Employee Engagement: The Role of the Laboratory Leader

Keeping employees engaged is more than a numbers game

Patty Eschliman, MHA, MLS(ASCP)DLM
Published:May 01, 2020
|Updated:Dec 07, 2022
|6 min read

Every year, the employee engagement survey rolls around. During this time, I think back to everything my clinical laboratory team has accomplished over the year and feel pretty good about their engagement. Why, then, do the survey results not always align with my own analysis? 

Two years ago, I overheard my niece, a frustrated teacher, complain that her creativity in the classroom had been replaced with a demand to meet state testing scores. This “teach to test” mentality made me wonder if  I had lost sight of  my team in my quest for numbers. It was that day that I adopted a new approach to leadership—one focused on building meaningful relationships with each and every member on my team. And one that did not rely on employee engagement surveys.

The role of the leader

Numerous studies have identified the impact a leader can have on an employee’s level of  mental and physical health. A recent survey by Gallup of  more than one million US workers found that 75 percent of  those who vol-untarily left their jobs did so not because of  job dissatisfaction but because of  their managers.1 It is clear that the interpersonal relationships and the culture created by you as a leader can either encourage self-determination or cause distrust and a sense of  hopelessness. In fact, another survey of  90,000 workers found that the primary element that drives employee engagement is the  belief  that the leader cares about the employee’s wellbeing.2

Building relationships with employees is totally within your control as a leader. Showing your team gratitude through genuine acts of  caring makes them feel appreciated. Never underestimate the value of  a hand-written thank you note mailed to your team member’s home. Get to know each member on your team and in doing so, become comfortable with vulnerability; it is impossible to build a relationship with someone if  you are not willing to share. Every morning at the end of  our shift change huddle, we do a gratitude lightning round. Everyone around the circle shares one thing they are grateful for. It has changed us. The entire team now knows the everyday joys, struggles, fears, and celebrations of  their teammates as well as mine. It builds trust and connection and allows the team to see each other as flawed, yet lovable human beings. Developing trust within your team is essential to establishing team loyalty, job satisfaction, and connectedness. All of  these, in turn, drive employee retention.

Starting off on the right foot

With the ever-increasing shortage of  medical laboratory professionals, employee retention has never been more important. Starting in 1970, the number of  accredited US medical laboratory training programs, both MLS and MLT, declined from nearly 1,000 to less than 450 in 2006.3 It wasn’t until 2008 that programs began to rebound, but it has not been enough. According to the National Accrediting Agency for Clinical Laboratory Science, the number of  MLS/MLT accredited programs in 2019 had only reached 476—an addition of  26 programs in 13 years.4 This decline in training programs does not paint a pretty picture for the future of  laboratory staffing.  

While hiring the first warm body may be tempting, it is important to screen for relationship potential during the interview process. Remain protective of  your team by searching for a good personality fit.  Quality laboratory skills are obviously important, but these skills can be taught; attitude, positive energy, and a desire to work in teams cannot.

Once you find and hire that employee, the onboarding process will make an immediate impact on whether or not the new team member feels like he or she belongs. A sense of  belonging reduces anxiety, builds trust, and gives individuals permission to be themselves. This, in turn, fosters honest communication and authentic relationship building. 

The graph below shows what happens to new employees if, shortly after training, they are tasked with an assignment or responsibility.5 Being handed projects demonstrates trust and encouragement for new employees and you can see the impact it has on their level of  engagement. Greater engagement builds confidence, which positively impacts the team by improving morale and departmental success. Anticipating this opportunity and choosing a project ahead of  time based on the skills and desires of  the new employee is imperative for savvy leaders committed to employee engagement. 

“Employee retention now a big issue: Why the tide has turned.” Bersin by Deloitte(2013)
Source: Bersin, Josh

Continued engagement

If  you currently work as a clinical laboratory professional, you will undoubtedly agree that there are few things more meaningful than providing patients with medical answers and helping clinicians make appropriate patient care decisions. It is unfortunate but very common for clinical laboratory staff  to lose sight of  the meaning in their work. Most of  this misdirection comes from the way clinical laboratory staff  are sometimes treated by non-lab personnel. Those who do not understand the level of  training and knowledge it takes to perform high-quality medical lab testing often view it as a commodity. This is a prime opportunity to educate. 

A leader must publicly celebrate his or her team’s accomplishments at every opportunity—not just during Lab Week. Building relationships outside of  the lab and thereby creating understanding of  who we are and what we do increases respect and improves behavior. Have new clinical hires tour the lab. Engage your team to sit on interdisciplinary task forces or act as non-lab department liaisons, creating presentations that foster the collaboration needed to meet the needs of  patients. It is no longer an option to stay in the basement. We do great work and it is up to us to shine the light!

Providing opportunities for career growth is another engagement driver. It used to be that several positions in the lab allowed employees an opportunity for advancement. Now, much of  the laboratory leadership ladder is gone. There are fewer bench leads, fewer supervisors, and sometimes only one manager. If  this is your situation, you must look at other ways of  developing intrinsic motivation. One idea is to create a ladder of  accomplishments where scientists can achieve different promotional levels by engaging in projects of  incremental impact. At the first level, a project would have a positive impact for the laboratory department. Next is a project that creates value for the hospital, then the health care system, and at the last level, the laboratory industry. This strategy encourages laboratory quality, hospital and system efficiencies, and professional growth while also building relationships and encouraging volunteerism on a national level. Incorporate the organization’s core values into these achievements and you now have a recipe for company loyalty and retention. Sprinkle in a pay raise at each level and you will have an added layer of  extrinsic motivation on top of  the employee’s internal drive to succeed.

Make sure employees have plenty of  opportunities for learning. Even if  you do not have the funds to send someone to a conference, it takes very few resources to put together a PowerPoint and teach your team new skills. Bring in speakers from other hospitals to share their successes or subscribe to an online education program.  

An employee’s engagement is heavily influenced by the attitudes of  other team members. Working alongside committed and happy people is just, well, more engaging. A recent Gallup survey found that only 34 percent of  the US working population over the age of  18 is fully engaged while 50 percent is not.6 Who is left? The 16 percent that are actively disengaged. These are the disrupters on your team that are preventing the unengaged from moving toward full engagement and placing the fully engaged at risk. 

One of  the most challenging aspects of  leadership is knowing who can be coached up to their full potential and who needs to be let go. Up to 80 percent of  your time can be spent on trying to change those who either refuse or cannot change.7 This only leaves 20 percent of your time to show gratitude and develop positive relationships in your team. Do your best to flip these numbers around. The staff  that jump at the challenge and become engaged deserve your attention and recognition. Not giving in and keeping the pressure on for those who do not engage should eventually lead to your disciplinary action programs where most people self-select and leave before termination.

Being a leader that is focused on building meaningful relationships and creating a culture of  open communication where co-workers are appreciated, and all contributions are valued, will encourage engagement and create a personal bond that makes employees want to stay. This won’t stay as a secret for long! As word spreads, it will also create a positive reputation within your community and act as a recruiting tool for others who want to join such a welcoming and quality-driven team. 

Moving away from the numbers game and focusing instead on building authentic caring relationships within my team has paid off.  Incidentally, my employee engagement scores have increased significantly two years in a row! But more importantly, I can see their engagement every day—my team is much more cohesive, they support each other, there are fewer patient errors, and I have far fewer attendance issues. I also enjoy hearing their laughter and friendly banter. 


1. Hyacinth, B. “Employees Don’t Leave Companies, They Leave Managers.” LinkedIn (2017).

2. Saks, Alan M. "Antecedents and consequences of  employee engagement." Journal of  Managerial Psychology (2006).

3. Diener, Ed. "New findings and future directions for subjective well-being research." American Psychologist 67.8 (2012): 590. 

4. The American Society for Clinical Laboratory Science. “Clinical laboratory personnel shortage.” https://www.ascls.org/advocacy-issues/workforce

5. Bersin, Josh. "Employee retention now a big issue: Why the tide has turned." Bersin by Deloitte (2013).

6. Harter, Jim. "Employee engagement on the rise in the US." Gallup (2018).

7. Wakeman, Cy.“Reality-based leadership: ditch the drama, restore sanity to the workplace, and turn excuses into results.” John Wiley & Sons (2010).