ORGANIZATION AND INSTITUTION FLOW PATTERNS OF WORK

General Considerations: Organizing and instituting flow patterns of clinical laboratory work involve implementing the basic responsibilities of management-planning, organizing, coordinating, directing, and controlling. These functions are interrelated and overlapping. These Management Functions can be defined as follows: 1-planning is deciding what to be done and determining the best way to do it. It’s Essentials:  understanding the assignment  Developing A plan. The plan should answer the questions: what is to be done, where is to be done, when is to be done, who will do it, how it will be done, and why it is being done.

2- Organizing is arranging human and material recourses to carry out a plan in the most efficient manner possible. 3- Coordinating is the process of communicating with others inside and outside the supervisors area of control. 4- Directing is the process of implementing the planned activities of the organization and using the recourses in the actual operation. 5- Controlling is the process of comparing operations with some measurable criteria to determine if these activities are going according to the plan.

Clinical Laboratory Work Flow Major steps of workflow:  Collection and Delivery of specimens.  Specimen receiving and entry into system.  Test Performance.  Recording and Reporting of results.  These major steps involve the application of the managerial functions of the supervisor.

Collection and Delivery of specimens An efficient acquisition and delivery of specimen workflow should include: 1. Regularly scheduled blood collection runs with specified contingencies for nonroutine requests. 2. A systematic delivery of specimens other than blood to the clinical laboratory. 3. A formal system for requesting clinical lab. Procedure. 4. Standard methods of specimen delivery to the clinical lab. sections. Blood and other specimens should arrive to the clinical lab. In a timely manner to assure smooth flow of the testing process. An example of a schedule for routine blood collection runs is 7:00 am, 11:00 am,3:00 pm, and 7:00 pm. If the institution has a large number of critical care and special units, it is usually necessary to make more frequent blood collection runs, these runs should be on a different timetable than the routine collection runs.

Specimen receiving and entry into system Steps carried out to receive a specimen:  Identification and Verification  Assigning of accession numbers to specimen and request slip.  Preparation of log sheets and/or worksheets.  Preparation and aliquoting of sample.  The physical arrangement must be considered; the logging process area should be adjacent to the receiving area, with centrifuges and sinks conveniently located.

Test Performance An effective workflow patterns must include:  The volume, variety and nature of procedures.  The instrumentation used in the clin. Lab.  The space and physical layout of the lab.  The type of institution for which service is provided. Clinical lab. Procedures fall into three categories:  Procedures must be performed immediately because either their nature or the demand for immediate results.  Procedures that are performed more or less continuously.  Procedures that can be deferred.

 Test scheduling must be developed in such a manner that the service provided meets the needs of those requiring it. Communication plays an important role in the success or failure of a plan to perform certain procedures on a scheduled basis.  The most effective way to communicate this information to physicians and nursing personnel is to maintain an up- to-date floor book which includes all necessary information (Table 2-1)

Recording and Reporting of results Tow systems are necessary: 1- a method of reporting stat results to the nursing unit as soon as they are available. (By telephone or by computer terminals). 2- a method of systematic delivery of routine reports.