Change Readiness and the Laboratory

The unique way that leadership styles can impact employee morale is a frequently studied topic in almost every career field but laboratory medicine. That’s what Taryn Waraksa-Deutsch, DHSc, SCT(ASCP), CMIAC, LSSGB, realized when she began studying how leadership can influence a laboratory’s readiness to embrace change.  

This oversight is not a minor issue. As laboratories face a scarcity of resources in a world hurtling toward change, understanding how to embrace that change can make all the difference in helping laboratories grow.  

Today’s laboratories must embody a mindset of continuous improvement if they want to ensure they’re providing high-quality care for patients. To do so, however, requires a specific leadership style that can help employees feel motivated rather than fearful.   

Dr. Waraksa-Deutsch, Supervisor of the Cytopathology Department of Fox Chase Cancer Center, spoke with Critical Values about her study, published in Laboratory Medicine, that  revealed just which types of leadership styles can help laboratory professionals the most. Her paper, “Leading medical laboratory professionals toward change readiness: a correlational study,” found that for laboratory leaders, motivating change is a goal truly within reach, if they have the right tools.  

A transformational mentor influenced her laboratory leadership study 

A transformational mentor in her own life inspired Dr. Waraksa-Deutsch to embark on her leadership study. After realizing just what an impact her mentor had on her own readiness for change, she wondered if the same could be true for other laboratory professionals.  

“I was fortunate to have had an incredible supervisor who encouraged me to move into his position when he retired.,” Dr. Waraksa-Deutsch says. “It’s been 10 years of training, and it's been an honor to learn from him. He has always exhibited a mentor type of relationship with me. In fact, I thanked him in my acknowledgments and dedicated my study to him because he’s 79 and still going strong by inspiring others. It brings tears to my eyes because of everything he’s done for me. He’s my transformational leader.” 

Dr. Waraksa-Deutsch embarked on her study after wondering if her experience was shared by others. Would her study uncover why this type of leadership works so well?  

She used the full-range leadership model of the Multifactor Leadership Questionnaire, and correlated it with another instrument, the Three Component Model of Commitment to Change. She wanted to uncover if there was a connection between the three leadership styles and the three commitments to change.  

The quantitative study found a significant correlation between leadership style and change readiness, leading to recommendations that can transform laboratory practices.  

Lessons learned from the study can help laboratories that are falling behind 

The timing of Dr. Waraksa-Deutsch’s study couldn’t be any better. The clinical laboratory field is falling far behind general medicine in terms of healthcare evolution, and learning how to embrace change could play a significant role in helping it catch up.  

“The impact of leadership style has been investigated in so many different fields, but laboratory medicine is left in the dark,” Dr. Waraksa-Deutsch says. “But we need that visibility like no other. General medicine gets all the media attention and all the research efforts. Laboratory medicine falls by the wayside, even though we’re so essential to the comprehensive care team. I wanted to see, how do we keep up? Why are we so resistant to change?”  

Of course, Dr. Waraksa-Deutsch adds, there are other issues facing laboratory medicine, like staffing shortages and lack of resources.  

“But I wanted to see if maybe there’s a leadership component too,” she says. “Change readiness is a measure of the confidence that a person or team is committed to and feels capable of embracing a change initiative. But it can be influenced by many factors. The pervasive staffing shortage in our field can negatively impact change readiness. But having ample support from leadership can serve as a buffer.”  

This buffer is especially important in a field hurtling toward increasingly complex levels of inevitable change, like AI and other technologies. Laboratories can either fear this or embrace change readiness, recognizing how these technologies can help.  

Employees can commit to change in a positive or negative way, depending on their circumstances 

As Dr. Waraksa-Deutsch’s study explains, there are different types of commitment to change. Two major types are a positive — “affective commitment to change” — and a negative — “continuance commitment to change.” The type that staff adopt can influence how well the laboratory functions in the future.  

Affective commitment to change is a more intrinsic motivation. “It’s the individual’s mindset that change is good,” she says. “It’s an emotional commitment, a psychosocial behavioral type of response. It’s linked to the mentor-mentee relationship.”  

She says this type of change embodies a positive mindset that says something like: “I’m proud of my work. I’m proud of who we are. I’m proud of our purpose. Even if we’re a little short-staffed today, I know my purpose here. My leader will help me, and I can get through this.” 

But some employees veer more toward a continuance commitment to change. This type is based on fear.   

“When you start committing out of fear of the risk or cost of leaving an organization, you have burnout,” she says. “You have turnover. You have all this stress compounding where the department stops functioning.”  

Transformational leadership can encourage change readiness 

Dr. Waraksa-Deutsch’s study found that specific leadership styles can foster affective commitment to change, and thus encourage a culture of change readiness in a laboratory.  

“Transformational leadership is the best kind for the laboratory,” she says. “And the next most effective kind of leadership style is contingent reward leadership. They’re positively correlated with affective commitment to change. They also tend to lead to fewer instances of continuance commitment, which shows they can help serve as a buffer against stress and turnover.” 

In a field like laboratory medicine, where stress and burnout can be so high, Dr. Waraksa-Deutsch’s study found that passive-avoidant leadership can be extremely harmful.  

“I’m recommending that at all costs, we please avoid passive avoidant behavior,” she says.  

What do these leadership styles look like in the laboratory? 

A transformational leadership style requires a careful focus on mentorship within the laboratory.   

“Transformational leadership in a laboratory is believing in somebody, nurturing them, taking them under their wing, acting as a mentor, and giving them the tools to thrive,” Dr. Waraksa-Deutsch says. “It's also somebody who actively solicits feedback and guides the team toward a shared vision. It says, ‘This is your role. This is why we need you. And this is how you're helping build a bigger, better health system.’”  

On the other hand, passive avoidant leadership does the opposite.  

“Passive avoidant behavior is essentially non-leadership,” she says. “Those are people who don't even check in on their employees. Or if an employee makes a mistake, they just quickly blame the person rather than looking at the process. It’s toxic. When there's a problem, you can't go to those leaders.” 

There’s also situational leadership, which mixes transactional leadership with transformational, utilizing each as needed.  

“There might be some people who are autonomous,” she says. “They can function without much leadership intervention. And then there are other people who might need a bit of give and take if they're a little resistant to change. A leader might say, ‘Try this and you'll be rewarded with this.’ And then once they get through that hurdle, the transformational aspect will take over and say, ‘All right, let's mentor you for the next step.’ Some people just need that dangling of the carrot and then the confidence comes back.” 

Interestingly, the study also found that the role someone has in a laboratory can affect the type of commitment to change they lean toward. Bench-level laboratory professionals, for example, might lean toward continuance because they’re doing the behind-the-scenes work and dealing with change head-on. They may need a little extra mentorship and encouragement.  

“They’re the ones doing the brunt of the work,” she says. “They’re the ones subjected to stress and burnout. So they’re in that very delicate group where commitment could go either way.” 

How to practice transformational leadership

If a laboratory director wants to embrace transformational leadership, what should they do first? 

Dr. Waraksa-Deutsch says it begins with understanding themselves so they can then help others. She suggests first taking the Myers-Briggs personality test to help with self-reflection. This is vital because employees often mimic their leaders’ reactions and become stressed if they’re stressed. 

“Too often we get caught up in patterns that can be self-destructive to a group and ourselves, and we don't realize that we've lost touch with who we are and our purpose,” she says. “Yes, life happens. You have to keep going at lightning speed. But if you can catch yourself, sit down and ask, ‘Is this reaction appropriate? Am I serving as a role model? Or are my team members seeing my stress and absorbing it and then becoming resistant to change?’” 

This also involves taking time to meet one-on-one with staff.  

“See what you can do for them, even if it’s just about life in general, because we bring our lives to work,” she says. “And remember, especially in times of change, the silent ones are the ones that may shut down at the last minute. Even if they’re your strong people, if you notice something a little off, it’s a red flag that they could bolt. So it’s very important to have those one-on-one meetings. Just ask, ‘How are you feeling? This is an open-door policy. What can I do for you?’ That sort of thing.” 

But don’t try to make the changes overnight.  

“Quick change is horrible; your employees will panic,” she says. “Incorporate changes slowly. Start testing the waters and seeing if your employees are responding differently.”  

At the end of the day, Dr. Waraksa-Deutsch hopes that her study will inspire laboratory professionals to use the findings to research the topic more for themselves.  

“Examine the other antecedents to change readiness, especially in light of our staffing shortage,” she says. “Keep going. Take the torch.”