Numerous seminars and articles discuss the staffing shortage in health care and in the laboratory. Most of these have dealt with the importance of retaining and recruiting good employees. Given the median age of laboratories (49 years old), the decrease in medical technology schools, and a decline in people choosing the laboratory profession, the staffing shortage is here to stay and will affect the way we run our laboratories for years to come. Clinical systems managers need to identify and make the changes necessary in their laboratories to deal with the staffing shortage while maintaining quality testing and good customer service. This article will review the need and the process to assess laboratory operations along with the needs of the facility and/or health-care community. Obvious and not-so-obvious ideas for streamlining laboratory efficiencies along with maintaining high levels of quality and service will be presented.