Recommendations and Considerations for Central Laboratory and Point of Care Testing Performed by Medical Laboratory Assistants

Clinical laboratories are facing severe shortages of qualified medical laboratory technologists (MLT). Given the vital role of the laboratory within the healthcare system, patient care in acute care settings, especially within emergency departments, are at risk if there are insufficient MLTs available to staff hospital laboratories. To mitigate this human resource challenge and reduce the overall risk to laboratory operations, clinical laboratories are exploring novel strategies to ensure continuous services that are crucial to patient care. One strategy being employed is leveraging medical laboratory assistant (MLA) staff to perform certain laboratory testing under the direction of MLTs. Options include testing in the central laboratory and point of care testing (POCT). Here, several recommendations have been developed by consensus of the authors, who are several clinical biochemists from across Canada and members of the Canadian Society of Clinical Chemists (CSCC) POCT Special Interest Group, with expertise in central laboratory and POCT oversight. These recommendations are aimed at clinical laboratory and healthcare system clinical and administrative leaders who are exploring alternative staffing models. The recommendations refer to two models of testing performed by MLAs, one whereby MLAs perform a menu of lower complexity tests within the central laboratory and one in which MLAs perform POCT outside of the laboratory in a true point of care setting.