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Stepwise Success

The Clinical Gap

Published November 8, 2013 6:03 AM by Scott Warner

There are two types of people in a hospital. Clinical professionals care for the patients, perform diagnostic testing, and make decisions that directly affect the quality of care. Everyone else should be in a crucial supportive role to that primary mission of healing our patients: housekeeping, plant maintenance, dietary, bookkeeping, payroll, administration, etc.

It’s easy for a place to be out of balance, however, with clinical folks tossed under the bus or the needs of the patient superseded by bean counter policies. This “clinical gap” makes it harder for those caring for patients to do their jobs. It can turn the tables where those in supportive roles are instead obstacles.

For example, suppose a hospital redesigned its outpatient registration area with a phlebotomy draw station adjacent to registration. The phlebotomists, however, have no way to see a queue and are forced to periodically walk into the waiting room to ask who is next. The lab manager asks for a physical or virtual pass-through between lab and registration. He meets vigorous resistance: plant maintenance says it would involve new construction, IT says it would involve too much wiring, medical records says it would be a HIPAA violation, HR says it’s discriminatory, and the CFO says it isn’t in the budget.

Maybe it isn’t discriminatory, but you get my point.

The patient in the waiting room doesn’t give a hoot. He or she chooses a hospital with an expectation of up to date equipment, compliant policies, and trained personnel. Most people will tolerate some inefficiency if human beings are working at a business, but they won’t understand why they can’t have access to the best services, especially while worried about their health or the care of a loved one.

And that is what is hard to explain to nonclinical people. Many times, they dismiss us with a wave of a policy, interpretation of the law, budget figure, credentials, or a claim that we don’t see “the big picture.” For me and most clinical people, that picture is not much bigger than a patient needing the best care.

NEXT: Junk Data Means Junk Decisions

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About this Blog


    Scott Warner, MLT(ASCP)
    Occupation: Laboratory Manager
    Setting: Critical Access Hospital
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