LABORATORY MANAGEMENT

Lecture 4

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

laboratory2. Formulating policies to carry out objectives3. Developing intermediate and short - range plans to

implement policies4. Stating detailed procedures for implementing each

plan

• 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

Organization Hierarchy

Planning & control mechanisms

Laboratory Planning & Control Structure

Organization Hierarchy

Planning & control mechanisms

Deals with

Deals with

Deals with

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.

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

Establishing Policies and Procedures• Variations• Origin• Characteristics

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

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

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:

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 Saturday3. Schedule appointments for all outpatients

• 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

• 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

Problem Solving• The steps for solving a problem involve:1. Definition of the Problem2. Fact – gathering3. Development of alternative

solutions4. Weighing of alternative

solutions5. Selection of solutions6. Implementation of the solution7. Measurement of consequences

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

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

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

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

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

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

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