The U.S. military has long recognized the importance of using force multipliers to leverage resources and enhance the probability of a successful mission, and this same concept can be applied in laboratory medicine. A force multiplier is a factor that dramatically increases the power of the forces or resources at a team’s disposal. This synergistic element increases effectiveness and potentially provides a competitive advantage. For example, military intelligence such as satellite images gives insights about an opponent’s position and use of advanced weaponry. Having this information can make a small unit of skilled soldiers even more effective by equipping the unit to successfully take on and defeat a much larger opponent.

On the laboratory medicine front, with increasing demands being placed on clinical laboratories amid a persistent workforce shortage, we have much to gain by taking a page from the military playbook and strategically implementing force multipliers to maximize our limited resources and minimize our productivity constraints.

Selecting the Right Tool for the Job

In clinical labs, force multipliers implemented without focus might not be enough to break the bottleneck(s) in a process and can be expensive exercises in futility if not well matched to needs. Laboratorians absolutely should take a holistic view of a process and decide which specific activities and tools are critical to its success. This will enable lab leaders to narrow down the types of force multipliers that should be taken into consideration and the degree of multiplication required to reach the output goal.

Workforce multipliers in laboratory settings might include advanced instrumentation, highly trained staff members with specialized skill sets, or cognitive software that performs tasks historically reserved for humans. Selecting the appropriate tool(s) to adequately multiply the effect of physical force, thought, or attention required to complete the job at hand is crucial. Using a combination of carefully selected multipliers potentially creates synergy—a total effect that is greater than the sum of the individual effects of each multiplier.

A tool’s effectiveness centers on how well it amplifies a team’s efforts. For example, if a lab seeks to decrease bottlenecks in sample accessioning and processing, implementing an electronic positive patient identification product with bedside barcoding for phlebotomy and/or nursing staff can be far more effective than hiring a few more lab-based specimen processors.

In general, the higher a system’s or process’s workforce multiplication potential, the higher the price tag. But that shouldn’t dissuade implementation of these projects. Investing in the right force multiplier(s) can give labs capabilities that would otherwise be out of reach!

Using a Winning Combination

Beyond the overall philosophy of force multiplication, the U.S. military also has adopted and further developed as a key component of warfare strategy the concept of a high-low mix of multipliers. This principle holds that a small number of advanced personnel/equipment (high) can be made much more effective if supplemented by a large number of less advanced personnel/equipment (low). Employing this approach to resource allocation potentially allows for greater success than using either of these elements individually and has proven successful not only for the military but also for the automotive, financial, and manufacturing industries. One of the best illustrations of its power involves deployment of industrial robots in manufacturing, which automate the tedious, repetitive tasks on assembly lines, leaving humans to perform higher-level tasks requiring judgment, creativity, or innovation. A parallel in clinical laboratories involves using automation lines to process, sort, and deliver samples to the appropriate instruments for testing, which frees lab personnel to complete value-added activities like data analysis and interpretation.

In our laboratory, we have implemented not only this type of automation but also other robotic force multipliers. We have used these systems to create sample aliquots for a variety of testing and to transfer specimens into different sampling formats with positive patient identification (for example, 96-well plates). This has significantly cut the amount of hands-on time required by our staff. We’ve also adopted cognitive technologies such as rule-based engines that have been programmed to mimic functions of the human brain and may even be more capable than our high-performing team at detecting errors, trends, and patterns.

Supplementing our small but mighty workforce with these force multipliers has enabled us to accomplish tasks that otherwise would not be possible. As we continue our journey into the robotic revolution, we encourage other labs to join us in harnessing the power of technology to maximize their workforce and effectiveness.

Shawn Silver, DO, is a pathology resident at Case Western Reserve University in Cleveland. +Email:

Jaime Noguez, PhD, DABCC, is director of clinical chemistry and toxicology at University Hospitals Cleveland Medical Center and an assistant professor of pathology at Case Western Reserve University. +Email: