The interface between clinicians and laboratory staff: A field study in northern Tanzania

Abstract

Background: Strengthening the communication and professional relationships between clinicians and laboratory workers is essential in order to positively change clinicians' attitudes about the reliability of diagnostic tests, enhancing the use of laboratory diagnostics and, ultimately, improving patient care. We developed an analytical framework to gain insight into the factors that influence communication amongst health professionals.

Objective: To explore whether the interaction between clinicians and laboratory workers influences the use of laboratory test results in clinical decision making.

Methods: Four health facilities in northern Tanzania were selected using convenience sampling, whereas study participants were selected using purposive sampling. The quantitative and qualitative data collection methods included self-administered questionnaires; semi-structured, individual interviews; in-depth, individual interviews; and/or focus group discussions with clinicians and laboratory workers. Thematic content analyses were performed on qualitative data based on the framework. Descriptive statistical analyses of quantitative data were conducted using Microsoft Excel.

Results: Contact between clinicians and laboratory professionals is seldom institutionalised and collaboration is rare. The clinicians believe collaboration with laboratory staff is a challenge because of the gap in education levels. Laboratory workers' education levels are often lower than their positions require, leading to clinicians' lack of respect for and confidence in laboratory professionals, which compromises the laboratory staff's motivation.

Conclusions: Hospital managers, clinicians and laboratory workers need to recognise the critical and complementary roles each professional plays and the importance of addressing the gap between them. Field application of the framework proved successful, justifying the expansion of this study to a larger geographical area to include additional healthcare institutions.

FIGURE 1

Factors related to the management of the organisation, response of clinicians.

FIGURE 2

Factors related to the management of the organisation, response of laboratory staff.

FIGURE 3

Professional factors. The perceptions of clinicians regarding the frequency with which test results are used for making clinical decisions.

FIGURE 4

Professional factors. The perceptions of laboratory workers regarding the frequency with which test results are used for making clinical decisions.

FIGURE 5

The frequency of professional contact between clinicians and laboratory workers. Eight of 16 clinicians reported having daily interactions with laboratory workers.

FIGURE 6

The frequency of professional contact between clinicians and laboratory workers. Eleven of 14 laboratory workers reported having daily professional contact with clinicians.