QUALITY ASSURANCE Work Load

Workload is the sum of the work achieved or to be achieved, obtained by multiplying the raw count of each individual procedure by its unit value expressed in units (minutes) Individual workloads for procedures are accumulated to obtain the total workload for laboratories, laboratory sections, shifts, etc. When discussing workload one has to consider a number of points, for example: how much work the laboratory does, whether the staffing level is adequate, whether the laboratory needs expensive equipment, whether the laboratory is working efficiently 2

Using the number of tests is not accurate Traditionally, the activity of the laboratory has been expressed by total number of tests achieved for a given period of time (raw count) This method does not take into account complexity which varies greatly from test to test And subsequently the specific time required to perform any test 3

Workload Unit Method This is a standardized counting method for measuring technical workload in a consistent manner 4 1 work unit = one minute of productive technical, clerical and assistant time

Unit Value Per Procedure Unit value per procedure, more often referred to as unit value (UV) It is the mean number of units involved in performing all activities required to complete the defined procedure once It includes the time required for: Initial handling of the specimen includes all activities related to the specimen once it reaches the laboratory All steps involved in specimen testing Does not include incubation or centrifugation time Recording and reporting Includes calculating, entering results in the computer, checking and filing the final report, telephone calls for reporting results are also included Daily and routine preparation of reagents, preparing standards, diluting quality control vials, instrument cleaning, warm-up and calibration 5

Unit Value Per Procedure Maintenance and repair Includes regular weekly or monthly preventive maintenance, emergency repairs, time spent in identifying defective reagents Does not include major breakdowns Solution preparation Glassware wash up Includes washing, drying and sterilization Technical supervision Standards, quality control, and repeats are counted as tests and are included in the raw count Unit value per procedure does not include specimen collection 6

7 Workload value (WLV) = (Minutes) Raw count for each procedure x its unit value (UV)

How is UV determined? Time Study A surveyor actually uses a stopwatch and times the procedure being done in the laboratory The watch is started at the beginning of the first step of the procedure and continues throughout its entire cycle Step endings and delays are noted as they occur The procedure is broken down into steps Each step must be outlined in detail, and must have identifiable beginning and ending points The sum of the steps must be equal to the total cycle of the process 8

How is UV determined? Time Study The procedure is performed in the same way as it is dealt with under routine conditions For example, individually or in batches, with different technologists These surveys are sent to coordinators by whom surveys are evaluated, using 10 different laboratories, before a permanent unit is acquired The following Table represent UV for different tests These units have proved to be applicable in some countries of the Eastern Mediterranean Region 9

Management application of WLU system 10

Productivity Productivity measures how efficient the laboratory does the work Paid Productivity This is represented by the ratio of workload units to total technical, clerical and assistant time in hours, for which laboratory employees are being paid, whether or not the employees are on site It determines cost-effective use of personnel It identifies the overall productivity of all employee resources dealing with the laboratory workload 11

Paid Productivity If one health center laboratory employs one laboratory assistant or full time equivalent and produces a total of WLUs annually, what is the paid productivity? 12

Worked Productivity 13

Actual Productivity Untimed activities include: Breaks (coffee breaks, prayers, etc.), laboratory administrative duties, prayers (Islamic countries), training others, ordering and inventory of supply, preparing monthly activity reports, staff meetings 14

Efficiency of productivity expressed as a percentage The median productivity will vary according to the local working facilities of the environment of the laboratory Some believe that the actual average of normal productivity ranges between 35 and 45 minutes of every paid hour 15

To increase the efficiency to 75% (45 min.), new tests can be introduced to the center WLU = Actual productivity x actual worked hours per year WLU = 45 x 1389 =

If the WLU of a laboratory is WLU/year, how many employees are needed? Actual worked hours/year = 1389 hours = min. No, of employees required = /83340 =