Point-of-care testing – a reality to be dealt with

Report on a seminar on 19 November 2002
Arranged by the Swedish Association of Health Professionals and the Swedish Institute for Biomedical Laboratory Science (IBL)

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How to create both customer and staff benefit?

Roine Hernbrand from IBL (Swedish Institute of Biomedical Laboratory Science) wanted to provide an employee perspective as a biomedical scientist on the question of the development of laboratory medicine.

An operational concept has to generate both user benefit and healthcare benefit and respond to questions such as: Who is our customer and what does the customer want? The procedure chosen is closely related to the staff concept – that is to say what is it that creates job satisfaction? What do we do to create both customer benefit and staff benefit?

It may perhaps be different for different categories of staff, but for biomedical scientists it is both developing our professional function and developing the activity, for example the range of tests and methods. We want to receive feedback from our management.

Hertzberg’s theory of motivation poses both external and internal factors. If job satisfaction is to be acceptable, there is a need for a good staff policy, decent working conditions and pay, a good physical environment. But if job satisfaction to be high, there are also requirements to be met in the internal factors: achievements, recognition, content of work tasks and opportunities for development. If employees in primary care laboratories are asked, they emphasise development opportunities in particular.

If a sense of coherence is to be attained the work needs to be experienced as manageable, understandable and meaningful. As an employee one moves in three fields: a routine field, a reserve field and a learning field. The routine field contains security, the familiar work tasks. The reserve field sometimes involves a need to go out and update old knowledge, obtain help from a colleague, solve problems. In the learning field entirely new knowledge is acquired.

All staff needs to move between the fields, even if they stop in the routine field during various periods of their life. What demands does this put on leadership? No professional group has a pure monopoly on work tasks, and in the routine field several can share them. In one way, this development resembles what has taken place in information technology. Technology also provides different underlying conditions, that is to say the routine field changes over time.

But seeing as it is difficult to recruit biomedical scientists into primary care, assistant nurses and laboratory technicians are trained. This creates conflicts and discussion between professional groups on the consequences of staff who lack training in laboratory medicine having to carry out laboratory work.

There are various steps on the staircase of knowledge: factual knowledge, understanding, application, analysis, synthesis, and evaluation. It is important to decide what level of skill the various work tasks require.

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