The Heroic Lab: Why Person Dependency is Destroying Performance

If you’re expecting your laboratory operations to stabilize once staffing shortages are solved, think again.

A 2023 whitepaper by the Association for Diagnostics & Laboratory Medicine found that clinical laboratories have been affected by personnel issues for at least 30 years.¹ To make matters worse, training programmes have been cut while retirement rates are rising, widening the gap between staffing needs and workforce availability.²

Yet many laboratory operating models still work on the premise that staffing will return to normal.

That’s because when staffing becomes unstable, the obvious responses are to either hire more people or offer overtime. Those measures only serve as stopgaps, but they do not alter the underlying challenge of a workforce shortage that has persisted for decades.

The more difficult question is whether the laboratory itself was ever designed to cope with that reality.

The 30-Year Cycle of Instability

How do laboratories maintain turnaround times when staffing is tight?

The ADLM identifies overtime and resource reallocation as ways laboratories can increase throughput when they are dealing with staffing shortages.¹ That keeps processes running, but it also places more pressure on the people who remain.

It’s an all-too-familiar cycle. Overtime becomes essential for maintaining turnaround times. That creates more pressure, which in turn leads to burnout and eventual turnover.³ And when experienced members leave, the pressure on the remaining co-workers increases again.

The median three-year average turnover rate for laboratory staff was 16.2%.⁴ That’s not just a recruitment statistic. It also puts a number on what happens when the experience built up inside a laboratory is no longer there.

When an experienced technologist leaves a person-dependent laboratory, some of what they know may walk out the door with them.⁵ The remaining staff may then have to absorb the additional workload, which can increase the pressure and the risk of errors.⁶

You only need to ask one question to find out how dependent a laboratory has become on its people.

When something goes wrong, does your team ask, “Who can fix this?” Or do they ask, “Where did the system fail?”

If the answer is the first question, there is a good chance that too much of the laboratory’s performance relies on years of individual experience.

That does not mean experienced people are the problem. It means the processes have been built around that institutional knowledge and can’t function without it.

So, a person-dependent system can appear perfectly healthy, provided its key people are present. The weaknesses only become visible when those people aren’t there.

As a consequence, employee turnover can also make it harder for an organization to retain institutional knowledge.⁷ When a senior technologist or manager quits without their practical knowledge being recorded first, years of experience can be lost.

When an error occurs in the laboratory, what is your first instinct?

Healthcare has traditionally had a tendency to blame the person responsible. We find the person who made the mistake, retrain them, or discipline them. Yet human error is inevitable in complex systems, and most errors are unintentional.⁸

“Just Culture” considers the circumstances surrounding a glitch rather than automatically treating the individual as the source of the problem.⁹ It recognises that accountability must also consider the system itself.¹⁰

Think about a laboratory that is chronically understaffed, with technologists working mandatory overtime and processes differing from one person or shift to another. If an error occurs in that environment, it is worth asking what role those conditions played.

That’s not to shield individuals from being held accountable. It just means accountability should reflect the circumstances instead of assuming that every failure begins and ends with the person closest to it.

Simply put, laboratory performance cannot be improved by continually expecting staff to compensate for shortcomings of the systems they work in.

Here’s an inconvenient truth: You cannot hire your way out of a 30-year trend.

That doesn’t mean recruitment is unimportant. It just means the laboratory also has to look more closely at how much its performance depends on having every position filled.

The establishment of resilient clinical laboratories amid workforce shortages starts with more consistent and standardized operations.¹¹ Standardized operations can provide a common framework for quality and workforce flexibility.¹² Achieving a high-reliability laboratory also requires operational strategies that support patient safety and procedural consistency.¹³

When a health system standardizes its laboratory operations, employees have a consistent way of working. A technologist moving between benches or facilities should not have to rely entirely on personal experience to work out how things are done if a common way exists.

The same principle applies to succession planning. Laboratory organizations need practical ways to capture and share knowledge so that critical information is retained and integrated into the system when an experienced employee leaves.¹⁴

That can mean documenting workflows, standardizing routine tasks, and making important knowledge accessible to more than one person. The goal is never to remove professional judgement. It is to make sure people can use that judgement where it matters, rather than spending it on workarounds and hurdles that better processes could have prevented.

Sustainable performance is never carried. It is designed.

Join us for our upcoming Activation Session, where we’ll look at the shift from person dependency to process dependency and discuss practical ways to build a more resilient laboratory workforce.

[1] Deaton-Mohney, E., Ehrmeyer, S., Farnsworth, C., Kunzler, T., Strathmann, F., & Thomas, M. (2023). AACC Whitepaper on Overcoming Lab Staffing Shortages. Association for Diagnostics & Laboratory Medicine.

[2] Quest Diagnostics. (2022). The Clinical Lab Staffing Crisis: How Will Hospitals Meet the Challenge? Quest Diagnostics.

[3] Siemens Healthineers & The Harris Poll. (2024). New Survey Reveals Burnout in Clinical Labs Impacts Patient Care, Staff Safety; Optimism that Automation, AI Will Help Tackle Challenges. Siemens Healthineers.

[4] Novis, D. A., Nelson, S., Blond, B. J., Guidi, A. J., Talbert, M. L., Mix, P., & Perrotta, P. L. (2020). Laboratory Staff Turnover: A College of American Pathologists Q-Probes Study of 23 Clinical Laboratories. Archives of Pathology & Laboratory Medicine, 144(3), 350–355.

[5] Knowledge Loss Induced by Organizational Member Turnover: A Review of Empirical Literature, Synthesis and Future Research Directions. (2023). The Learning Organization, 30(2), 117–161.

[6] George Washington University Health Sciences. (2025). The Laboratory Workforce Shortage: A Silent Crisis Impacting Health Care. George Washington University.

[7] HRMorning. (2026). Turnover and How to Avoid Institutional Knowledge Loss. HRMorning.

[8] Davis, T. R., & Straatmann, K. (2025). Promoting a Culture of Patient Safety: Using the Principles of Just Culture to Improve Transparency and Risk Reporting in the Hospital Setting. Patient Safety Journal.

[9] Boysen, P. G. II. (2013). Just Culture: A Foundation for Balanced Accountability and Patient Safety. Ochsner Journal, 13(3), 400–406.

[10] Eng, D. M., & Schweikart, S. J. (2020). Why Accountability Sharing in Health Care Organizational Cultures Means Patients Are Probably Safer. AMA Journal of Ethics, 22(9), E779–E783.

[11] Kozak, A. J. (2026). Building Resilient Clinical Labs Amidst Workforce Shortages. Lab Manager.

[12] HNL Lab Medicine. (2026). Laboratory Standardization for Health System Partnerships. HNL Lab Medicine.

[13] Freeman, C. (2025). Achieving a High-Reliability Laboratory: Operational Strategies Designed to Promote Patient Safety and Heighten Quality in the Clinical Lab. American Journal of Medical Quality, 40(4), 146–155.

[14] Kridelbaugh, D. (n.d.). Succession Planning: Best Practices for Knowledge Transfer. Lab Manager.