1. LABORATORY MANAGEMENT Lecture 4

2. Planning at the Departmental Level The laboratory director must determine both laboratory goals and objectives, as well as the means for achieving them, before he can organize, direct or control the results Planning is divided into four phases: 1. Establishing the goals and objectives for the laboratory 2. Formulating policies to carry out objectives 3. Developing intermediate and short - range plans to implement policies 4. Stating detailed procedures for implementing each plan

3. It is difficult to separate planning from organizing and controlling functions The pyramid structure is typical when describing a hierarchy The inverted pyramid reflects the degree of detail in each of the mechanisms listed in the planning and control structure

4. Organization Hierarchy Planning & control mechanisms

5. Laboratory Planning & Control Structure Organization Hierarchy Planning & control mechanisms Deals with e.g. introduction of new tests e.g. rules for action that will contribute to the successful achievement of goals and objectives. He might establish policy regarding cost/test ratio To achieve short - range plans e.g. applying special procedures governing the staffing and instrumentation required. The rules that govern everyday testing.

6. Establishing Policies and Procedures Planning is referred to as preparation for where the organization is going Establishing policies and procedures addresses the question of how the organization is going to achieve specific goals As shown in the figure planning mechanisms go from the abstract (general purpose objectives, strategies, goals) to the specific (rules) In between are the purposes and rules of action known as policies and procedures, which guide an organization Their purpose is to designate the aims of an organization and the means to be used in their accomplishment

7. Establishing Policies and Procedures Variations Origin Characteristics

8. Variations Within the clinical laboratory, individual policies and procedures will vary according to purpose and application Policies will vary in specificity; some policies should be stated in general terms to allow flexibility e.g. policy dealing with time off for continuing education may be written in general terms, by contrast a procedure written to protect against hepatitis will usually be quite detailed

9. Origin Policies and procedures may originate from various stimuli: From the organization itself From government institutions From agreements with other agencies From tradition

10. Characteristics Policy must be: reasonable, flexible and comprehensive Preparation of manual for the adopted policies and procedures Manual should begin with broad objective narrowing the focus to details for its accomplishment in the form of policies, procedures, methods and rules as shown in the following example:

11. Example on Establishing Policies and Procedures Objective: To provide optimum service in the laboratory department for both inpatients and outpatients Policy: It is the policy of the laboratory to maintain: 24 hours service 7 days a week for inpatient testing and 8 hour service 5 days a week for all outpatient procedures, unless special arrangements are made Procedure: 1. Maintain sufficient laboratory staffing around the clock for all inpatient services 2. Provide outpatient services between the hours of 8 AM and 4:30 PM Monday through Friday, and 8 AM to noon on Saturday 3. Schedule appointments for all outpatients

12. Method: Laboratory staff will be assigned to the following shifts: 7am to 3:30 pm; 3pm to 11pm; 11pm to 7am Obtain approval from medical director or administrative director to schedule outpatient procedures outside the regular assigned hours Daily work schedules and job assignments will be posted 2 working-days in advance

13. Rule: All employees will report for duty at time assigned Deviations from these hours without prior approval will be considered cause for possible disciplinary action Three reported incidents of unexcused tardiness of more that 10 minutes will result in a written and verbal warning Five reported incidents of unexcused tardiness of more than 10 minutes will result in 1 day suspension without pay Additional reported incidents of unexcused tardiness will result in termination

14. Problem Solving The steps for solving a problem involve: 1. Definition of the Problem 2. Fact – gathering 3. Development of alternative solutions 4. Weighing of alternative solutions 5. Selection of solutions 6. Implementation of the solution 7. Measurement of consequences

15. 1- Definition of the Problem The manager must look beyond the symptoms of the problem and focus on the real issue Symptoms defined as adverse events or things which are present in an operation but have not yet developed to the point of emerging as basic deviations Basic deviations are problems that are reflected to as glaring mistakes

16. 2- Fact - Gathering The manager should begin to gather information needed for developing alternative solutions Facts surrounding the decision situation are important to seek out, as are constraints and assumptions Constraints are factors that limit the scope of alternatives Assumptions are applied to factors in an effort to simplify the problem and its solution Fact gathering requires a search for pertinent information from persons directly involved in the problem, from books, other people and from experts

17. 3- Development of Alternative Solutions The generation of possible solutions calls for creative thinking Past experience, similarities, differences Past experience acts as a guide Seeking information from others who solved a similar problem

18. 4- Weighing of Alternative Solutions Analysis by of alternative solutions by stating the advantages and disadvantages of each alternative How each alternative will effectively accomplish the objectives and requirements of a satisfactory solution Consideration should be given to the question of where a chosen alternative will eliminate reoccurrence of the problem or generate another in its place

19. 5- Selection of Solutions In choosing solution consider: quality, acceptance, speed, Value, or cost. When the decision is made, it is often wise to discuss it with someone who has considerable problem - solving skills

20. 6- Implementation of the Solution A critical step The most time consuming If not properly implemented, it is useless Involve those who are directly affected by the problem Inspect the details of the decision and develop necessary procedures Participation by all levels - management and employees alike

21. 7- Measurement of Consequences Not all decisions will have the effect that was planned Consequences should be evaluated Problem - solving as a management skill is probably best developed through repeated exposure