Medical Laboratory Technologists Standards of Practice

Introduction

The Standards of Practice outline the level of quality and safety expected for professional services provided to the public by College members. Health regulatory Colleges may use these Standards of Practice to explain the responsibilities of medical laboratory technologists (MLTs) to their stakeholders and the public in a meaningful and understandable manner. Legislation, regulations, bylaws, code of ethics, standards of practice and practice guidelines collectively establish a framework for the practice of medical laboratory science technology.

Standards of Practice reflect the expectations of competent practice by the members of a recognized professional organization which have been adopted by provincial health regulatory Colleges, and define the levels of performance against which actual professional practice can be compared.

Standards of Practice:

  • Guide the professional practice of MLTs.
  • Represent the minimum standards of professional behaviour and ethical conduct expected of all MLTs.
  • Apply to MLTs at all times in all dimensions of professional practice, including technical and nontechnical fields such as education, administration, quality assurance, and research.
  • Define the measure by which the quality of performance of an individual MLTs professional practice is judged; they provide an overview of the expectations on MLTs.
  • Specify the standards against which MLT’s performance will be judged when undertaking the activities required for safe and effective professional practice.
  • Promote the continuing competence of MLTs by helping members identify opportunities for professional practice improvement.

Standards of Practice will evolve from time to time in response to regulatory, legal, and ethical expectations and are adopted only after stakeholder consultation.  

Essential Competencies and Indicators

Medical laboratory technologists must be able to demonstrate knowledge, skill and appropriate judgments in the competencies described in this document, and maintain the standards for both (a) the services delivered, either alone or in collaboration with a multidisciplinary team, and (b) any services rendered under the member’s direction and supervision.

Each Standard of Practice is followed by a list of ‘indicators’ which illustrate how each Standard of Practice is applied. Indicators are guidelines to assist in determining if a specific Standard of Practice has been achieved. Indicators may not be applicable in all settings and are not exhaustive, nor are the Standards of Practice listed in order of importance.

Professional Conduct and Accountability

Medical laboratory technologists are expected to meet the ethical, legal and professional expectations of practice and are accountable to the patient/client, themselves, the employer and the health regulatory College. Medical laboratory technologists strengthen excellence in professional practice by supporting the development and use of new knowledge.

Medical Laboratory Technologists shall:

  • Use a client-centered approach to facilitate and deliver safe and comprehensive medical laboratory services to patients and clients.
  • Understand and comply with the ethical, legal and professional expectations of their practice.
  • Exercise independent judgment, assume responsibility and accept accountability for professional practice and fitness to practice.
  • Practice within the scope of their professional competence and adhere to institutional and laboratory policies and ensure processes are performed according to approved procedures.
  • When requested to practice beyond their scope of practice, follow appropriate processes, and seek appropriate support and guidance to protect the public.
  • Assume responsibility for professional development and invest time, effort and resources to maintain and enhance competence in areas of professional practice.
  • Protect the public, above all other considerations, by promoting and maintaining high standards in professional practice, and reporting unsafe practice or professional misconduct.
  • Protect the client/patients’ welfare and right to respect, autonomy, dignity and comply with applicable privacy legislation and policies relating to confidentiality and access to information.
  • Maintain first aid training if involved in direct patient contact in order to intervene in the case of an emergency.

Knowledge and Skill

Medical laboratory technologists possess in-depth scientific knowledge of the current theory, techniques, and clinical application of medical laboratory procedures, and integrate this with knowledge from other laboratory specialties.  To ensure ongoing enhancement of knowledge and continued competence over the span of their professional career, medical laboratory technologists maintain an up-to-date knowledge of trends, new and emerging diseases, and evolving practices in medical care that impact laboratory services.

Medical Laboratory Technologists shall:

  • Demonstrate knowledge of the current theory, technique and clinical application of laboratory analyses, which is relevant, adequate, and appropriate to an area of professional practice and are skilled in the performance of those procedures.
  • Integrate the principles, techniques, and methodologies of evidence based medical laboratory science to professional practice.
  • Demonstrate competence in judgmental and interpretive skills to ensure the accurate, precise, and verifiable performance of laboratory analyses and the timely reporting of results.
  • Adhere to institution-specific policies, procedures, and protocols and must recognize and deal with abnormal situations related to test results, methods and quality control.
  • Display professional behaviour that is appropriate to the situation.
  • Promote and implement interdisciplinary and interprofessional professional practice by effectively sharing knowledge with clients / patients, colleagues and other healthcare practitioners.
  • Demonstrate the ability to adapt to the changing needs of the clients / patients, the profession and the health care system.

Application of Knowledge and Skill

Medical laboratory technologists combine the competent performance of tests, based on the current principles of medical laboratory sciences, with the accurate and timely reporting of results to provide reliable information for the diagnosis/monitoring of each patient/client. Medical laboratory technologists collaborate and communicate effectively with clients / patients, medical laboratory technologists and other health care providers to ensure the safe and effective delivery of service.

Medical Laboratory Technologists shall:

  • Evaluate and analyze relevant information to facilitate continuous improvement of the laboratory process in the interest of quality patient care.
  • Treat all clients / patients with courtesy and respect, ensuring that their rights are protected and their consent obtained to facilitate the provision of safe, effective and comprehensive medical laboratory services. 
  • Apply the principles, techniques, and methodologies of evidence based medical laboratory science knowledge acquired through experience, clinical analyses, and research findings to professional practice.
  • Recognize, troubleshoot and document equipment, instrument and reagent malfunction and initiate corrective action in a timely manner; are proficient with the use, operation and maintenance of the equipment employed.
  • Follow appropriate guidelines, protocols and local institutional policies to ensure that only adequate and appropriate specimens are procured and used for laboratory testing.
  • Collaborate effectively with health professionals and patients to ensure best practice and patient centered care, including the provision of appropriate instructions regarding collection, transportation, documentation and storage of specimens.
  • Understand the principles and perform analytical techniques on a variety of specimens and ensure accuracy of analyses by using appropriate quality assurance protocols.
  • Understand and interpret references ranges (intervals), critical values, and detection limits of each technique.
  • Understand and identify the cause of interferences and adverse effects and take appropriate action, and respond to any adverse event and disclose the event to the appropriate authority to mitigate harm and prevent reoccurrence.
  • Analyze data for the purposes of quality control and verification of test results.
  • Evaluate the technical sufficiency of test results and ensure that reports are issued in an appropriate and timely manner.
  • Demonstrate competence in safe professional practice in compliance with relevant current provincial and federal legislation, safety and infection prevention and control principles, practices, and policies, established institutional policies and procedures, and environmental considerations.
  • Provide leadership to other members of the health care team with regard to process-related, quality and safety issues.
  • Manage resources and communicate effectively and respectfully in meeting the needs of patients / clients.

Quality Management

Medical laboratory technologists demonstrate an understanding of quality management principles and apply these in the delivery of medical laboratory services supporting optimal patient care.

Medical laboratory technologists shall:

  • Engage in continuous improvement; demonstrate critical thinking to analyze, synthesize, and apply information to improve the quality and effectiveness of service.
  • Maintain established standards for quality control in specimen procurement, preparation, analysis, interpretation and reporting.
  • Recognize nonconformance, identify and communicate recommendations for laboratory service and process improvement.
  • Operate within the context of a quality system approach to external quality assessment (EQA), internal quality programs, internal quality audits and accreditation programs.

Summary

While the essential competencies are presented in sections as discrete activities, the MLT must recognize that in practice these competencies are implemented as part of daily processes and do not stand alone. MLTs must utilize a combination of their knowledge, skill, judgment and attitude to adjust to changing circumstances and evolving environments.

References

College of Medical Laboratory Technologists of Alberta (CMLTA). (2012). Standards of Practice. Edmonton, Alberta. Author.
College of Medical Laboratory Technologists of Manitoba. (2014). Medical Laboratory Technologists Standards of Practice. Winnipeg, Manitoba. Author. College of Medical Laboratory Technologists of Ontario. (2007). Standards of Practice for Medical Laboratory Technologists. Toronto, Ontario. Author.
National Association of Pharmacy Regulatory Authorities. (2009). Model Standards of Practice for Canadian Pharmacists. Ottawa, Ontario. Author.
New Brunswick Society of Medical Laboratory Technologists. (2012). Standards of Practice for MLT. Memramcook, New Brunswick. Author.
Newfoundland and Labrador College for Medical Laboratory Science. (2013). Standards of Practice. St. John’s, Newfoundland. Author.
Nova Scotia College of Medical Laboratory Technologists. (2013). NSCMLT Standards of Practice. Halifax, Nova Scotia. Author.
Ordre Professionnel des Technologistes Médicaux du Québec. (2005). Normes de pratique du technologiste médical. Montréal, Québec. Author.
Saskatchewan Society of Medical Laboratory Technologists. (2001). Standards of Practice: Medical Laboratory Technology. Regina, Saskatchewan. Author.

Definitions

Accountability: Taking responsibility for decisions and actions, including those undertaken independently or collectively as a member of the health care team, i.e., an obligation or willingness to accept responsibility and the consequences of one’s decisions and actions, and acting in the best interest of the patient/client.

CAMLPR: The Canadian Alliance of Medical Laboratory Professional Regulators (CAMLPR) is a voluntary alliance of medical laboratory technologist provincial health regulatory authorities.  Provincial health regulatory authorities are created and defined by provincial legislation and statute. The purpose of CAMLPR is to clarify a mutual understanding of the criteria for registration in each province in which medical laboratory technologists (MLTs)  are regulated with a view to ensuring that all regulated MLTs have the same competencies at the  entry to  practice level regardless of which province they are first registered in or where they were  trained, and that the public is, therefore, adequately protected.

Client / Patient : An individual, family and/or substitute decision-maker, patient, group, agency, employer, colleague, other healthcare practitioner, or stakeholder who is a recipient of an MLT’s professional and health services.

Client / Patient-centered : An approach which recognizes the MLT’s expertise and values the respect for and partnership with individuals receiving an MLT’s professional and health services. A collaborative approach whereby the client’s own experiences and knowledge are central and carry authority within the client-professional relationship.

Code of Ethics: A document which reflects a set of guiding principles and values on the collective moral standpoint of a profession on which its practitioners rely.

Collaboration: Working cooperatively with members of the health care team to achieve the best possible outcome for the patient/client.

Competence: The collection of knowledge, skills, judgements, and behaviours required by an MLT during their professional career. Competency is the extent to which an MLT successfully translates their knowledge, skills, judgements, and behaviours into professional services resulting in safe, effective and ethical client / patient outcomes.

Consent: a person’s right to accept or refuse treatment, assuming that they have mental capacity to do so.  Consent is further defined in legislation in all Canadian provinces.

Continuing Competence : An ability to effectively apply current knowledge, skills and attitudes in professional practice, resulting from professional development processes undertaken by an MLT.

Indicator: Guidelines which illustrate how each Standard of Practice may be applied, and assist in determining if a specific Standard of Practice has been achieved.

Medical Laboratory Technologist : A regulated health care professional, with a defined Scope of Practice and protected professional title, as prescribed by provincial legislation.

Professional Development : The acquisition of new knowledge and skills by all types of facilitated learning for the purpose of professional development.

Professional Misconduct : Professional behaviour or actions that contravene, among others, the standards of professional practice.

Professional Practice : The practice of medical laboratory technology in accordance with professional, legal and ethical standards.

Public: Anyone who an MLT interacts with, but does not provide care to, including private citizens and other healthcare providers.

Quality Control : A single or set of laboratory procedures intended to ensure that the performed laboratory service adheres to a defined set of quality criteria.

Quality Management : A manner of providing laboratory services that inherently includes the ongoing evaluation of services provided and the results achieved as compared with accepted standards.

Regulatory Body : A provincial organization with the authority to regulate a health profession or group of health professions as created and defined by provincial legislation and statute with the sole purpose of public protection.

Scope of Practice : A profession’s Scope of Practice encompasses the activities its practitioners are educated and authorized to perform. The overall Scope of Practice for the profession sets the outer limits of practice for all practitioners. The actual Scope of Practice of individual practitioners is influenced by the settings in which they practice, institutional requirements,and the needs of their clients / patients.

Standards of Practice : An expectation reflecting a general agreement on competent practice by the members of a recognized professional organization which have been adopted by provincial health regulatory Colleges, and define the levels of performance against which actual professional practice can be compared.