitted but welcomed in the student laboratory and on the bench to encourage the development of this innovative, focused thinking.
If a mistake is to be made, the student laboratory could be judged as the best place to do so. I would go as far as to encourage mistakes in the student laboratory, as this allows for opportunities for students to take accountability and develop a sense of ownership and pride for their work and profession. Just as a documentation of a mistake in the laboratory without proper discussion and follow up is without significance, deducting points from a student’s grade without discussing the error is a wasted opportunity. What remains more significant than the error made is the recovery and remediation process. If a student allocates the incorrect unit of blood to a patient in a mock transfusion laboratory, they should be expected to take accountability for the error through discussion of patient implications and remediations moving forward.
It’s crucial that medical laboratory professionals understand that the basis of all testing is not the sample, but the patient, and when mistakes happen there needs to be an environment that allows for honesty, accountability, and transparency. It is the tone of educators, supervisors, and colleagues that allow for this nature of honest discussion. This is how we develop a community of future medical laboratory professionals that value the integrity and accountability that allows for the stewardship of patient safety from the laboratory.
Ethics in laboratory medicine extends beyond compliance with regulations; it involves the moral responsibilities of laboratory professionals to their patients, colleagues, and society. Medical laboratory professionals serve a crucial role in patient advocacy by applying their expertise to improve patient outcomes and eliminate barriers to access in laboratory services. Due to this great responsibility, laboratory professionals have a duty to develop a firm foundation of cultural competency and understanding of ethical considerations, as well as a commitment to the continued education around such topics as exemplified in the addition of ethics to the ASCP Board of Certification recertification and continued education process. Ethics and cultural competency courses are included in most medical laboratory science curriculums. While studying ethical principles of healthcare, such as patient autonomy and HIPAA, are both important and essential to patient safety, it’s encouraging open discussions about ethical challenges faced in the laboratory that helps students to navigate similar situations from a multitude of different perspectives in their future careers.
Fostering a culture of patient safety and ethical practice within clinical laboratory science education programs is not merely an academic obligation; it is a moral imperative. Without these principles, the integrity of the profession is compromised. Whether the learning is in the classroom or on the bench with clinical instructors, the first step in the evolution of patient safety-centered medical laboratory professionals begins with a strong foundational knowledge and stewardship of the profession. By embedding these principles into the curriculum, utilizing innovative teaching methods, and encouraging a collaborative environment, educational programs can instill knowledge, skills, and the ethical framework necessary to safeguard patient safety.
Larissa Todd is an Assistant Professor of Medical Laboratory Science at the University of Alaska in Anchorage, Alaska.