Serving the patient has always been at the heart of clinical laboratory medicine, however the Institute of Medicine has identified improving patient-centered care as a key competency to improve healthcare quality.1 For laboratory professionals, providing patient-centered care means identifying, respecting and caring about patients’ values, preferences, differences, needs and expectations. This requires effectively listening to, clearly communicating with and educating our patients about laboratory testing.2 As the laboratory scientists who play a critical role in patients’ care, we have the duty to ensure that our patients and their providers understand preparation requirements for testing, receive information about the meaning of lab tests and our services meet their needs and expectations. Providing direct access testing and patient access to laboratory test results are other ways we can become more patient focused. These are obvious areas to focus on in order to work towards this goal, however there are critical skills laboratorians can develop to become more patient-centered.
Thinking more holistically about patients’ experiences and patient outcomes is a first step in becoming more patient-centered. For example, we cannot measure turnaround time as the time when the specimen is received in the laboratory to the time that the result is released. Would this lab focused definition of turnaround time matter to the patient if a stat test arrived in the laboratory 3 hours after its collection? Of course not. What really matters to the patient is how much time it takes from specimen collection to when their care provider can use the information for clinical decision making. It is often less convenient and “messier” to think outside the boundaries of the laboratory, however developing big picture, patient-centric thinking enable us to participate on interdisciplinary teams with other care providers, provide feedback and effectively problem solve with non-laboratory providers. This allows laboratory professionals to truly have an impact on what is important to the patient and their care.
Sharing information about laboratory testing with patients and healthcare providers requires a new set of communication skills. For some of us, effectively communicating with patients and their providers is challenging. Many of us work in our insulated laboratories with only the occasional phone call from a care provider. Effective consultative communication is a skill that lab professionals need to consciously work to develop. This will allow us to communicate important information to patients and to become valued members of the patient-centered care team. Although we may think we don’t have control over a certain aspect of the pre-pre-analytical phase, we certainly have influence. This influence increases with effective communication. Laboratory professionals have valuable information to share with providers caring for patients. How often do we proactively and strategically communicate our knowledge and concerns? I would argue not often enough.
Clinical laboratories are not a black box where specimens go in and test results come out. Clinical laboratories are the places where scientists with important, often critical, medical information is identified and communicated to patients and their care providers. We owe it to ourselves and our patients to look for ways to make laboratory service more patient-centered and share our expertise with the rest of the patient care team.
Institute for Healthcare Improvement. Across the Chasm Aim #3: Health Care Must Be Patient-Centered. 2015. retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/AcrosstheChasmAim3HealthCareMustBePatientCentered.aspx.
Committee on the Health Professions Education Summit, National Academies Press. Greiner AC, Knebel E. Eds. Health Professions Education: A Bridge to Quality. Washington DC: National Academies Press; 2003.