How Clinical Laboratory Science Shaped Modern Health Care and the IPC Roadmap

(Third installment)

Infection prevention personnel in a training class.

(Adobe Stock 1196827000 by Carlo)

This is a continuation of an article from Shahbaz Salehi, MD, MPH, MSHIA; and Anna Arifin, MD, MBA, MT, CIC. Find the first installment here. The second installment here. The references continue from the first article.

The Evolution of Clinical Laboratory Science as a Hospital Discipline

Clinical Laboratory Science (CLS), also known as medical laboratory science, has evolved into an essential discipline within modern health care, grounded in a nearly century-long history of scientific advancements and professional organization. The origins of CLS date back to the 1930s, a decade that saw the formalization of laboratory science as a profession through the establishment of the American Society of Clinical Laboratory Technicians (ASCLT) in 1933. This organization, later renamed the American Society for Medical Technology (ASMT), sought to standardize practices, promote certification, and elevate the profession's credibility.⁶

The publication of Quantitative Clinical Chemistry by John P. Peters and Donald Van Slyke in 1932 marked a pivotal moment in the development of CLS. This foundational text established clinical chemistry as a scientific field and emphasized the importance of laboratory testing in diagnosing and understanding disease.¹³ Their contributions laid the groundwork for integrating laboratory data into routine medical practice, reinforcing the relevance of CLS in patient care.

Throughout the 1960s and 1970s, the field underwent significant growth and professionalization. In 1962, the requirement for a baccalaureate degree in clinical laboratory science reflected the increasing complexity of diagnostic testing. Organizations like ASMT expanded internationally, and continuing education initiatives, including the Professional Acknowledgment for Continuing Education (PACE) program, were implemented. Additionally, the establishment of the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) ensured consistent educational standards for training programs.¹²

Gap in Formalization of IPC Program and the Proposed Solutions

(Courtesy of authors)

In 1993, the ASMT changed its name to the American Society for Clinical Laboratory Science (ASCLS) to reflect its evolving scope. Today, CLS professionals play a crucial role in hospital settings, contributing to diagnosing, treating, and monitoring diseases across various specialties, including microbiology, hematology, immunology, and molecular diagnostics. Their work is foundational to patient outcomes and public health.

The development of CLS from a loosely organized field into a disciplined and credentialed profession reflects broader trends in medical science and healthcare delivery. Its history underscores the vital role of laboratory professionals in supporting clinical decision-making and improving patient care.

Creating a Roadmap for Infection Prevention

IPC is a critical discipline within health care, yet the pathway to becoming an IP remains fragmented and poorly defined. Unlike other clinical or public health professions, which have established educational and certification standards, the field of IPC lacks a standardized roadmap outlining the prerequisites, core competencies, and required coursework for entry into and advancement within the field.

Professional IPC associations, such as the APIC, in collaboration with credentialing bodies like the CBIC, should be more active in establishing a national and international framework. This framework should define the educational prerequisites, essential coursework, practical training, and professional competencies necessary to become an IP.

The field is siloed and segmented, often requiring individuals to “fall into” IPC rather than intentionally entering it. The lack of a clear, standardized pipeline creates barriers for students and professionals interested in pursuing IPC as a career. To address this, the IPC credentialing process must mirror the US Department of Education's structure in accrediting academic institutions, ensuring uniformity, credibility, and quality assurance across training programs.

A formalized roadmap could include undergraduate exposure to public health and microbiology, followed by specialized postgraduate training in infection control, health care epidemiology, and quality improvement. APIC’s Competency Model provides a strong foundation and should be integrated into formal educational pathways. Moreover, establishing partnerships with universities, accrediting infection prevention certificate programs, and creating bridge programs for nursing, public health, and laboratory professionals could help build a more intentional and diverse workforce.

Ultimately, aligning educational standards, certification requirements, and training resources would not only make the field more accessible but also ensure a consistent level of expertise among practitioners, leading to safer, higher-quality health care.

Conclusion

The COVID-19 pandemic starkly illuminated the critical yet often underrecognized role of IPC professionals in safeguarding patient health and the integrity of health care systems. While IPC has been a cornerstone of health care for decades, the article underscores a significant and persistent challenge: the lack of formalization and standardization within the profession. Unlike well-established health care disciplines with clear educational pathways and professional entry points, IPC remains a field often entered by chance, characterized by on-the-job training, inconsistent expectations, and a general lack of understanding of its scope and required expertise. This lack of a defined roadmap creates significant barriers for individuals seeking to enter and advance within IPC, contributes to workforce shortages, and ultimately impacts the consistency and effectiveness of infection prevention efforts.

Several key issues contribute to this challenge. Firstly, there is a lack of a clearly defined entry point and career pathway into IPC. Unlike nursing, respiratory therapy, and CLS, no standardized educational degrees or licensure requirements specifically guide individuals toward this profession. Secondly, the absence of standardized education and training programs results in varied competency levels among practitioners, with learning often being self-directed rather than through structured academic frameworks. Thirdly, hospital administrators and hiring managers frequently misunderstand and underappreciate the IPC role, resulting in misaligned expectations and potentially unqualified hires. This is compounded by inconsistent job descriptions across institutions and a misconception that a clinical license is a prerequisite, which deters potentially valuable candidates with backgrounds in public health or epidemiology. Ultimately, the aging workforce within IPC necessitates urgent action to attract and cultivate a new generation of professionals, supported by formalized mentorship and clear advancement opportunities that are currently lacking.

The article proposes several key solutions to address these critical gaps and strengthen the IPC workforce. Establishing a national and international framework for IPC education and training, spearheaded by professional organizations, is paramount. This framework should define clear prerequisites, standardized curricula, and required competencies. This involves the development of specialized educational pathways and university programs, including postgraduate training and bridge programs for professionals from related fields.

Furthermore, a concerted effort is required to increase awareness and understanding of the IPC profession among health care leaders, emphasizing its distinct expertise and crucial role in patient safety. Standardizing job descriptions and competency requirements across institutions will contribute to a more cohesive and respected profession. Promoting the value of diverse backgrounds and dispelling the myth of mandatory clinical licensure will broaden the talent pool, ultimately benefiting the health care industry. Finally, implementing formalized mentorship and professional development programs will support the growth and retention of IPC professionals, ensuring a sustainable and expert workforce for the future.

In conclusion, formalizing the IPC profession is not merely an administrative necessity but a crucial step towards enhancing patient safety, improving health care outcomes, and bolstering preparedness for future public health threats. By addressing the identified gaps through the proposed solutions, we can create a clear, respected, and accessible career pathway for aspiring IPC professionals, ensuring that health care systems have a knowledgeable and competent workforce dedicated to preventing infections and protecting the health of all.

Reference

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