Dear Workforce How Do I Determine Whether Our Clinical Lab Is Overstaffed

What benchmarks are there for hospital clinical laboratories to determine full-time equivalents versus workload units? How do I determine if our laboratory is overstaffed?

September 7, 2011

Dear Counting Heads:

The short answer to your first question is yes. A study conducted in 2004 by pathologist Dr. Paul Valenstein of St. Joseph Mercy Hospital in Ann Arbor, Michigan, provides very helpful (although highly technical) guidance on optimum staffing levels for clinical labs.

Your second question, a very important one, is more complex. We would start by saying that using industry benchmarks is one--but only one--way of determining your lab's best staffing level. Customize your data by also considering your people's experience and expertise, the degree of automation in your lab, and other relevant factors. Before looking at clinical studies, do some informal studies of your own. Ask your people how they feel about their workload. Are they sufficiently challenged, but not overworked? How's your quality? Could you be as close to error-free as possible with fewer people working fewer hours? Then ask yourself what effect downsizing might have on morale, quality and productivity versus reduction by natural attrition.

According to the College of American Pathologists, lab staff account for 50 percent to 70 percent of direct clinical lab costs, so it's critically important to get staffing levels right to manage costs. (Is your staff cost higher than 70 percent of total direct lab costs? If so, that might suggest overstaffing, overcompensating, or both.)

Even more important from the patient care perspective is the need for quality, accuracy and timely results. CAP is an excellent resource for clinical laboratories. Take a look at its Laboratory Management Index Program, a proprietary tool that can be administered, for a fee, to yield extremely valuable management information about staffing and many other factors, based on the input of your lab's data.

Dr. Valenstein's study, "Staffing Benchmarks for Clinical Laboratories" (available through CAP), shows varying staffing benchmarks based on the type of tests the lab typically performs: histology, hematology, cytology, for example.

To give you a rough idea of some numbers to consider, the Valenstein study showed that of the 151 facilities studied, on average, one non-management full-time equivalent processed 8,223 "tissue blocks" in a year; average cytology accessions were 4,857 per year; and the number of billable tests in the microbiology section of the study was 10,457 per year. These are only averages, and productivity numbers varied widely among the labs studied.

If all of this sounds too clinical, keep in mind that although we refer to FTE's for accounting purposes, what we're really talking about are people. While the importance of cost control and efficiency can't be overemphasized, neither can the human factor in managing not only the total labor force in the lab, but the motivation and commitment of each individual employee.

SOURCE: Richard Hadden and Bill Catlette, co-authors, Contented Cows Give Better Milk, October 16, 2006.

LEARN MORE: An article to help you determine staff-to-manager ratio. Also, how to tie workforce planning to revenue.

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