In the past decade, a higher number of medical laboratory personnel work more than one job due to the medical lab personnel shortage situation nationwide and the depressed global economy overall. With more of the baby boomers retiring now, the threat of increasing lab personnel shortages is imminent. Healthcare organizations face challenges in recruiting lab personnel, especially in the highly specialty areas such as microbiology and blood banking. Alarmingly (but perhaps not surprisingly) in metropolitan areas a significant number of clinical personnel work two full-time jobs – that means these employees are working for a minimum of 16 hours per day! If travel time is considered, these employees could have less than 5.5 hours sleep per day. How many people can function long term with such limited sleep? While federal laws do govern how many slide reviews a cytotechnologist can perform per day, there are none that govern the number of hours per day laboratory professionals can work. Should such laws exist?
In December 2011, the Joint Commission (JC) published a very important Sentinel Event Alert (SEA) Issue on “Healthcare worker fatigue and patient safety.” The publication addressed the effects and risks of an extended workday and cumulative days of extended work hours beyond 12.5 hours. The SEA cited the 2004 study that when nurses worked more than 12.5 hours, they were three (3) times more than likely these personnel created errors in patient care. This alert raised awareness that fatigue could jeopardize patient safety. Transcription errors or reading a patient ID number incorrectly can occur when personnel are fatigue or sleep deprived.
Are efforts to reduce or prevent the errors jeopardized by allowing laboratory professionals to work long hours? Should clinical personnel’s total hours be regulated for patient safety protection? Regardless of the answers to the above questions, healthcare leaders should start planning on how to perform root cause analysis on the medical errors pursuant to the best practices guideline. It is crucial to identify whether or not sleep deprivation and fatigue are a contributing factor and then implement strategies to mitigate the risks on patient safety.
Information on policies or practices are solely from my personal experience ONLY and have NO relation to my affiliation with any regulatory or government agency.
-Caroline Satyadi, MT(ASCP), SM, DLM, SLS, MBA, MS, CQA (ASQ) has been a laboratory management professional for over 25 years. She has worked with several different medical industries for CLIA/CMS, FDA/ICH/ISO, TJC/CAP/COLA/HFAP accreditation survey readiness.