Laboratory Management - 05 Management of Laboratory Operations

o o o o LABORATORY MANAGEMENT MANAGEMENT OF LABORATORY OPERATIONS OUTLINE • • • Management of Laboratory Operations Policy and Procedure Manuals o Objectives of Policy and Procedure Manuals o Policy Manuals o Procedure Manuals o Types of Policy and Procedure Manuals o Writing Policy and Procedure Manuals Staffing and Scheduling o The Staffing Process o Performance Training o Workload Projections o The Scheduling Process o Management Of Absenteeism • POLICY MANUAL • • • MANAGEMENT OF LABORATORY OPERATIONS • • A marketing manager at IDEO, a Palo Alto–based consulting design firm, once said: “If you hire the right people … if you’ve got the right fit, then everything will take care of itself.” This is what human resource management, or HRM, does—attracting, developing, and maintaining a talented and energetic workforce. Organizations that can’t do this well have very little chance of being competitive in the long term. Recruitment is becoming more candidate-centric. In an economy where talent is at a premium, employers are focused on learning about candidates’ needs and expectations while creating a positive recruiting experience. Recruiting is very crucial in the way that hiring should be specific people for specific job descriptions. • POLICY AND PROCEDURE MANUALS • • • • Policy - a statement or memo that outlines the institution’s position on an administrative or operational issue o Broad statement, guide on decision making Procedure - an instructional document that provides explanations and step-by-step directions on how to perform a task, test or process o Specific on providing instructions Policy Manual - collections of statement or memo that outlines the institution’s position on an administrative or operational issue Procedure Manual - provide detailed information about subjects only alluded to in memos, performance evaluation, training sessions and day-to-day verbal and written interchange between laboratorians and their clients. • • To ensure effective communication between the members of the organization Must attempt to remove ambiguities and allow uniform and consistent application of the laboratory’s policies and procedures Examples of activities that are tied directly to the contents of policy and procedure manuals: o Responsibility and control o Performance appraisals o Completion of tasks and duties o Quality standards and monitoring indexes A policy can range from simple statement about the intent and philosophy of a company to a detailed plan of implementation A policy may also be a more extensive document listing strategies on how minorities will be recruited as potential employees General topics commonly found in policy manuals include: o Administrative organization o Employment and personnel policies o Adherence and enforcement of safety and health procedures o Disaster plans o Confidentiality and release of patient information o Security and access to facilities o Solicitation on the premises Examples of laboratory policies: o Dress codes o Food and smoking rules o Telephone use o Specific statements about enforcement of safety rules o Laboratory organization and reporting relationships o Writing, review and authorization of procedures o Absences and late-arrival notification o Vacation and holiday requests o Supply requisition o Reporting and releasing of test results PROCEDURE MANUALS • • • Procedures are often referred to as SOP (technical manuals) Technical manuals that contain procedures for performing tests, operating instruments or processing quality control information Objective: STANDARDIZATION o To reduce human error & variation TYPES OF POLICY AND PROCEDURE MANUALS • • OBJECTIVES OF POLICY AND PROCEDURE MANUALS • Job descriptions Work flow and job analysis Productivity and measurement Financial accountability External Manuals o Specimen Collection Manual o Laboratory Service Manual Internal Manuals o Administrative Manuals o Technical Manuals o Safety Manuals o Quality Management Manuals WRITING POLICY AND PROCEDURE MANUALS • • Policy and Procedure Manuals should be written in a way that enables easy consultation and retrieval of information. Consistency in design allows the users to become familiar with the location of needed information and serves as a checklist for all pertinent directions 1 • The format and style selected by the laboratory should consider the following factors: o Skills and technical ability of the users o The manual’s use as a ready resource for checking performance criteria o Performance and behavior expectations of the laboratory STAFFING AND SCHEDULING • • POLICY MANUAL FORMAT • • • Policies by nature are not as specific or detailed as procedures They are usually organized by topic and composed according to standard writing styles A policy can range from a one sentence statement to a more extensive discussion of a topic PROCEDURE MANUAL FORMAT • • • • • Procedures are detailed and comprehensive documents. Regulatory agencies have a specific guidelines governing the information that must be provided and many have recommendations about the format that should be followed in preparing procedures The laboratory must adhere to the rules and guidelines governing a variety of agencies of governing the hospital and the laboratory itself. The following items are often found in the laboratory’s technical procedure manuals and are consistent with the requirements and recommendations of JCAHO, CAP, AABB, NCCLS and CLIA: o Name of test, procedure, task or duty o Effective date and any subsequent changes o Short summary of main elements of the procedure or a list of items that may frequently be checked or looked up o Brief discussion of the principle of the test with key points that may be use to the analyst o Specimen requirements, patient preparations and rejection criteria o Instrumentation, equipment and glassware requirements and care o Reagents and their preparation o Calibration and control material requirements and preparation o Calibration procedures including linearity and test limitations The following items are often found in the laboratory’s technical procedure manuals and are consistent with the requirements and recommendations of JCAHO, CAP, AABB, NCCLS and CLIA: o Quality control procedures including run acceptance and rejection protocol o Primary problem detection o Actual testing procedures with a detailed step-by-step instructions o Calculation and interpretation of results o Results reporting parameters and instructions o Normal or reference ranges along with critical or panic levels o Procedure notes concerning important aspects of the tests o Troubleshooting suggestions o Lists of references and sources for additional information o Authorization and schedule for review Staffing - The setting of long-term goals and objectives for the number and types of personnel needed to meet the labor requirements of the laboratory Scheduling - Matching the people presently working in the laboratory with current workload requirements THE STAFFING PROCESS • • • Staffing is the process of determining personnel and job needs, recruiting qualified staff, matching them with the appropriate job, and training them to perform the work assigned Staffing establishes how many and what types of personnel are needed Staffing must address the following issues: o Set the types of personnel needed by the laboratory o Determine the number and placement of each type needed o Ensure that the staff is suitability trained to perform its duties o Project long-term variations in personnel needs cause by such factors as changes in workload, tests mix, methodology and extent of automation TYPES OF PERSONNEL NEEDED • The types of personnel needed to staff a laboratory depend on: o The technological and analytical complexity of the procedures being performed o The amount of supervision and support available to the persons actually performing the tests o Testing volumes or workload o Analytical throughput or turnaround time expectations o Equipment, instrumentation and computer technology available STAFFING LEVELS • • The primary determinant in the staffing decision: level of service expected from each unit and the results of workload To be effective, the staffing function should support the scheduling process and help to avoid the gaps in the personnel that could cause a scheduling crisis and possible disruptions of service. PERFORMANCE TRAINING • • An important aspect of staffing is to make certain that employees are properly trained to perform their assignments Training a personnel to staff the laboratory begins with their arrival (orientation) and follows through with the employee development programs run by the laboratory to ensure competency, availability of future staff and the continual growth of both the laboratory and its employees 2 o WORKLOAD PROJECTIONS • Data on which to prepare the workload projections may come from: o Historical records such as productivity and financial data o Analysis of future trends o Analysis of foreseeable changes o o o Exempt and Professional Status: Employees are exempted by salary levels or professional classification from the overtime provisions of wage and hour laws. Work-at-home Programs Offsite testing and satellite laboratories Freelance Employment STEPS IN MAKING A SCHEDULE THE SCHEDULING PROCESS • • Scheduling is matching the people now working in the laboratory with current workload requirements Scheduling is a major part of the directing and controlling management functions ISSUES AND FACTORS INFLUENCING SCHEDULE DECISIONS • • • Availability of Staff o Staff availability issues that define the scheduling options: ▪ The skills of each worker ▪ The paper qualifications of the employee ▪ The employee’s flexibility in hours available to work ▪ The total number of persons available including their employment status Type and Volume of Work Performed o Alignment of staff and workload must take into consideration: ▪ The test and procedures offered and technical expertise needed to provide the appropriate level of service ▪ Timing elements Workplace o Involves instrumentation, methodology, organization and facility layout as well as support resources 1. 2. 3. 4. 5. 6. 7. 8. 9. • • Select the type of schedule Establish staffing levels Develop staffing levels Determine format, terminology and schedule keys Set posting time frame Prepare skeleton stage Complete routine scheduling stage Fill in gaps Post schedule Types of Schedules o A format that simply lists attendance showing who is working and who is off o Work assignments which give the station or section in which the laboratorian is to work on a particular day o A combination which lists both attendance and work assignment Staffing Levels • Schedule Terminology and Keys o Acronyms, symbols and marks are used on schedules vary according to the institution • Time Frame o Schedules are frequently posted for either 1 month or 4 weeks o The final schedule should be posted at least 2 weeks prior to the end of the current cycle to allow the staff time to plan accordingly. Skeleton Stage o Skeleton schedule is a working draft that includes weekends and requested time off. It should be started as far in advance as feasible Routine Stage o This phase normally follows a set of pattern of marking Xs and Os WORK SCHEDULE • • 40-Hour Rule: Wage and hour laws that require employers to pay overtime to employees who work more than 40 hours in a 7-day calendar period 8/80-Hour Rule: A special provision to the wage and hour law that allows health care employees to work extended periods of time outside the 40-hour rue and sets overtime pay when they exceed 80 hours in a 2 week calendar period or work more than 8 hours in a single day TYPES OF WORK SCHEDULES • • Traditional Work Schedules o 40-hour work week: 5 days on and 2 days off o 8/80 hour-hour work cycle: 10 days on and 4 days off during a 2-week calendar period Alternative Work Schedules o Compressed Work Cycle: An individual may work multishifts or extended time periods (10-12 or 16-hour shifts) within a 40-hour calendar week o Flexible Working Hours: Employees are responsible for a set amount of work but are allowed to establish their own hours around a core period o Job sharing: Two individuals share the responsibilities and benefits of a position usually filled by one worker • • 3 • • Filing in the Gaps o No matter how well the manager plans for staffing needs, unanticipated scheduling slots need to be filled ▪ Check with part-timers ▪ Seek volunteers ▪ Use overtime ▪ Call in temporary help Computer Programs and Posting o Making the schedule available well ahead of the starting date enables both the employee and the supervisor the chance to find and correct any deficiencies MANAGEMENT OF ABSENTEEISM • • • Key Elements in Absenteeism Management Program o A clearly defined policy on when absenteeism becomes corporate problem (affects products) o Measurable and objective criteria for monitoring attendance o A plan for following and correcting a problem at its earliest stage in a mature manner beneficial to both individual and the organization Absenteeism Define and Measured o Absence occurs any time a person is not at work when scheduled o The seriousness of absenteeism depends on its duration and frequency of occurrence o Absenteeism is a failure to meet the standard for attendance set by the laboratory Absenteeism Management Plan o Absenteeism must be handled in the same framework as all behavior and performance problems, following closely the corrective action policies of the institution o Examples of absenteeism patterns: ▪ Certain days of week or month • Fridays • Mondays • Day after payday • School holidays 4