Laboratory Administration and Management

Chapter 1

Introduction

Definitions:

1. the management process involves the use of both human and technical resources to
accomplish goals and objectives set by a group or organization.
2. "Getting things done through people".
3. A manager is anyone who directs the activities of another employee.
4. A process, with both interpersonal and technical aspects, through which the
objectives of the health service organization are specified and accomplished by
using human resources and technology.
5. Working with and through people to accomplish a common mission.

Conditions that must be present for management to succeed:

1. A Mission or goal that should be accomplished by the organization.

2. Leaders with Authority to direct the learn towards the goal.
3. Necessary Resources (people, equipment, supplies and money).
4. Responsibility for achieving the goals assigned.
5. Accountability for using resources established.

Leadership Qualities:

A manager or a supervisor of an organization should have certain characteristics for

them to succeed.
1. 1.Personal characteristics of resources such as Patience, perseverance and
open minded.
2. Management Skills including the following:
a. Organizational skills.
b. People skills.
c. Financial management skills.
d. Technical skills.

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 Why Lab Supervisors Fail
1. Human relations difficulties: The supervisor has trouble getting along with his
staff, peers, or boss.
2. Technical or professional incompetence
3. Character and personality defects. Lack integrity, initiative, fairness, a spirit of
service and emotional stability
4. Improper attitude
5. Lack of management skills

Management Functions of Supervisor

1. Planning: Defining and selecting a course of action

2. Organization: Establishing objectives and bringing the resources to bear on the
accomplishment of the plan
3. Directing: Leading subordinates personnel in the accomplishment of the work
4. Control: Determining whether or not plans are being adhered to

Management Skills required of laboratory supervisor

1. Motivation: Creating a desire to achieve results

2. Communication: Everyone knowing what he needs to know
3. Time management: Making the best use of time
4. Decision making
5. Coordination
6. Training

The New Supervisor

The new supervisor is a person or a " Medical Technologist "who is promoted from bench
work to management.

The supervisor of the laboratory is the man in the middle; he is caught between upper
management and workers. Management expects you maintain discipline, prevent waste,
control costs, keep production rolling and be loyal to the organization. The workers expect
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you to represent their needs and be loyal to them. You were one of them and expect to
maintain the same relationship they once enjoyed. Therefore, a new supervisor should
know how to manage this new position.

1. Relationship with former fellow employees

a. You must change social relationships with former employees, Spend less time with
them and more time with new fellows
b. You must discipline them. Start to say "NO", and that you mean it.
c. Control your tongue (what you say). What you say now has more meaning, they
listen to you more and repeat what you say.
d. keep your employees informed communication, counseling, and couching.

2. Relationship with new peers

a. Develop ties with new peers (other supervisors). They may have doubt about you
and your new position.
b. Keep loyal to employees in your department but keep good contacts with other
supervisors in other departments (nurses, doctors, managers, etc.)
c. Coordinate and cooperate with other sections of the lab or hospital.

3. Relationship with your boss

a. Must earn his respect
b. Keep him informed (writing or talking with him)
c. Use his time (the boss) carefully. Do not bother him with trifles

4. Relationship with your previous job

a. You must restrict nonsupervisory activities only to those you cannot delegate.
b. Devote yourself to learning all those managerial associated with the new job.

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 Chapter 2

The Planning Function

Planning is determining the best use of your resources of money, materials, equipment,
and people to accomplish established goals and objectives.

Planning Categories
Planning in the laboratory falls into three categories:

1. Plans related daily routines: These concerns organizational planning

including:
a. Lines of authority
b. Channels of communication
c. Staffing patterns
d. Work stations
e. Work schedules
f. Vacation and holiday schedules
2. Plans related to periodic duties. These include three major types
a. Physical planning equipment arrangement, inventory control and safety
measures.
b. Process planning: developing lab procedures, methods of requesting and
reporting results, blood collection system.
c. Financial planning: budgets, laboratory charges and cost analyses

3. Creative Planning: this include:

a. How to expand services (new tests, new lab sections, etc.)
b. How to improve lab services
c. Continuing education programs

Elements of the Planning process

1. Assess the need or problem
forecasting and predicting conditions that may occur to what has been
planned for. Examples: Based on experience, the workload may increase by
10 % for the next year. Or a new test for TDM should be introduced in the lab
since many physicians are requesting the test.

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 2. Define goals, objectives, and priorities

Goals of employees, management and customer must be taken care of.

Objectives are another prerequisite for effective planning and should have
following characteristics:
a. Relevant: An objective must agree with the organization's overall objectives and
policies.
b. Understandable: Everyone must understand these objectives
c. Measurable: The objectives must be finite and measurable. For example, the
measurement may be in time, money, standard deviation, number of complains, or
percentage.
d. Behavioral: To meet the objectives, someone should change his behavior.
e. Attainable: Objective must be realistic.
f. Specific: It must stale exactly what to be achieved and when it must be done. For
example, if a lecture to be given by the lab staff once a week, it must be planned “when,
where, what”, etc.

3. Consider Alternatives

Do not stick or adhere to one specific or previously established plan. Look for
alternatives and seek advice and look for other resources.

4. Select the method to be used

Make decisions. Once you have decided, alternatives often will disappear.
5. Determine Procedures for Planning
The procedure outline should answer the questions of " where, how, and
when ". Examples: weekly or monthly meeting schedules, establishing a new
method of analysis. A step - by - step outline must be established.
6. Assign Responsibilities
This include preparing work schedules, assigning specific responsibilities to
individuals, and establishing standards or performance. Also, it is important to
set deadline for an assigned task or duty. The employee would be committed
to achieve that goal on time.
7. Take corrective action
Admit mistakes. If plans failed, take corrective actions and use alternatives.

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 Chapter 3

The organizing Function

Organizing means establishing a structure to carry out decisions made during the
planning stage. It starts with creating a hierarchy and ends with formulating position
description. Organizing also deals with policies, rules, regulations, procedures, and tasks.
Elements of organization may include the following:

1. Organization Chart:
The following summarizes the purpose and functions of an organization chart:
a. Shows ranks from top to bottom
b. Shows lines of communication
c. Shows lines of authority and responsibility
d. Shows that each employee has only one boss

2. Authority
Authority is the power to make decisions, take action, and give orders. A supervisor with
professional ability is well respected by his employees. Therefore, his authority would be
very powerful and very effective.

Degrees of authority
a. DO. The supervisor can do things without getting permission or reporting to anyone.
Example: Refuse do Stat procedure that is not on the Stat list.
b. DO AND REPORT. The supervisor is authorized to do something but then report it to
his boss. Example: Refuse to perform Stat test and then tells the lab director what he
has done.
c. REPORT AND DO. The supervisor get permission before he acts.

In general, however, a new supervisor must know all the authorities that he was granted
through his job or position description. For example, can he:

• Discipline, suspend, fire, employees?

• Exceed budget for overtime?
• Change technical, quality control, or safely procedures?
• Approve an employee's request to attend a meeting?
• Select new employee?
• Call in part - time technologists?

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 Responsibility Authority Degrees of authority
1. Maintain discipline Give verbal warning A
Suspend or discharge C
2.Keep instruments in good Call in outside repairmen B
operating condition Order spare parts C

Chapter 5

The Position Description

Position description is the supervisor's most valuable management tool; effective

inanagement is virtually impossible without it.
Position description is important for each of the following parties:
1. Importance to personnel department

Personnel department cannot select, hire, or nominate employees

without a job description. The minimum requirement for job
description should include the following:
a. Minimum educational requirement
b. Minimum experience required
c. Hours of employment
d. Title and salary
e. Health hazards

2. Importance to the new employee himself

A new employee should know exactly what to expect before accepting new job. Details
should be written, such as:

a. work every other Friday.

b. Work night shifts or holidays
c. Give lectures to medical technology students
d. May work extra hours without being paid for
e. Draw blood early mornings
f. Authority and responsibilities should know, especially for senior positions.

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 3. Importance to supervisors:

Job description would make supervisors to know the following:

a. Their authority and responsibility
b. To know what is expected from each employee
c. To eliminate misunderstanding
d. To avoid duplication of responsibilities
e. To plan for recruitment or hiring new employees

Chapter 6

The directing Function

The directing function of a supervisor is to lead personnel to accomplish work and

objectives planned for. Some of the directing activities of a supervisor may include
the following:

1. Fielding the best team

This involves recruiting and selecting personnel, orienting and training new
employees, and providing instructions as needed .

2. Getting daily results out

This is the most important part of the job. It will be considered a failure iſ results
did not get on time.

3. Insuring the quality of work

The quality of work and reported results must meet standards expected by the
higher authority and by physicians who requested the work.

4. Teaching and introducing procedures and instruments

5. Coordinate activities
He must know the responsibilities and duties of other sections of lab.
He must now the functions of other departments in the hospital.
He must know how to conduct meetings, be able to compromise, be diplomatic,
persuasive, and cooperative.
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 6. Maintaining Morals
Must keep employees satisfied enough to stay on.
Prevent employees turnover. This will destroy the lab.

7. Identify and change unacceptable attitudes

Define the attitude impairing the employee's performance
Find out what caused it and what continues to support it
Remove or weaken those supports
Substitute a healthy or acceptable attitude

Some Typical Managerial Mistakes

1. Trying to be liked rather respected

2. Communicating poorly with employees

employees like to know about changes that may affect them
They like to be appraised when they do well
They like to be told when they are not performing well

3. Failing to Delegate
Give employees some responsibility and some authority

4. Criticizing Poorly
Accusing or blaming employee without getting all facts
Criticizing in front of others
Inconsistent in giving orders or maintaining rules

5. Playing favorites and ignoring right and complaints

6. Failing to ask subordinates for advice and help

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 Chapter 7

Recruitment and Selection of Personnel

A. How to Select Employee

1. Review Position Description

• Do not depend of personnel department to select candidates
• Check experience, education, and qualification requirements
• Always look for high standard qualification

2. Seek Candidates
• Post job opening in laboratory
• Review ex-applicants
• Advertise job in local paper and in professional journals
• Check with employment agencies

3. Initial screening of applications

• Check for each applicant's experience and education
• Check for each applicant's of previous jobs
• Length of previous employment
• Salary Requirements
*** This screening will bring applicants to minimum

4. Arrange for an interview

• Decide who will do it? Personnel department, lab director or supervisor?
• Decide how to do the interview? In groups or in individual?
• Check for convenience of candidate and interviewers

5. Interview the candidate

6. Obtain additional information

• Contact previous employer (Prepare specific questions)
• Talk to candidate's immediate supervisor
• Ask the previous employer if he can talk about the candidate
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 Example of questions to be asked:
− Date of employment
− Duties of employee. How did he do it
− Would you hire him again
− How was his attendance.
− How his relationship with others
− Would he take night, evening, or holiday shifts?
− How was his performance (Weakness and strengths)?

7. Make your Selection. Notify successful and unsuccessful candidates

B. The Pre-Employment Interview

Objectives interview
a. To select the best candidates
b. To sell the job to the candidate
c. To make the candidate know about the job and people whom he is going to
work with
d. To present the lab and hospital to candidates: to make candidate leave with
good impression about the hospital and its administration

The interview

Can be done by groups of people or by individual person.

An interview by an individual person is better than by a group, especially if it is
done by the supervisor of the lab. This is because the supervisor knows exactly what
to ask and the candidate will feel more free to talk about his capabilities.

Steps of the interview

1. Preparation
• Review position description
• Review qualification of candidates
• Review applicant's history of employment
• Arrange for interview: Dale, time, and place
• Arrange for few interviews
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 2. Establish Rapport (Relationship, link, or communication)

• Meet the candidate in reception room. Greet him by his name

• Introduce yourself to him and who are you
• Do not sit behind your desk
• Use small talk to reduce stress
• Offer him coffee or tea
• Give him full attention

3. Determine the candidate Suitability

• Ask him easy, understanding questions. For example: tell me about your
daily routine about your previous job?
• Ask him about his special interest and strength, weakness ....
• Ask few technical or professional questions. (Not an exam-type questions.)

4. Terminating Interview

• Summarize his qualities that applicable to position

• Tell him when you will make your choice
• Give him an idea about his chances (Do not exaggerate)
• Ask about the best way how to contact him
• Ask when he would be available to work

5. Post-interview evaluation and documentation

• Prepare immediate summary of the interview

• Indicate if he/she is qualified
• Evaluate how he will get along with you and the other stuff
• Do feel uncomfortable about this candidate? why if yes.

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 C. Effective Interview Technique

1. Use good questions

• Use closed (directive) questions for specific information. Example:

Questions that answered with Yes or No, such as " Are you available now ".
• Use open ended (nondirective) questions to assess subjective elements
such as attitudes, goals, and motivation.

2. Do not use forbidden questions

3. Use pauses
Wait at the end of an answer the candidate to continue. Use phrases sus as
"I see ".

4. Use the reflection technique

Paraphrase what the candidate says. If he said, "My previous supervisor
assigned me nothing but routine work ", you could respond with, "You
thought you were capable of something more; right ?"

5. Note the kind of questions the candidate asks

Do the questions concerns opportunities for education, promotion, the
work itself, or only pay and fringe benefits?

6. Limit Detailed taking

• Detailed note taking during an interview can make candidate uneasy.
Simply take short key notes.
• You may make a list of certain qualities such as training, experience,
appearance, personality, motivation., etc. and write number after
each item to a rating system .

7. Watch for clues to personality and attitude

• Listen carefully and watch the body language, you may get important
clues .

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 • Is he communicative or withdrawn? Does he has odd manners? What
impression you get when he answers questions relating to likes and
dislikes?
• Observe his maturity in answering questions: Try to get positive and
negative attitudes.
• You should like candidates who say good things about previous
employer and supervisors, and you should be worry about those who
says nothing than complains and saying bad things about ex-
supervisors. They may do the same for you in future.

Chapter 8

Decision Making and Problem Solving

A. Introduction

Why do we Have to make a decision??

• To prevent the occurrence of problem (Preventative measures)

• To Solve existing problems (Therapeutic measures)

Who should make the decision??

• The person who have authority

• The person who is very close to the problem

** But remember that Rules, Regulations, and Standards of the lab would
prevent or reduce the frequency problem occurrence and decision making.

When should you NOT make a decision??

• When the problem or issue is not yours. But give encourage
concerned person to make up his mind. if you advise him or try to
make a decision for him it would be as follows: He will take the credit
if it was good, and you will take the blame it was wrong.

• Do not take a decision when you do not have the authority. Give
advice only.

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 • Avoid decision making by ignoring the problem. You can say that you
need more time to think about it or you will discuss it with your boss.
BUT do not do this very frequently

B. How to handle big decisions

Step 1: Identify the problem

• Understand the problem before solving it.
• Spend more time on defining the cause of the problem.
• Write memos prevent occurrence of problems.

Step 2: Get the Facts

This can be done by asking questions.
For example: The problem is: Delay in getting glucose results on time.
Questions to ask:
• What time blood received in the lab
• When the specimen was collected
• What is the cutoff time for accepting specimens?
• Who deliver or perform the test?
• How many complaints are made and who mad them?

Step 3: Consider possible solutions

You should list all possible solutions, then evaluate them

Step 4: Make your decision

Making the decision should be based on the following:
• Previous experience of your own or others
• Comparison of advantages and disadvantages.
• Consideration of long -range effects

Step 5: confirm your decision

Step 6: Implement the decision

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