The support staff in our facility is responsible for registering patients and ordering lab tests.  They do not report directly to me.  We have frequent issues with ordering errors and with the staff altering processes to suit themselves.  We provide the office coordinator with statistics on ordering errors, education on changes and write detailed procedures on how things should be done.  The office staff continues to make their own decisions and makes changes.  Does anyone have any suggestions on how to make this group more compliant with our requirements?

Follow your company's disciplinary (insubordination) policy...  Inform them that policy and procedures are setup in such a manner that your facility has developed them to be either more efficient, less error producing, for sample integrity, paper trail throughput..  etc..

Document, document, and document.  make accurate notes on who and how and when what errors were made and by who.  Any supporting statements from staff on big errors can help too.

 And if that doesnt resolve the matter at hand... Ask yourself if you need them more than they need you?  if not let some go...  that may speak in actions to the rest that this won't be tolerated.

 This may sound draconian, but, hey --  Tyrany and fear worked for the last eight years, why not try it in our local office?

Philip Weissman:

We provide the office coordinator with statistics on ordering errors, education on changes and write detailed procedures on how things should be done.  

It does make it harder when those who make the errors are not under your supervision.  You've appropriately provided information on how things should be done but perhaps it's time to take a different tact and provide an inservice for these personnel.  I couldn't tell if whether this office manager has any laboratory experience like you do so perhaps they need to hear from the horse's mouth.  A lot of times, in my own laboratory, I have noticed we instruct people the "how to do" but we lack the 'why do we do it and why it is important'.  You'll be surprised as the number of times people will respond and say 'I didn't know the reason and that makes sense'.  Good luck.  I know it is frustrating to deal with.