Laboratory Management - 01 Intro to Management

LABORATORY MANAGEMENT LEADERSHIP VS. MANAGEMENT INTRODUCTION TO MANAGEMENT • OUTLINE • Introduction to Management o Roles of Clinical Laboratory o Leadership vs. Management o Health Insurance Portability and Accountability Act o Quality Systems Management o Nature of Management o Management Process o Management Principles • INTRODUCTION TO MANAGEMENT • • • • Management is part of our everyday lives. We manage ourselves, relationships, teams, and co-workers. And as the world grows more and more complex, it has never been more important to study the fundamentals of management, understand your capabilities, and build critical skills for long-term career success. In an article titled “Putting People First for Organizational Success,” Jeffrey Pfeffer and John F. Veiga argue forcefully that organizations perform better when they treat their members better. Managers in these high-performing organizations don’t treat people as costs to be controlled; they treat them as valuable strategic assets to be carefully nurtured and developed. So, who are today’s managers and just what do they do? Medical technologists - work in clinical laboratories How critical is laboratory? o 70% of all medical decisions are based on laboratory results. o Laboratories are critical ▪ Most earnings comes from laboratory as most decisions come from lab results • • ROLES OF CLINICAL LABORATORY • • Purpose of Clinical Laboratory: provide physicians and other health care professionals with information to: o detect disease or predisposition to disease o confirm or reject a diagnosis o establish prognosis (possible outcome) o guide patient management o monitor efficacy of therapy Laboratory also plays a role in: o Education & Research o Information technology design & implementation o Quality improvement TO ACHIEVE GOALS: • A laboratory must use: o Medical scientific, and technical expertise o Resources such as personnel, laboratory and data processing equipment, supplies, and facilities ▪ Personnel - most important resource o Organization, management, and communication skills ▪ Management - direction ▪ Communication - important in achieving goals; allows efficient management/organization • • Leadership o Provides the direction where the organization is going o Pattern of behaviors used to engage others to complete tasks in a timely and productive manner o Leadership styles include: ▪ Supporting ▪ Directing ▪ Delegating ▪ Coaching o A leader may adopt any behavior style periodically to suit a situation, but in general, one style usually dominates. Management o Provides the “road” to get there o Oversees everything o Primary functions include: ▪ Planning and prompt decision making ▪ Organizing ▪ Leading ▪ Controlling Leadership Styles o Supportive Leader - provider; provides physical and personal resources to his/her subordinates ▪ Listens to the needs of his/her subordinates ▪ Not strict in giving directions; trust subordinates and lets them do their jobs on their own ▪ For managing seasoned personnel o Directive Leader - presents rules/orders ▪ Defines process for their subordinates ▪ Detail-oriented ▪ For handling beginners/new to profession o Delegating Leader - simply appoints tasks ▪ Assumes the knowledge of subordinates despite the actual capacity of subordinates ▪ Simply delegates task and lets subordinates do their job on their own ▪ Provides low support/attention to subordinate o Coaching Leader - provides high support/direction ▪ Not as directive/authoritarian as a directive leader but provide set of instructions as well as motivation to their subordinates o There is no perfect leadership style. Use a style appropriate for the current need Good management uses the human, financial, physical, and information resources available to an organization (in the most efficient and effective manner). o For long term planning & utilization o Accounts for future developments/organization Basic Managerial Responsibilities o Operations Management ▪ Quality assurance • Standardization of policies/procedures ▪ Policies and procedures ▪ Strategic planning ▪ Benchmarking ▪ Productivity assessment • Checks efficiency of personnel ▪ Legislation/regulation/HIPAA compliance • HIPAA - confidentiality compliance ▪ Medicolegal concerns ▪ Continuing education ▪ Staff meetings • Improvement of processes/productivity 1 o • • Human Resource Management ▪ Job descriptions ▪ Recruitment and staffing ▪ Orientation ▪ Competency assessment ▪ Personnel records ▪ Performance evaluation/appraisals ▪ Discipline and dismissal o Financial Management ▪ Departmental budgets ▪ Billing ▪ CPT coding ▪ ICD-10 coding ▪ Compliance regulations ▪ Test cost analysis ▪ Fee schedule maintenance o Marketing Management ▪ Customer service ▪ Outreach marketing ▪ Advertising ▪ Website development ▪ Client education Managerial Levels o Each managerial level dictates the daily activities and skill sets required for that position o A top-level manager may or may not possess technical skills that a first-line manager uses every day o First-Line Managers ▪ Most concerned about completing about completing the day’s work ▪ Supervisors, Team leaders, Chief Technologists o Middle Managers ▪ May straddle both areas to some degree by engaging in a variety of activities that may be strategic as well as tactical ▪ Operations managers, Division heads o Top Managers ▪ Concentrate on strategizing and planning for the next 1-5 years ▪ Laboratory Directors ▪ Chief Executive Officers (CEOs), Chief Financial Officers (CFOs), Chief Information Officers (CIOs) Leader vs. Manager Traits o Leader ▪ Administrator ▪ Organizer & Developer ▪ Thinks long term ▪ Asks what & why ▪ Risk taker ▪ Challengers of status quo ▪ Inspiration ▪ Does the right thing o Manager ▪ Implementer ▪ Maintains ▪ Control ▪ Thinks short term ▪ Asks how & when ▪ Watches bottom line ▪ Accepts status quo ▪ Is a good soldier ▪ Does things right • • Skills of Managers o A manager in laboratory should have following skills: ▪ Conceptual Skills/Organizational Skills • Conceptualizes process - knowledge of the concept & medical technology practice • Organization - conceptualized process ▪ People Skills/Human Skills • Interprofessional/interpersonal skills • Relates, communicates, help colleagues • Relationships with patients/clients ▪ Financial Skills • Monitoring monetary assets/finances • Approving budgets/purchases ▪ Technical Skills • Performing lab procedures to maintain correct procedures Styles of Managers o Authoritarian - manager makes all the decisions ▪ Do not take into consideration the inputs of others ▪ Advantage: can make quick decisions ▪ Disadvantage: least accepted by subordinates; less commitment from subordinates ▪ Quality of decision is flawed (50/50 - good/bad) o Democratic - makes decisions after pooling the staff ▪ Has representative for every section to provide input; more inclusive in decision process ▪ Take into consideration inputs of others ▪ Decision may take longer; waits for majority decision causing minority to feel ignored o Consensus - everybody has a say ▪ All inputs shall be considered ▪ Decisions are longer to be formulated ▪ Highest quality decision as more brains are working together; however there may be clash of ideas/brains working together o Laissez-faire - least effective ▪ Managers allows subordinates on their decisions with no regard for consequences ▪ Lack of supervision/overseeing/organization ▪ Cause egos/personal agenda to arise ▪ Perceived like there is no manager HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) • • • • Was enacted in 1996. Providing standards that protect the confidentiality of health information, while allowing interchange of information in appropriate circumstances. Various rules have been implemented that have a direct impact on the laboratory and include the use and disclosure of protected health information (PHI). Protects privacy of patients QUALITY SYSTEMS MANAGEMENT • • Key Management Goal: o Ensure the quality laboratory services are provided How to accomplished this goal? o Every laboratory should: ▪ Strive to obtain modern laboratory equipment ▪ Hire a well-trained staff ▪ Ensure a well-designed & safe physical environment ▪ Create a good management team 2 • • • • Quality Healthcare issues & Medical Errors should be addressed. Laboratory Errors are as follows: o Pre-analytical Errors ▪ Specimen collection & transport • QNS - quantity not sufficient ▪ Identification & labelling o Analytical Errors ▪ Quality control ▪ Calibration ▪ Preparation ▪ Testing ▪ Instrumentation o Post-analytical Errors ▪ Delivery of Reports ▪ Turnaround Time ▪ Clerical Errors ▪ Missing Reports Standard Approaches to Quality Leadership & Management o Total Quality Management (TQM) ▪ A systems approach that focuses on teams, processes, statistics, and delivery of services/ products that meet or exceed customer expectations. ▪ Maintains quality o Continuous Quality Improvement (CQI) ▪ An element of TQM that strives to continually improve practices and not just meet established quality standards. ▪ Improves previous approaches Tools to Improve Quality throughout Health Care Industry o Six Sigma ▪ A performance improvement program, the goal of which can be summarized by the mantra “improvement by eliminating process variation”: improved performance, improved quality, improved bottom line, improved customer satisfaction, and improved employee satisfaction. ▪ Hierarchy of quality managers (tiers) o Lean ▪ A system for reducing waste (“nonvalued activities”) in production or manufacturing processes. • For waste management ▪ Developed from principles used by Toyota Corporation ▪ Lean utilizes the 5S & PDCA • Sort, Set in Order, Shine, Standardized, Sustain • Plan, Do, Check, Act MANAGEMENT PROCESS • PLANNING • • • • • • • • NATURE OF MANAGEMENT • • Managerial Functions o Planning o Organizing o Directing o Decision Making / Problem Solving o Coordinating o Communicating Information Age: o Management has changed from supervision of “factory” workers to coordination of knowledge workers. Organizational Structure • Develop a pathway(s) to accomplish the organization’s mission and goals using resources and time. Take into considerations everyone’s welfare (licenses) Failing to plan is planning to fail SWOT Analysis – determine both internal and external factors of the organization standards. o Internal Factors ▪ S – strengths of the organization ▪ W – weaknesses of the organization ▪ Innate to the organization ▪ Depends to capacities within the organization o External Factors ▪ O – opportunities available to organization • May provide advantages ▪ T – threats to organization • May provide disadvantages ▪ From outside the organization o Allows formulation of goals/objectives ▪ Objectives - individual tasks to reach goal ▪ Goals - individual points to accomplish mission/vision Types of Plans o Tactical Plan o Operational Plan o Strategic Plan Short Range or Tactical Plans o Cover a 1-5 year period and focus on tasks that can be completed in this time frame. Operational Planning o May be for 1 year or one budget period & concerns operations. Strategic Planning o Maps out the course of an organization for approximately 20 years. ▪ Expansion & development, partnerships o Involves Tactical & Operational plans o Evaluated & modified annually. o Process of making a high-level decisions. o Can also be defined as: ▪ Deciding on the objectives of organization and need to modify existing objectives if appropriate ▪ Allocating resources to attain these objectives ▪ Establishing policies that govern the acquisition, use, and disposition of these resources. Strategic Planning Vs. Tactical Planning o Strategic Planning → based on long-term projections and a global view that can have an impact on all levels of a laboratory’s operations. o Tactical Planning → consists of the detailed, day-today operations needed to meet the immediate needs of the laboratory and works toward meeting the longterm strategic goals that have been set; shall be aligned with strategic plan 3 ORGANIZING • • • • Time Management - Flexibility to plan their work. o Time allotment for tasks, establish flexible time frame o Manage workload based on expertise, do not overload Structure - Organizational Structure is based on: o Authority ▪ Formal – assigned by organization or administration ▪ Informal – Gained informally through competence or leadership qualities o Responsibility – Assigned by administration through delegation o Accountability – Occurs when the person responsible for completing a task is evaluated to determine if the task was completed. Reengineering - Reorganizing work processes in organization o Benchmarking – is a process whereby the best process in one organization is modified to fit similar processes in another organization. Inventory Management - Objective of an efficient laboratory is to experience few shortages in testing reagents, supplies, & materials. o To minimize wastage of materials & reagents COMMUNICATING • • DIRECTING • • • • • Persuading employees to perform tasks that help the organization accomplish its mission & goals. Techniques of Directing o Authoritative o Coaching o Empowerment Authoritative o Encompasses issuing orders & telling someone what to do o Does not allow employee to decide how best accomplish task. Coaching o Allows instilling of confidence & motivation into an employee about accomplishing a task. o Employee has more “say-so” in how to accomplish a task Empowerment o Allows an employee to determine what task to do & how to accomplish. o Employees are allowed to be creative & innovative to solve problems. o Employees are allowed to take risks without fear of admonishment for failing. o Perceived as ideal directing • • MANAGEMENT PRINCIPLES • • • DECISION MAKING/PROBLEM SOLVING • 5 steps of Problem Solving o Define Problem ▪ Identify issue o Brainstorm ▪ Digest problem, seek perspective ▪ Thinking of possible solutions o Pick the best solution o Implement the solution o Review the solution COORDINATING • Regulation of processes performed by laboratories in coordination/accordance with the coordinating body Act of transmitting or receiving messages Face To Face Spoken Communication o Advantages ▪ Immediate message conveyed ▪ Immediate feedback ▪ Other factors can be determine: body language, tone of voice, eye contact, etc o Disadvantages ▪ Cannot save the communication ▪ Receiver interpretation of message may be different from that of speaker’s intention. Written communication o Advantages ▪ Can communication encounter ▪ Readers can review, interpret & then respond to initial message o Disadvantages ▪ Feedback delayed (delayed review, reviewing) ▪ Informal: Memos & emails ▪ Formal: Letters Listening o Active listening components: ▪ Privacy ▪ Eliminate (reduce) physical barriers ▪ Listen to words, but look at behavior, & interpret implied meaning Mission - Purpose of the laboratory; Organization’s purpose Vision/Goals - Organization’s broad, long term ambitions Objectives o Directives o Accomplishment ▪ Specific ▪ Measurable ▪ Attainable ▪ Realistic ▪ Time-bound ▪ Agreed-upon (consensus) MANAGEMENT BY OBJECTIVES • • • Program that embodies all management process Important core: Communication Goals should be well-communicated so objectives are done to achieve the goals/mission/vision 4