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Woodrow Wilson was famously quoted as saying, “If you want to make enemies, try to change something.” This bit of wisdom is not only true for politics; it’s also true in the lab. But, although we may be initially inclined to resist change, we have to remember that it has been an integral part of the histology profession since the beginning.
The Godfather of Histology, Johannes Müller, would hardly recognize the scientific discipline he established in 1838. Since publishing On the Nature and Structural Characteristics of Cancer and of Those Morbid Growths Which May Be Confounded With It, we have seen the introduction of the use of microtomes for animal tissue (1848), formalin (1893), automated tissue processors (1945), disposable tissue cassettes (1972), and fully-enclosed processors (1979).
And the way histotechnologists do their jobs will continue to change—whether those changes stem from new scientific discoveries, regulatory updates, or even procedural revamps that take place in a specific lab. We may not always like it, but like histologists past, we have to accept it.
“Change is not new to histology. There’s actually been multiple evolutions through the course of time in the laboratory—and standardizing and automating a lot of these manual tedious and error-prone processes that we had before has shown to be a great benefit for histology laboratories today,” said histology educator Joshua Greenlee, MBA, IASSC CBB, HT/HTL(ASCP)cm. “And on some of that, the patients benefit from having a better, more safe system their tissues go through in order to be diagnosed by the pathologist. But just like changes today, the changes earlier histotechnologists had to experience were also difficult. They aren’t always met with open arms.”
Common Reasons Labs Don’t Make Changes
Although people may not embrace change, the reasons that changes don’t happen in a lab aren’t because management is trying to avoid making enemies. Generally, there are some underlying problems that can preclude necessary changes. In the NSH webinar, Change, What’s in it for Me?, Greenlee discusses some of these issues.
Lack of awareness. You do your job in the lab day in and day out, and may not have time to think about whether or not processes can be improved. In many cases, labs may have done things the same way for so long that the practices and procedures are just deeply ingrained in the work culture. But that doesn’t mean a change wouldn’t make you more efficient—it’s just that management doesn’t recognize it.
“We get so lost being in our own bubble and working in our own environment within the laboratory that it can sometimes warp our perception, and we don’t see that some of the things we’re struggling with can actually be changed,” Greenlee explained. “In some cases, laboratories have found ways around it, so they aren’t struggling with that anymore.”
Lack of a starting point. Greenlee says that while some labs may not recognize that a change is needed, others know they need to change the way they work, but have no idea how to embark upon such a seemingly large undertaking.
“Sometimes there could just be so many things that need to change at one time, and they all are kind of interlinked, so we don't know which one to start with first,” Greenlee said. “Or we really want to do something, but we can’t get there because something else is blocking it and we don’t know how to get moving on it.”
Lack of focus. In order to make meaningful changes in any workplace, there needs to be a focus on the real problems, so the changes get to the heart of them. However, Greenlee says that oftentimes in a lab, a change is made in response to an abnormality. This leads to a procedural update that can long outlive the problem it was meant to solve, while problems that need to be addressed get ignored.
“Sometimes we’re focused on the completely wrong problems. You have probably lived through those situations where a weird anomaly happened in the laboratory that caused some sort of error. It was just a confluence of events that actually happened. Then the pathologist said, “Well, what are you going to do about it?” and the next thing you know, created this whole new process with redundant checks to try to solve this almost one in a million type of problem,” said Greenlee. “Then it just lingers on for years to the point where no one even remembers why they’re doing that weird thing anymore in order to check, check, check, and check again. But they still do it the way they’ve always done it.”
Going through change in your lab can be challenging. Even unpleasant. But in the end, change can help labs work more effectively to ensure that patients ultimately get the care they need. To find out more about the factors that make change in the lab so difficult, effective change management strategies, and tools that can be used when managing change, watch NSH’s Change, What’s in it for Me? webinar.
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