• Name of patient is familiar, someone they see frequently, may take added significance

• ○ “even if I don’t know the patient. I think in blood bank particularly you know we see names so… and we work on everyone individually and so we’re preparing something for that patient in addition to just testing so I think it takes on a little added significance” ∼MAROON

• Knowing the impact of a result for someone they know

• ○ “so, there is someone that I know that gets urine cultures done quite often I have never talked to the person about it. I don’t know why but I just happened to see their name quite often” ∼ORANGE.

• ○ “Mom was in dad’s chart. Dad’s cancer spread. She was worried. I told her I didn’t know what it meant, but I did” ∼FUCHSIA.

• Contact with patients is outside of the laboratory’s role

• ○ “[T]here is no relationship between the lab worker and the patient other than the lab worker receives the patient sample, they perform the testing, they result the testing” ∼GRAY.

• Patients are deidentified

• ○ “it doesn’t register for me it’s not important really what the name is. How you usually go with not with the patient’s name you know I go for the identifiers I look for the numbers […] the date of birth and the MR numbers and all that” ∼BURGUNDY

• No time to form a connection

• ○ “I mean if you see the patient a lot it makes you like ‘oh I know this patient’ but then it’s so busy […] you move on […] there is no time to wallow” ∼GREEN.

• Participating in procedures at the bedside

• ○ “I have direct contact with [patients] especially if I go up on a bone marrow and ended up crying inside the room because you know their story” ∼GREEN

• Knowing the likely implication of a test result for a patient

• ○ “I was fairly confident with my own observation that the patient probably had leukemia and they were wanting a copy of their results and […] I really didn’t want to give them the results […] they could tell from my apprehension that there was a problem” ∼AMBER.

• Desire to remain anonymous

• ○ “lab people—their personalities tend to be that kind of person they just want to be in the background […] they don’t want anybody to notice them” ∼CYAN

• ○ “[W]e need to remain anonymous, that way [patients] don’t like ask us […] questions because that might affect the professionalism” ∼GREEN

• Get phone calls from patients but usually redirect them and try not to communicate about results

• ○ “we do sometimes get calls from patients; we direct them to MyChart for example […] it’s not a direct communicative relationship” ∼KHAKI.

• Specific laboratory policies prevent verbal communication of laboratory results to patients

• ○ “I can’t give you results over the phone directly. I’m not a clinician, so please contact either your clinician or medical records at this number” ∼INDIGO.

• ○ “so, for us we essentially have to tell them that unfortunately we can’t give out test results directly we can’t even give them to outside hospitals” ∼ORANGE.

• Interacted with patients constantly

• ○ “I have some patients that do come in and pick up copies of the results” ∼CYAN.

• ○ “I actually enjoy it when… um patients come in and say explain this to me and I always have to say “you know I can’t interpret it. I can’t tell you what you can do about it, but I can tell you that an AST is related to your liver” or just some of those facts of what the lab test is” ∼JADE.

• These individuals were confident in their ability to speak with patients.

• ○ “[W]e’re so small and everybody knows everybody […] I don’t mind discussing with them or trying to figure out [as patient] ‘well why did the doctor order this for me?’ is like [as self] ‘well do you have this going on?’ […] they trust us to give them the right information” ∼AMBER.

• Some MLPs believe that patients being able to see their test results directly can be positive for increasing visibility of their profession

• ○ “I think it would increase visibility because patients would know that we’re actually the ones doing the tests, right? […] We have no visibility because any results to patients come through a doctor or clinician, right? And so, I think it would increase the visibility to lab” ∼INDIGO.

• ○ “[W]ith a patient seeing all those different results and seeing how many there are and how many different results are… I think that could definitely spark someone’s interest to wonder how they all got there and who did them” ∼BLUE.

• Others said DPA alone would not make much of a difference

• ○ “I use the portal as a… as a patient I don’t think about the people who are running the test. I just see it myself and I’m curious to talk to the physician about it I mean the although I’m in that profession I don’t think about the people who are running the tests as a patient” ∼BURGUNDY.

• MLPs should engage in other efforts that can help them gain visibility

• ○ “I think the visibility has more to do with the legislation I think… because nurses… nurses are more visible they have more unions and stuff like that, and we don’t have any of that you know? I mean we don’t get that kind of exposure I don’t think this would be one way to do it.” ∼BURGUNDY.

• ○ “it comes down to just promoting ourselves […] nobody’s going to promote the lab except us, and we have to do that whether it’s taking the time to explain to a patient what their test involves. Simple things like giving tours of the lab… just getting us out there because nobody will get us out there but us. […] And let them see what the lab actually is” ∼JADE.