In the first two articles of this series, we discussed the workflow impediments of Silos and minimal Cross-Training among personnel. It was emphasized that both are extreme liabilities to the laboratory and cause a high frequency of the lab working in crisis mode, ultimately compromising turnaround time and quality patient care. Communication is the central element that binds the former two together and facilitates a smooth, uninterrupted, day-to-day workflow. Effective communications bring staff and information together on the same page with the goal of accomplishing consistent patient case flow. Communication requires personal responsibility and accountability that all information be passed on (directly or indirectly) to the next chain in the process; AND that it was received and understood by the next recipient.
From lab leadership, supervisory or management, down to the bench level, the mode of communication used must be appropriate to the situation and effective in maintaining the integrity of information. As previously mentioned, personal responsibility and accountability are an absolute mandate in patient care. If a doctor gives patient testing orders via computer, phone or written request, the person receiving the orders is responsible for not only receiving the information, but also making sure that it is received and interpreted by the next person exactly as it was submitted. This means that you cannot just leave work without giving the intended recipient verbal notice, a note, or some form on communique letting them know. Work left unattended with the intended recipient not knowing that it is there is one way that workflow slows down and stops at some point. Work ‘flow’ must be maintained.
The illustrations to the right demonstrate various models of communication from a supervisory perspective. The model on the top shows a linear model where each person receives information from the previous person, and the integrity of the information can be altered as it is filtered from person to person, especially if it is verbal communication. In the model in the center-right each person feeds information (from their perspective) to the supervisor, but there is no unified interaction between the group. The third model shows the optimal workgroup communication structure. Each member is brought into full knowledge of the process and takes responsibility for their individual role in achieving smooth workflow.
Managers must disseminate information to the group as a whole to ensure that all are working together towards the common goal. This is crucial in breaking down Silos previously mentioned because each member is brought into ‘some’ degree of knowledge as to what each section does. It also helps facilitate the previously mentioned Cross-Training as members interact with co-workers and share knowledge, experiences, and challenges in their sections in daily workload or individual cases.
Bench workers are advised to leave notes, especially when individual casework is transferred to a co-worker or from one work shift to another (night shift/day shift). This also helps explain ‘why’ work may have been left and not just dumped on someone else. The note writer should always focus on writing a complete message so that it makes sense to the recipient, not just to themselves. Remember, it is the integrity of the information that is important. This may require you to write, not in a condescending manner, but rather giving detail to fully explaining the information.
While communication break downs can happen at all levels of the laboratory, ultimately it is the responsibility of management to consistently mandate to employees to thoroughly communicate information and hold the employees accountable when obvious failures that could have easily been prevented occur. Managers who just turn away from situations of employees showing lack of commitment to engage other employees, or to take the time to leave sufficient detail (such as notes), only enable this kind of behavior and give indirect permission for it to continue. When it comes to patient care, employees do not have a choice. It is everyone’s responsibility to be an advocate for the patient in this manner.
In defining communication failures, successful organizations rely on these key factors:
- Transparent and regular communications
- Authentic and committed leadership
- Inclusion of every employee in communication from a bottom-up leadership style
- Silo-free platforms for seamless information exchange and workflows
Without these factors some of the most immediate casualties to an organization are disrupted workflow, an increase in error ratios, and loss of competency in service.
Optimization of workflow requires a day-to-day commitment of monitoring the present situation of the day, and proactively addressing potential and sudden situations impeding continuous ‘flow’. Crisis preparation and the willingness to immediately engage situations before they become full-blown disasters are key to managing the day-to-day deviations from the norm. Consider the focus of the three articles in this series and you will be well on your way to uninterrupted lab flow in crisis.
- Brown, S., “The Circle of Service” Workshop; Lab Management Consultants-Professional Development Series, 2003.
- Brown, S., “Silo Conditioning – The Hinderance to Global Organizational Management”, Lab Management Consultants – Professional Development Series, 2019.
- Friedman, E.G., “Generation to Generation”, Guilford Press, New York, NY, 1985.
- Slotosch, A., “5 Business Communication Failures and How To Avoid Them”, Beekeper.io.com., 2021.