Laboratory Administration's Perspective: Masters Entry Level CLS/MT

Laboratory administrators are increasingly faced with the task of cost reduction due to the ever decreasing Medicare/Medicaid reimbursement, managed care, and the increasing cost of labor. These give one cause to question the requirement of a master’s degree for entry level CLS/MT which, at first glance, appears to increase labor costs. To address this concern, the complete financial picture of the operation must be considered as well as the competencies and availability of the work force.

The design of workflow is the optimum opportunity to improve efficiency. The selection of instrumentation designed to eliminate potential errors that reduce the frequency for calibration and repeat testing is essential in today’s laboratory. Instrumentation must also require less hands-on-time for operation, and more stable methodologies.

Total automation can further reduce the need for personnel. It is now a feasible option for mid- size laboratories. Total automation eliminates specimen handling: sorting, centrifuging, transporting to the appropriate instrument, and storage and retrieval. This frees professional staff to deal with the exceptions, trouble shoot, consult, and perform other needed job functions.

Electronic review reduces the need for verification of normal test results. Information is readily transported to the appropriate place without professional intervention.

Professionals have and will have more of a consultative and problem solving role in the future. They will become more directly involved with the health care team.

Administration must address not only increasing costs but the shortage in the workforce that is expected to continue. Indicators of the continued shortage are the declining number of educational programs, the declining numbers of students entering clinical laboratory science, and the Bureau of Health Statistics forecast of the need for double the number of health care personnel in the next ten years.

Labor costs and the work force shortage can be addressed several ways. Two-year CLT/MLTs can perform many of the tasks now being done by CLS/MTs. The CLT/MLT standards are comparable to those of the CLS/MT in the recent past. Moreover, because of the shorter education time, CLT/MLTs can be in the work force more quickly. Further, on-the-job education and orientation can be reduced for the CLS/MTs if they are better educated; prepared to do higher level tasks; and perform supervisory, problem solving, and consultative functions when they enter the work force.

Below is an example of a budget utilizing reduction of professional staff and utilizing different levels of personnel.

ASSUMPTIONS

1. No increase in revenue from current to proposed.

2. Staffing wages with benefits included
        $23/hour CLS/MT
        $18/hour CLT/MLT
        $12/hour Phlb and Clerks
        $28/hour CLS/MT Masters Degree

3. Proposal I: Addition of automation; 6 positions deleted.

4. Proposal II: Addition of automation; 5 positions converted to master’s level.

5. Proposal III: Addition of automation; 10 CLS/MT positions converted to CLT/MLT positions.

6. Staffing

LABORATORY ANNUAL BUDGET
 

With a combination of automation, use of masters level personnel, and use of technician level personnel, a potential 17% increase in profit margin can be obtained along with the addition of new services performed by master’s level personnel. This strategy achieves an added value in service as well as a saving to the bottom line.

	Questions
1	Rationale for Task Force Activity
2	Why NAACLS?
3	Risks in Moving to Post Baccalaureate Entry to CLS/MT.
4	What are the Benefits?
5	The Impact on Hospital-Based Programs if the CLS/MT Entry level is advanced to a Master’s Degree?
6	Problems for Certification Agencies.
7	What are the problems perceived for employers?
8	Laboratory Administration’s Perspective: Masters Entry Level CLS/MT.
9	What Problems Would CLS/MT Post Baccalaureate Entry Pose for NAACLS?
10	Ramifications for CLT/MLT if CLS/MT becomes a Master’s Entry Level.
11	Differentiation Between the CLS/MT and CLT/MLT
12	The Progression of Academic Standards in CLS.
13	The Debate Continues: Is a Master’s Degree the Answer for Clinical Laboratory Science?
14	Clinical Laboratory Scientist/Medical Technologist of the Future: Task List.
15	Bibliography

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