Teamwork and Communication in the Lab
By Dr. Zubair Khalid, DVM, MS, PhD ·
Quick Answer
- Lab technicians reduce errors by confirming critical values verbally, reading back the result, and documenting the conversation in the patient record.
- Use the SBAR framework (Situation, Background, Assessment, Recommendation) when calling a physician about an abnormal result to keep the exchange structured and brief.
- Communication failures cause most laboratory errors, yet no single script fits every institution, so learn your facility's specific call protocols before you need them.
The Laboratory as a Communication Hub
The medical laboratory sits at the center of patient care, yet its work happens away from the bedside. A phlebotomist collects the sample, a technician runs the analyzer, and a pathologist interprets the result. Each step depends on accurate information passing between people who may never meet. The U.S. Bureau of Labor Statistics describes clinical laboratory technologists and technicians as professionals who examine body fluids, tissues, and other specimens and who operate sophisticated laboratory equipment to detect diseases or track treatment progress. That description captures the technical side, but the interpersonal side is equally demanding.
A new lab tech often enters the field expecting to work alone with instruments. The reality is different. You will coordinate with nurses who collected the specimen, physicians who ordered the test, and other technicians who share the workload. You will answer phone calls from floors that are short-staffed and from providers who are waiting on a result that affects a treatment decision. You will also train students, explain procedures to new staff, and report problems to supervisors. The Occupational Outlook Handbook notes that clinical laboratory technologists typically need a bachelor's degree while technicians usually need an associate degree, and both roles require attention to detail and the ability to work under pressure. The pressure comes from the fact that a mislabeled tube, a misread order, or a misunderstood phone call can change the course of a patient's care.
The laboratory is also a workplace with its own hierarchy. A medical laboratory scientist may supervise technicians, while a phlebotomist may report to a senior phlebotomist. The National Institutes of Health Office of Intramural Training and Education describes the research environment as one where clear communication between trainees, mentors, and technical staff is essential for both scientific progress and professional growth. That principle applies directly to the clinical laboratory. A technician who cannot communicate with a supervisor about a broken instrument or a confusing order creates a bottleneck that affects the entire shift.
The practical problem for a new technician is not whether to communicate but how to communicate well. This article covers the specific protocols, scripts, and habits that reduce conflict and prevent errors. It also explains when to escalate a problem to a supervisor and how to document what you said and what you heard.
The Laboratory's Role in the Healthcare Team
The laboratory is a diagnostic service that supports decisions made by other professionals. A physician orders a complete blood count to check for infection. A nurse collects the specimen. A technician runs the sample and reports the hemoglobin level. The physician then decides whether to start antibiotics or order additional tests. The laboratory result is one link in a chain that begins with a clinical question and ends with a patient outcome.
The U.S. Bureau of Labor Statistics groups clinical laboratory technologists and technicians under healthcare practitioners and technical occupations. The work setting is usually a hospital, a diagnostic laboratory, a physician's office, or an outpatient center. The technician's role is to produce accurate and timely results, but the role also includes interpreting the results in context. A technician who sees a potassium level of 6.8 mmol/L knows that this is a critical value that requires immediate notification. The technician does not make the treatment decision, but the technician does decide who to call and how fast to call them.
The relationship between the laboratory and the rest of the hospital is governed by protocols. Most laboratories have a critical value list that specifies which results require immediate phone notification. The list is usually developed by the laboratory director in consultation with the medical staff. The technician's job is to follow the list exactly. If the list says to call the ordering provider within 15 minutes, the technician calls within 15 minutes. If the list says to call the nursing station when the provider is unavailable, the technician calls the nursing station and documents the conversation.
The laboratory also serves as a consultant. A physician may call to ask whether a test is available, how to collect a specimen, or what a result means. The technician who answers the phone should be able to provide accurate information or find someone who can. The American Society for Microbiology notes that microbiology professionals work in a variety of settings and that career development often depends on networking and communication with colleagues in other disciplines. The same principle applies to the clinical laboratory. The technician who builds a reputation for clear, accurate communication becomes a resource for the entire hospital.
Core Communication Principles for Laboratory Work
Communication in the laboratory is not the same as casual conversation. It is a professional exchange that must be accurate, complete, and documented. The following principles apply to every interaction, whether it is a phone call, a written note, or a face-to-face conversation.
Use the SBAR Framework
SBAR stands for Situation, Background, Assessment, and Recommendation. It is a structured way to communicate critical information that is widely used in healthcare. The Situation is a brief statement of what is happening. The Background is the relevant context. The Assessment is the interpretation of the situation. The Recommendation is the action that the speaker suggests.
A technician calling about a critical potassium level might say, "I am calling from the lab about a critical potassium result for Mr. Smith in room 204. The potassium is 6.8. The sample was collected at 10 a.m. and the result was verified at 11 a.m. I recommend that the provider be notified immediately because this is a critical value." This structure gives the listener the essential information in the first sentence and then provides the context and the suggested action.
The SBAR method is not a regulation. It is a communication tool that many hospitals adopt because it reduces the chance that important information is lost. The National Institutes of Health Office of Intramural Training and Education teaches similar structured communication skills to research trainees because the ability to present information clearly is a core professional competency. The same skill transfers directly to the laboratory.
Read Back and Verify
When a physician calls the laboratory to order a test, the technician should write down the order and then read it back to the physician. The physician confirms that the order is correct. This read-back step catches errors that would otherwise go unnoticed. A physician who says "CBC with differential" may be heard as "CBC without differential." The read-back step catches that error before the test is run.
The read-back step is also used when a technician gives a critical value over the phone. The technician states the result, the receiving nurse or physician repeats the result back, and the technician confirms that the repeat is correct. This process is often called "read back and verify" and is a standard practice in many hospitals. The technician should document that the read-back occurred and note the name of the person who received the result.
Document Everything
The laboratory record is the legal and clinical record of what was done. Every phone call, every critical value notification, and every conversation about a specimen should be documented. The documentation should include the date, the time, the name of the person contacted, the result that was communicated, and the read-back confirmation. The documentation should be written in the patient's record or in the laboratory's logbook, depending on the institution's policy.
Documentation is not optional. It is the only way to prove that a critical value was communicated. If a patient is harmed because a critical value was not acted upon, the laboratory must be able to show that the value was reported and to whom. The documentation is the evidence.
Handling Critical Values
Critical values are results that are outside the normal range and that indicate a life-threatening condition. Examples include a very low hemoglobin, a very high potassium, a positive blood culture, or a very low platelet count. The laboratory has a list of critical values that is approved by the medical staff. The list defines the threshold for each test and the time frame for notification.
The technician who identifies a critical value must follow the protocol exactly. The protocol usually includes the following steps:
- Verify the result. The technician should check that the sample was collected correctly, that the instrument was calibrated, and that the result is consistent with the patient's history. If there is any doubt, the technician should repeat the test or consult a supervisor.
- Notify the appropriate person. The protocol will specify who to call. This is usually the ordering physician or the nurse responsible for the patient. The technician should call the number listed in the protocol and identify themselves and the laboratory.
- Give the result using the SBAR method. The technician should state the situation, the background, the assessment, and the recommendation.
- Read back and verify. The technician should ask the receiver to repeat the result and the patient's name.
- Document the notification. The technician should record the date, time, name of the receiver, and the result in the patient's record or the laboratory log.
The time frame for notification is defined by the hospital. Some hospitals require notification within 15 minutes, others within 30 minutes. The technician should know the time frame for each critical value and should escalate to a supervisor if the primary contact cannot be reached.
The critical value process is a source of stress for new technicians. The fear of making a mistake can cause hesitation. The best way to manage this stress is to practice the protocol. The technician should know the critical value list, the phone numbers, and the SBAR script before the situation arises. The technician should also know who to call if the primary contact is unavailable.
Communicating with Non-Laboratory Staff
The laboratory does not work in isolation. The technician must communicate with nurses, physicians, and other hospital staff who do not have a laboratory background. The challenge is to provide accurate information without using jargon that the receiver does not understand.
Nurses
Nurses are the most frequent contacts for the laboratory. They collect the specimens, they call for results, and they receive critical value notifications. The technician should be respectful and efficient when speaking with a nurse. The nurse is often busy and may be caring for multiple patients. The technician should state the purpose of the call immediately and provide the information in a clear, concise manner.
When a nurse calls to ask about a result, the technician should ask for the patient's name and date of birth to verify the identity. The technician should then provide the result and the reference range. If the result is not ready, the technician should give an estimated time of completion and offer to call back when the result is available.
Physicians
Physicians may call the laboratory to order tests, to ask about results, or to discuss a patient's case. The technician should be professional and direct. The physician is the person who makes the treatment decision, so the technician should provide the result and the context without offering an interpretation unless asked.
When a physician calls to order a test, the technician should write down the order, read it back, and confirm the patient's identity. The technician should also ask about the specimen type and the collection time if the order is not clear.
Patients and Family Members
Patients and family members may call the laboratory to ask about results. The technician should not provide results to patients or family members over the phone. The results are confidential and should be discussed with the patient by the ordering provider. The technician should explain that the result will be discussed by the physician and provide the physician's contact information.
The technician should be polite and empathetic when speaking with a patient or family member. The caller may be anxious and may not understand the laboratory process. The technician should explain the process in plain language and reassure the caller that the result will be available soon.
Scripts for Common Laboratory Conversations
The following scripts are examples of how to handle common laboratory conversations. The scripts are not official protocols. They are templates that the technician can adapt to the local policy and the specific situation.
Script for Calling a Critical Value
"Hello, this is [name] from the laboratory. I am calling about a critical value for [patient name] in [location]. The result is [test name] of [value]. The sample was collected at [time] and the result was verified at [time]. I recommend that the provider be notified immediately. Can you please read back the result and the patient's name?"
Script for Receiving a Test Order
"Hello, this is [name] from the laboratory. I am ready to take the order. Please provide the patient's name, date of birth, and the test you are ordering. I will read the order back to you to confirm."
Script for Answering a Result Inquiry
"Hello, this is [name] from the laboratory. I have the result for [patient name]. The result is [test name] of [value]. The result is within the normal range. The result is not yet available. I expect it to be ready by [time]. I will call you back when it is ready."
Script for Declining to Give a Result to a Patient
"I understand that you are waiting for your result. The result is not yet available. The physician will discuss the result with you when it is ready. If you have questions, please contact the physician's office."
At a Glance
The following table summarizes the key communication scenarios, the recommended action, and the documentation required.
| Scenario | Recommended Action | Documentation Required |
|---|---|---|
| Critical value identified | Verify the result, call the designated contact, use SBAR, read back and verify | Date, time, receiver name, result, read-back confirmation |
| Test order received by phone | Write the order, read it back, confirm the patient identity | Order in the laboratory information system |
| Patient or family member asks for a result | Decline to give the result, refer to the ordering provider | Note of the call in the patient record |
| Nurse calls for a result | Verify the patient identity, provide the result and the status | Result in the laboratory information system |
| Physician asks about a test | Provide the test availability, collection instructions, and turnaround time | No documentation required unless the call is about a critical value |
Practical Steps for a New Lab Technician
The following steps are a practical guide for a new technician who wants to build strong communication skills.
Step 1: Learn the Local Protocol
The first step is to learn the laboratory's communication protocol. The technician should read the policy manual, attend the orientation, and ask the supervisor about the critical value list, the phone numbers, and the documentation system. The technician should also learn the names of the key contacts on the floors, such as the charge nurse and the unit secretary.
Step 2: Practice the SBAR Method
The technician should practice the SBAR method until it becomes automatic. The technician can practice with a colleague or a supervisor. The practice should include the critical value scenario, the test order scenario, and the result inquiry scenario.
Step 3: Use the Read-Back Step
The technician should use the read-back step for every phone order and every critical value notification. The technician should not skip the read-back step even when the call is busy or the receiver is impatient. The read-back step is the safety net that prevents errors.
Step 4: Document Every Interaction
The technician should document every interaction that involves a patient result or a test order. The documentation should be done immediately after the call, not at the end of the shift. The technician should use the laboratory information system or the paper log as required.
Step 5: Escalate When Needed
The technician should escalate to a supervisor when the situation is beyond their scope. The escalation criteria include the following:
- The critical value cannot be verified.
- The primary contact cannot be reached.
- The receiver does not read back the result.
- The order is unclear or the specimen is not collected correctly.
- The instrument is malfunctioning and the result is not reliable.
The technician should not wait to escalate. The escalation is a sign of professional judgment, not a sign of failure.
Records and Measurements
The laboratory should keep records of communication to measure the quality of the process. The records include the critical value log, the test order log, and the incident report log. The records are used to identify patterns of errors and to improve the process.
The critical value log should include the date, time, the patient name, the result, the person notified, and the time of notification. The log should be reviewed regularly by the supervisor to identify any delays or missed notifications.
The test order log should include the date, time, the patient name, the test, and the person who placed the order. The log is used to track the volume of orders and to identify any errors in the order entry.
The incident report log should include any communication errors, such as a missed critical value, a misread order, or a result given to the wrong person. The incident report should be reviewed by the quality committee and used to improve the process.
The technician should be aware that the records are legal documents. The records should be accurate, complete, and legible. The technician should not alter a record after it is written. If a correction is needed, the technician should draw a single line through the error, write the correction, and initial the change.
Common Failure Patterns in Laboratory Communication
The following are common failure patterns that lead to communication errors in the laboratory. The technician should recognize these patterns and take steps to avoid them.
Failure to Verify the Patient Identity
The most common error is the failure to verify the patient identity. The technician may assume that the person on the phone is the correct patient or that the specimen is correctly labeled. The technician should always verify the patient's name and date of birth before providing a result or accepting an order.
Failure to Read Back
The technician may skip the read-back step because the call is fast or the receiver is impatient. The read-back step is the only way to confirm that the order or the result was heard correctly. The technician should never skip the read-back step.
Failure to Document
The technician may forget to document the call or may document it at the end of the shift. The documentation is the only evidence that the communication occurred. The technician should document the call immediately after the call.
Failure to Escalate
The technician may hesitate to escalate a problem to a supervisor. The technician may think that the problem is not serious or that the supervisor is too busy. The technician should escalate when the situation is beyond the control.
Failure to Use Plain Language
The technician may use jargon that the receiver does not understand. The technician should use plain language and explain the result in terms that the receiver can understand.
Welfare and Safety Context
The laboratory is a safe environment when the communication is accurate. The errors in communication can lead to a misdiagnosis, a delayed treatment, or an unnecessary procedure. The patient's safety depends on the accuracy of the result and the accuracy of the communication.
The technician should also be aware of the safety of the laboratory staff. The technician should follow the safety protocols for handling specimens, using the instruments, and disposing of the waste. The technician should also be aware of the stress of the work and the need to take breaks and to ask for help when needed.
The National Institutes of Health Office of Intramural Training and Education emphasizes the importance of a safe and supportive work environment for research trainees. The same principle applies to the clinical laboratory. The technician should be able to report a safety concern without fear of retaliation.
Professional Escalation Criteria
The technician should escalate to a supervisor in the following situations:
- The critical value cannot be verified or the instrument is not working correctly.
- The primary contact cannot be reached and the protocol requires a specific time frame.
- The receiver does not read back the result or the order.
- The order is unclear or the specimen is not collected correctly.
- The technician is asked to perform a task that is beyond the scope of the training.
The escalation should be done in a professional manner. The technician should state the problem, the action that was taken, and the recommendation for the next step. The supervisor will decide the next step.
Frequently Asked Questions
What is the most important communication skill for a lab technician?
The most important skill is the read-back and verify step. This step confirms that the order or the result was heard correctly and prevents errors that would otherwise go unnoticed.
How do I handle a critical value when the provider is not available?
The protocol will specify the backup contact. The technician should call the backup contact and document the call. If the backup contact is also unavailable, the technician should escalate to the supervisor.
Can I give a result to a patient who calls the laboratory?
No. The result should be given to the ordering provider. The patient should be referred to the provider for the result.
What is the SBAR method and how do I use it?
SBAR stands for Situation, Background, Assessment, and Recommendation. It is a structured way to communicate critical information. The technician states the situation, the background, the assessment, and the recommendation in a clear and concise manner.
How do I document a critical value notification?
The technician should record the date, time, the patient name, the result, the person notified, and the read-back confirmation. The documentation should be in the patient's record or the laboratory log.
What should I do if I make a communication error?
The technician should report the error to the supervisor immediately. The supervisor will decide whether to file an incident report and how to correct the error.
How do I communicate with a physician who is busy?
The technician should be direct and concise. The technician should state the purpose of the call and provide the information in a clear manner. The technician should not apologize for the call or provide unnecessary details.
What is the role of the laboratory in the healthcare team?
The laboratory produces diagnostic results that are used by the provider to make treatment decisions. The laboratory is a service that supports the clinical team.
Using the Evidence
| Source | Best use in this topic | Important limitation |
|---|---|---|
| Occupational Outlook Handbook | official guidance | Check the linked page for current local requirements |
| O*NET OnLine | official guidance | Check the linked page for current local requirements |
| Office of Intramural Training and Education | official guidance | Check the linked page for current local requirements |
Related Articles
- Lab Tech Careers: Specializations and Certifications
- Laboratory Technician Career Progression: From Entry-Level to Specialist
- Radiology Tech Jobs
- x ray tech programs
- medical lab science reddit
References and Further Reading
- Occupational Outlook Handbook. U.S. Bureau of Labor Statistics.
- O*NET OnLine. U.S. Department of Labor.
- Office of Intramural Training and Education. National Institutes of Health.
- Careers at NSF. U.S. National Science Foundation.
- Career Services. American Society for Microbiology.
- AAVMC Career Resources. Association of American Veterinary Medical Colleges.
- NCBI Literature Resources. National Center for Biotechnology Information.
- PubMed. National Library of Medicine.
This article is educational and does not replace institutional policy, professional advice, or applicable safety and regulatory requirements.