Clinical lab managers are currently faced with unprecedented logistical challenges due to the ongoing pandemic, which can affect their work and the productivity of their teams. Below I will discuss some of these challenges along with real-world strategies that clinical lab managers can use to deal with them. Implementing these strategies will help clinical lab managers lead their labs more effectively for the duration of the pandemic.
Address urgent supply shortages immediately. Reach out to the purchasing and/or supply chain group at your organization for help with delayed orders and difficult-to-find items. They have resources available to assist them in finding available supplies that could save you many hours of work. Purchasers can also reach out to vendors on behalf of your organization to negotiate prioritizing your institute’s orders and can work with vendors to find equivalent substitutes when specific supplies become difficult to obtain. The purchasing group at my university has been an invaluable resource to me through this pandemic. This is their job; let them help you!
Once the immediate shortages have been addressed, it’s time to come up with a long-term plan to avoid future shortages. The best solution is to survey the laboratories at your institution to find out what specific items they are having trouble getting ahold of, and how much of each item they will need for the next six months. With this information in hand, contact those vendors for quotes to buy six months’ worth of each item, and find out the lead-times. It will again be important to involve your purchasing group as well as your institutions leadership to set-up a central stock supply of these items.
If you work for an institution where each group pays for their supplies from their own individual account numbers, ask labs to pay for the items as they retrieve them with the system your institute uses to transfer funds internally. Even if items are back ordered, once the central stock is in place, you will know you can get the supplies you need when you need them, which will alleviate a great deal of stress.
Beginning this process sooner rather than later is critical as vendors are expecting shortages to get worse. I have found that the most problematic shortages, other than the ones associated with PPE, include any supplies that have to do with PCR (0.2ml tubes, 96 well plates, PCR reagents, buffers, and primers), conical tubes, pipette tips, alcohols, bleach, and -80 °C freezers.
Illness in the lab
The best way to prevent staff shortages is to prevent staff illness in the first place. To do this, all staff should still be wearing face masks at work, and hand sanitizer and hand-washing stations should be readily available in all areas of the work environment as well as surface cleaning wipes. Do not neglect common areas such as break rooms and other communal gathering spaces. Supplies to wipe down surfaces and hand sanitizer are particularly important to have available in areas where people eat and drink.
It is important to educate your staff about how they are expected to behave outside of work in order to keep the environment inside of your work clean and free of the risk of infection from COVID-19. Staff should always wear masks when they leave their homes and the same should be done by anyone living in the same home as your staff. Staff, and the people in their homes, should not gather in groups of more than 10 people and whenever they are around people they do not live with, they should be wearing masks and social distancing. Staff should always carry wipes and hand sanitizer with them to disinfect surfaces and clean hands often. These expectations should initially be delivered to your staff in a formal setting, such as a team meeting. These expectations should then be reinforced regularly through e-mail, text, and at informal gatherings.
However, illnesses among lab staff are bound to occur. Many managers have concerns as to whether their staff’s illness claims are warranted, while lab staff often feel torn between staying home when they have mild symptoms and their work obligations.
To deal with these kinds of concerns among clinical lab managers and their staff, it is crucial to have very clear policies in place regarding illness. Work with your institute’s infectious disease staff and ensure all staff know the policies and procedures to follow if they feel sick. They will need to know how to report their symptoms and who to go to for guidance regarding testing, quarantining, and returning to work. Having very strict and clear policies in place will alleviate a lot of stress put upon lab managers as they try to navigate this unprecedented landscape.
Be transparent with staff in terms of policies and post them in highly visible areas to be sure everyone knows the policies to follow and knows what to expect if someone becomes ill. At my institute, staff are only contacted regarding a COVID-19 positive colleague in their vicinity if the staff member is identified as being at risk for infection from the infected individual.
Despite all of our best efforts, some staff will get ill and be quarantined. Sometimes entire labs will be quarantined due to exposure to a single lab member. Many clinical lab managers are facing unprecedented staffing shortages, putting them into a position of constantly rearranging staff schedules to accommodate social distancing and sick staff.
Cross-training—defined as the process of training individual staff in more than one role—is a key strategy to deal with staff shortages. For example, you may oversee a clinical pathology lab that employs two staff members, each of whom competently performs the same functions every day. If both staff members were out sick at the same time, you would not have any staff available to assume their roles. This is where cross-training comes into play. The manager in charge of the pathology lab could work with the manager in charge of the microbiology lab, which employs three staff members, to train the pathology lab staff in microbiology techniques and vice versa. Staff might take turns twice a week working in the other lab in order to master the techniques needed to work there if the need arises. Once staff are proficient, their skills can be maintained by again swapping work with a member of the other lab once a month. Now instead of having only two staffers in the pathology lab who know how to do the work, you have five people who can do the job in either lab if needed.
Staff should also have the opportunity to get whatever certification is needed to do the work in the other lab. You will need staff to be more flexible than ever before, and using cross-training as a staffing shortage mitigation technique is an excellent way to give your staff the skills they need to be flexible.
Gaining control in uncertain times
Employing the above strategies can go a long way in allowing clinical lab managers to feel more in control and less at the mercy of the pandemic. Once these strategies are set up, lab managers will find that there are fewer demands on their time, which should go a long way toward alleviating some of their feeling of being overwhelmed and overworked.