Far too many healthcare laboratories today are overcapacitated. That’s just a fancy word for too much or over-supplied. All too often, the chemistry, hematology, and microbiology systems found in hospital laboratories are way above the required testing capacity of the hospital.
For example, the laboratory will acquire a floor model analyzer when it could have met its needs with a benchtop analyzer. Or microbiology, which performs only 20 tests per day, acquires a 100-test-capacity analyzer when clearly one with a 50-test capacity would have more than sufficed. The list goes on and on.
There are many reasons for this phenomenon, but four major ones stand out. Put them all together, and the result is a huge bundle of overcapacitation.
- Acquisition process
The sales staff of laboratory vendors push very hard to convince hospitals to buy a new analyzer. They don’t care whether the size is extreme — they just want to make the sale. When new instrument platforms are developed, high-end, high-volume analyzers are the first to be FDA-approved and marketed; only later will a vendor focus on lower-end systems. Vendors try to sell these large new systems to anyone. Hold tight and wait a little longer until the vendor releases a smaller version. Be wary of new lab automation platforms, and know that smaller versions may be coming.
Physicians can easily convince a facility that if they fail to offer a new test, patients may go elsewhere. This can happen to lower-volume facilities and even high-volume facilities that are anxious to attract every physician that they can. Some labs get pushed into buying analyzers to test for only one thing: PTH, procalcitonin, or hepatitis testing, for example. To make matters worse, a facility may accede to the wishes of a physician to acquire a particular analyzer, only to find that the physician has departed, and nobody else requests the test. Many of these one-test systems take up a huge amount of floor or counter space and may be sitting in labs today virtually untouched.
Some hospitals develop an attitude of “bigger is better,” and the more sophisticated the equipment, the more likely physicians and patients are to be attracted to the facility. Often the physician and the public don’t really care, or the hospital fails to effectively communicate the message. Bigger is not necessarily better — especially when it is underutilized.
Many healthcare facilities don’t have an effective and efficient acquisition process. In addition, the hospital lab is often perceived to be so complex and intimidating that materials and finance personnel just let the lab go wild. Pressure from physicians can muddy the waters, and materials management may yield to the wishes of the laboratory without understanding the overcapacitation monster that they are creating. The laboratory has to be the main player in decision-making, but sometimes they can’t see the forest for the trees.
Team effort makes the difference
The moral of the story is that it takes a village and a lot of work to buy the right laboratory analyzer. When only a few people in the healthcare setting are acquiring the instrumentation, that facility is doomed to overcapacitation.
Laboratory, nursing, physicians, and especially purchasing and finance need to be involved in the acquisition of laboratory instrumentation. Certainly consider asking a third party before acquiring the newest, brightest, and biggest system on the block.
The laboratory seems too often to acquire a whole lot more than they need. Seek out data, email people, don’t go it alone. Don’t set up a standalone ER and try to equip it modeled after a hospital laboratory. Don’t go big. Purchasing and finance don’t need to drive the process, but they certainly need to moderate it. Help the laboratory to not face these decisions alone, so that the hospital makes rationale, cost-effective lab instrumentation acquisitions.