Managing an interventional lab is an important task; the degree that a lab is managed well (or poorly) will have a direct impact on the profitability of the lab and, more importantly, the well-being of patients. Below are 6 steps to help you run your interventional lab as efficiently and effectively as possible.

1. Lead Well

   An obvious statement, sure, but an irrevocably true one. A lab (or any organization for that matter) can only succeed to the degree in which it is led. Being a great leader isn't something that can be mastered overnight, but there are some key attributes that we can aspire towards:

   • Have humility - When we think of what defines a ‘great manager’ or ‘excellent leader’ the characteristics that come to mind are often those of someone who is charismatic, outspoken, and confident. These character traits do indeed make someone standout and attract ‘followers’ but they aren’t necessarily indicative of great leadership. The best leaders have a reserved humility about them. A humble attitude leaves the door open for learning and improvement and allows the people you manage the flexibility to speak openly about their concerns, propelling you and your team to success. Humble leaders aren’t afraid to ask questions, get help, and learn from more experienced people in their network too. “Fake it till you make it” is a recipe for mistakes; being a lifelong learner requires a humble attitude. C. S. Lewis sums it up nicely: “Humility is not thinking less of yourself, it's thinking of yourself less.”

   • Be a team player - This ties in with the above mentioned point, but it’s worth mentioning. A lab manager who is concerned with exhibiting the dominance of their position and worried about the security of their roll has divided motives and cannot succeed. The best leaders happily pass credit down to their staff while accepting responsibility for the team’s faults as their own. A great book on this topic is Extreme Ownership by Jacko Willink.

   • Have unflinching determination - In the medical industry there are a hundred different things that can go wrong. When things don’t go to plan your team is going to look to you on how to react. In times of distress, it’s crucial that you stay focused on the end goal. This doesn't mean burying your emotions, but it does mean staying focused on the task at hand, no matter how difficult the circumstances.

   • Never lose sight of the big picture AND understand each roll - Another crucial function of a leader is to act as the compass during times of confusion or disarray. Having a clear and defined end goal will help you make the right decisions, even under pressure. Often times urgent problems (those that demand your attention right now, like a ringing phone) can continually take precedence over important problems (like thinking about your team’s long-term strategy); being able to distinguish the difference between the two, and delegating the tasks that are urgent but not important, will be crucial to your success. This method of splitting up tasks based on urgency and importance is called the Eisenhower Matrix, named after the President who coined the idea. You can learn more about this method of prioritization here. In addition to keeping your eyes on the big picture you need to be well informed about each roll that every person on your team performs. You don’t need to know how to do every job specifically but, if you don’t understand what it is that each person needs to be doing, you can’t accurately set expectations and hold people accountable to them.

2. Hire the right people

   The US Dept. of Labor estimates the cost of a bad hire to be 30% of their 1st years wage. And that expense only encompasses the sunk costs of bringing on the wrong person. If you keep the wrong person on your team the cost could be significantly worse. So, who are the right people?

   • Look for attitude first, then skills - You can teach skills, you can’t teach character. Don’t underestimate the negative affect one bad hire can have on the culture of your lab.

   • Trust your gut - Don’t hire someone you don’t feel 100% confident in. If something doesn’t feel right don’t ignore it. Getting the opinions of others who will be working with the new hire is a great way to vet for culture fit. Another good method to verify fit is to ask yourself the question “Would I want to work for this person?” Asking this will help you see them from the perspective of your current staff and better understand if they are the right person for the job.

   • Assign rolls well - Give the areas of greatest opportunity to your best performers. It can be tempting to turn your best performers loose on your most problematic tasks, but you must resist doing so. The issue with this approach is that you will miss out on the potential exponential gains to be had with your ripe opportunities and will burn out your talent at the same time. Ask your staff what they are passionate about or what they dream about doing in 10 years. Understanding what makes them light up will help you guide and mentor them, allowing them to reach their fullest potential.
     

3. Balance optimism and realism

   People tend to error on either one side or other when it comes to optimism and realism. Knowing where your natural tendencies lie will help you be a better lab manager. In the medical field it’s easy to become disconnected from the results of a case because getting too emotionally involved can be draining, particularly if things don’t go to plan. Finding a healthy balance will help you propel your team to success. If you tend to be a dreamer, a creative, an emotional leader - you need to ensure that you aren’t over inflating the outcome of the future based on outcomes in the past. And on the flip side, if you are an analyst, a thinker, a low emotion leader - you need to ensure that you are showing some enthusiasm and excitement about what is to come. Keeping a healthy perspective, one that is neither overly optimistic, nor lacking in zeal, is going to be essential to the success of your lab. A good way to discern where your current tendencies lie is to ask the people who work with you; they will certainly know and that information shouldn’t hurt your feelings, but rather empower you to be a better, more balanced, leader.
   

4. Connect you and your team’s passion to the mission

   A great manager helps remind people why what they are doing is important. In life it’s easy to get hyper-focused on what is right in front of us and forget why what we’re doing matters. In the medical field there are a myriad of things that can distract you away from the main mission: pinched budgets, staff shortages, difficult patients, threat of malpractice lawsuits, frustrating bureaucracies, lopsided work-life balance… the list goes on. Keeping the bigger picture in mind, for you and your staff, is crucial for the health and success of your lab. There isn’t a one sized fits all answer to this problem; some people respond well to daily meetings to talk about the main objective, some people need time off to recharge and remember why they got into the medical field, some people respond well to writing their thoughts in a journal, and for others speaking their thoughts to someone who can listen and ask good questions is what helps. It’s important as the lab manager that you keep both your heart, and your teams, attached to mission of the lab. Get to know your team and figure out how you can facilitate an environment where they feel connected to the mission. Keeping the team focused on the bigger purpose improves moral and motivation and reduces the risk of burnout and depression. A great read on this topic is Start with Why by Simon Sinek.
   

5. Nurture a culture of discipline

   A team of people, each thinking critically and making good decisions for the benefit of the team, is more effective than a group of people, each only doing what they are told. This method intuitively makes sense as it maximizes the brain power of the entire group, rather than placing all the thinking responsibility onto the leader, making for a more intelligent, more agile and more productive team. But, in order for this distribution-of-thinking to work, there has to be two things: Autonomy and Discipline. Autonomy (ie. the ability to make decisions without approval) is necessary because without it, regardless of how creative or smart your team is, they won’t be able to enact their ideas. The enemy to autonomy is bureaucracy. Unfortunately, bureaucracy is a dragging anchor behind many otherwise good hospitals. While it can’t be avoided entirely, you can mitigate its affects by creating a culture inside your lab that allows for autonomy, creativity and freedom. Your team will look to you to know whether or not your lab is a safe place to make suggestions and speak openly. You can nurture this autonomous culture by asking open ended questions and getting your teams opinions before making decisions. Also experiment with staying quiet during meetings and assigning people goals without specifically telling them how you want them done.

   The second critical ingredient in a successful lab is a culture of discipline. Giving undisciplined people the autonomy to make decisions doesn’t result in success, it results in anarchy and chaos. A balance must be struck where people feel open to express their ideas and take risks, but are also disciplined to stay focused and engaged on the success of the team, not just their ideas. There are many ways to nurture a culture of discipline but one of the most impactful will be seen by who you allow to be on your team (as discussed above in Hire the Right People). By having zero-tolerance for undisciplined team members you communicate to everyone else that you value the culture of the entire group more than the feelings of one person, enforcing the importance of discipline and teamwork. Where a lot of leaders get tripped up when trying to teach and model discipline is when they confuse disciple with perfectionism. Sure, disciplined people make fewer mistakes, but that doesn’t mean they don’t make mistakes. A truly disciplined person, when they do make a mistake, follows procedure, making it known that a mistake was made. Transparency and honesty might be painful at times, because it makes you and your team come face-to-face with your shortcomings, but in the long run it will help make you a better, more highly functioning, team. Nurturing an environment in which professional discipline is paramount means that people can be trusted to make decisions and perform at their best; resulting in less managing and more leading. This balance of autonomy and discipline is an important concept; you can learn more about it in Ray Dalio’s book Principles.

   
   

6. Leverage technology

   Over the last couple decades the medical industry has transformed from being largely defined by information to being defined by its technology. Information is still a critical component, to be sure, but now medical information is much easier to access (think online resources like uptodate.com, Sg2, The Advisory Board, ect.). The proliferation of medical information in conjunction with the increasing integration of medical devices into procedures means that it’s becoming ever-more important for lab mangers (and all healthcare providers) to be up-to-date on the latest advancements in technology. The best lab managers are in tune with what the latest technologies are and understand the ROI for the different pieces of equipment available to them. Finances are a limited resource, so allocating them towards the things that will be the most impactful in your lab is important. Don’t be afraid to engage with vendors and ask them about what they see in your workflow. Their exposure to a large number of labs makes them a great resource to learn about what others are doing and can help you make your lab as efficient as possible. Another great way to gather information about what works and what doesn’t is to contact current customers that are already using a particular technology and see how it is affecting the labs performance. Technology is shaping the medical industry; the better we understand how to use it and leverage it, the more successful our labs will be.

Managing a lab is an important job inside a hospital. When it’s done well patients are healthier, residents and physicians are happier and hospitals are more profitable. This blog post was inspired by Jim Collins book Good to Great, check out his book to explore these ideas in more detail.