lab management 2

a. Compactness

b. Consistency of terminology, format and usage and under stability

c. Clear and easy to understand

d. Logical and accessible location in medical chart

e. Statement of date and time of collection

f. Gross description and source of specimen when pertinent

g. Sharp differentiation of reference or normal and abnormal values.

h. Sequential order of multiple results on single specimen

i. Identification of patient, patient location and physician

j. Assurance of accuracy if transcription of request.

General qualities of a Laboratory Report

2\. Verbal Reports

● It constitute a major problem for most laboratories. It is essential that verbal or telephone communication must be given in order to facilitate medical care, particularly in an emergency situation. On the other hand, this is major potential source of errors and medical liability.

● A minimum, the laboratory should require proper identification of the person receiving the report. The person giving the report should repeat the patient’s name, identification number and location along with the results in order to further confirm the identification.

● Hand-written results on either blank or pre-printed form - it has the advantage of being 21 reliable and relatively inexpensive, but it is subject to error.

● Facsimile transmission, a process similar to photocopying a document, but done electronically to a remote output device - gives an exact facsimile of the original test report but has the disadvantage of being more expensive, generally slower in some cases less reliable.

● A permanent report from the laboratory in the usual format would follow for medico-legal and medical record purposes:

1\. Patient identification, usually in the upper right hand corner. Provisions should be made for either hand written or printed information.

2\. The date and time of specimen collection and identification of the person who collected the specimen.

3\. The measurement or examination requested. When the same requisition is to be used for reporting, appropriate space for the results should be included.

4\. Date and time of reporting and the initials of medtech performing the determination.

5\. The identification of the laboratory. It is also desirable to have imprinted on the form, the name of head of the laboratory and/or associate Pathologist of the laboratory section in which the requisitions is used.

Alternative Methods to Verbal Reports

DATA

raw elements or single facts that by themselves have no meaning but when organized and evaluated together have the potential to reveal information.

Information

data have been processed, sorted and presented in such a manner that in increases the knowledge of the user

Information System

a collection of interlinked and dependent parts that are organized to collect and input data, process the data into information, output of the information, to users to provide feedback to the system with the goal of meeting the complete informational needs of the organizations.

HARDWARE

the physical (plastic, wire) parts of computer.

a. Central Processing Unit – electronic portion of the computer; includes controlling unit and the quantitative analysis and data processing unit.

b. Input devices – include keyboards, bar code readers, computer links.

c. Output devices – include printers and screens to disseminate information

d. Computer memory and data storage.

e. Data Storage devices

Application software

program designed to meet specific needs of the users, such as word processing, pay roll, blood bank inventory management.

System Software

programs designed to control and run operating systems of the computer including communications, application software and database management

Local Area Network (LAN)

a computer network that connects computers and their equipment in a 22 confined area, usually a building or a place in which the users are in close geographic proximity to each other.

Wide Are Network (WAN)

a computer network that connects computers and their equipment over a large disbursed geographical area such as state, nation or the whole world, usually through the facilities or common carriers such as telephone lines or satellite channels.

Host based Lab Information Systems (LIS)

LAN interfaced with central controlling CPU whose program determines hoe data are received, processed and disseminated.

Client server LIS

an open system that allows users to tap into the LIS with their independent computer systems, extract only the information they want, and present it in formal they wish on their own computer screen or printer

PERSONNEL MANAGEMENT

The responsible laboratory head should be concerned in the development of human resource to its optimal level, as management has been defined as “getting things done through the efforts of other people.” this requires an understanding of those factors affecting motivation and those techniques available for personnel management.

MOTIVATION

● The day-to-day operation of the laboratory and the motivation of the persons in the laboratory will determined to a large extent by the management style of those responsible for directing the institution, the laboratory, and various laboratory sections.

● Management styles are determined by a person’s personality and previous experience, but can modified if a conscious effort is made.

Maslow’s Theory

Herzberg’s Theory

Mc Gregor’s Theory

Mc Clelland’s Achievement Model

Alderfer’s Theory

VROOM’S EXPECTANCY THEORY

ADAM’S EQUITY THEORY

SKINNER’S REINFORCEMENT THEORY

THEORIES OF MOTIVATION

Maslow’s Theory

Maslow’s hierarchy of needs theory prioritized human needs into five categories namely physiologic, safety, social, self-esteem and self-actualization.

a. Physiologic

b. Safety and security

c. Belongingness

d. Self-esteem

e. Self-actualization

Herzberg’s Theory

cites importance of needs satisfaction and proposes that some work place or job related factors can generate dissatisfaction in the employees whereas others offer promise as motivators. He suggested the following motivators as an integral part of job:

a. Achievement – feeling of making difference and having sense of contribution and accomplishment.

b. Recognition – for one’s roles in the success of the group.

c. Challenging – work that reinforces employee’s conflict.

d. Responsibility – feeling that one is in control of one’s future.

e. Professional Advancement / Professional Growth - chance for advancement.

Mc Gregor’s Theory

described the two extreme management style.

a. Theory X Style – still exists in any medical care settings. Little delegation of authority and sharing responsibility. Management style based on the assumption that people hate work; that they have to be driven, threatened and punished to achieved organizational goals (such as good patient care) and they lack ambition and want only security.

b. Theory Y Style – Authority and sharing responsibility. Theory based on the following assumptions:

1\. People don’t have to be forced or threatened to work

2\. Work is considered as natural as rest or play

3\. They will commit themselves to external organization only to the extent that they see ways of satisfying their own internal ego and development needs

Theory Z Style

theory is relationship oriented; democratic leadership style; participative management, shared authority, responsibility and accountability

Mc Clelland’s Achievement Model

ties the strength of behavioral motives to the individual’s 23 assessment of likelihood of achieving a specific goal. This further proposes that even though that there are definite needs that provide explanation for behavior, the strength of a specific motive is directly linked to the opportunities offered by situation. This theory needs the following work related needs:

a. Achievement needs - job and career success (self-actualization)

b. Power needs – control and influence

c. Affiliation needs - warm, family relationships.

Alderfer’s Theory

\- ERG Needs Theory

E – xistence needs; physiologic needs.

R – elatedness needs; interpersonal relationships, acceptance and belonging

G – rowth needs; creativity, challenge and personal growth on the job

6\. VROOM’S EXPECTANCY THEORY

● This is process of making choices in direct response to the expected potential for rewards. This motivational theory holds that:

a. Effort will bring rewards.

b. The effort expended will be related to the perceived value of the reward to the person.

The following variables influences the selection decision: 1. Expectancy – the belief that effort brings performance and performance leads to rewards.

2\. Outcome – the perceived expectancy that the outcome from the effort (reward) will actually be realized.

3\. Instrumentality – the degree of faith in the belief that current efforts may make possible achieving even larger or more long-term rewards.

ADAM’S EQUITY THEORY

Propounded by J. Stacy Adams. This theory holds that employees are motivated by the degree of equity that they perceived in their work situation, especially compared with people in similar positions. Key concepts include comparison and perception.

SKINNER’S REINFORCEMENT THEORY

based on the observation that we tend to behave according to the way we are treated. This focuses on the environment rather than on needs, motives, and personality as an explanation of behavior. Example: wage is directly proportional to performance evaluation.

SKINNER’S REINFORCEMENT THEORY Components

a. Law of Effect (E.L. Thorndike) – states that we act in response to expected consequences. Example: provide pleasures-recur; discomfort-avoided.

b. Stimulus – an event that leads or influences to a response.

c. Response – behavior that results from a stimulus.

d. Reinforcement - consequence of an action or response.

e. Behavior motivation – the application or practice of reinforcement.

1\. Structured – formal and list of questions, standardized checklist, interview form.

2\. Unstructured – band agenda, free to discuss any issues, allows spontaneity.

3\. Stress interview – expose to dangerous, intimidating situation (police officers), problem solving session (job related problem).

different Interview Strategy

1\. Preparation – review information (job description) and data submitted (resume preferences).

2\. Establishing rapport – make him relaxed and comfortable.

3\. Questioning and information exchange – obtain information

4\. Listening – assumes understanding, clarifies intent, demonstrate interest.

5\. Cleansing and Follow-up – brief review to clarify information. Opportunity to ask questions.

6\. Evaluations – check list, fill-up form, impression, recommendation

Interview Process

Recruitment

● It is the process of locating and attracting qualified job applicants.

● It is the searching stage, designed to build a pool of candidates from which to select the person suited to fill the position. The objective of recruitment process is highly dependent on the conditions of the labor market.

a. Tight labor market

b. Open Labor market

those who are already known to the manager or human resources department, either personal knowledge or because their applications are on file; and candidates campaign.

Sources of Recruits

employees that are change in duties, focus on identifying persons who want to improve their positions. Candidates may acquire new skills and jobs through in-house, on-the-job training programs or by obtaining a promotion

Inside sources –

Inside sources

the database of employees seeking lateral and vertical moves should be available from the performance appraisal systems and the employee development programs, in which the attributes and aspirations of an employee have been identified and become part of individual’s and organization’s long term plans.

Outside Recruitment

there are reasons and advantages to looking outside the organizations as well some more legitimate than others:

a. Acquisition of new skills, knowledge and expertise

b. Need for improvement in performance; that is management is unhappy with the way things are going.

c. No suitable in-house candidate.

d. Low morale, group dissension or rivalry.

e. A worthy candidate who deserves a chance maybe somewhere else in a large corporation.

f. First-time managers have a high failure rate (80% of new supervisors fall in their first management situation because of a lack of training and commitment by the organization.

Position Classification

● A method for position classification has been developed. This involves determining the different kinds or classes of positions existing in the institutions.

● Each class is consists of all positions regardless of departmental location that are sufficiently alike in duties and responsibilities to the descriptive title, to have the pay scale and to require substantially the same quantification.

● Within its class, such as Medical Technologist I, Chief Medical Technologist or Senior Medical Technologist, a number of pay steps are established. This provides a means to compensate the experienced employee at job entry.

1\. Director – a physician or holder of bachelor’s degree or higher in a science discipline with corresponding experience.

2\. Technical consultant – same as Director’s qualification

3\. Technical supervisor – same as technical consultant qualification.

4\. Clinical consultant – a physician or a Doctoral level scientist.

5\. General supervisor – a laboratorian with an associate degree or higher in a medical laboratory science / medical technology and two years of training and experience in a high complex laboratory.

6\. Testing personnel – a person performing tests in a high complex laboratory. Must have at least an associated degree.

Job positions:

Orientation

● Formal introduction of new employees to the organization and their duties.

● Orientation program is one of the most overlooked tools available to the manager.

● Each laboratory shall have their own program of orientation for new employees. Even though a new employee is a registered medical technologist, but his experiences with a particular procedures in use in a new environment may be limited.

● During this orientation it should be emphasized that suggestions for changing procedures or methods are welcome and will be given due consideration, but each employee must follow the laboratory method and procedure exactly is prescribed.

● If done correctly, orientation can establish early in the employee’s career an understanding of the philosophy of the laboratory and the institution.

● It can correct those misunderstandings that are so often present with employees and can establish in the beginning an open channel of communication between the supervisor and the new employees.

1\. Job description duties and responsibilities.

2\. Overall objectives of the laboratory and employee’s role.

3\. Employee evaluation form and how it is used.

4\. The departmental organization and the “key personnel.”

5\. The location of the procedure manuals and their contents.

6\. Time records and they are handled.

7\. Laboratory policies relative to meal time breaks, Service incentive leave, off and holiday scheduling.

8\. Employee’s role in fire and disaster plans.

9\. Employee’s privileges.

10\. Schedule of duties (regular, night and special)

The following is a minimum list of items that should covered in the orientation:

● Orientation is only the start of a relationship between the individual and the organization. This activity is referred to as human resource management and consists of the following components:

1\. Wage and Salary Administration

2\. Staffing and Scheduling

● The supervisor and the personnel department have the responsibility to ensure the well-being of this association and the productivity and coherence of the workforce.

Human Resource Administration and Supervision

● Compensation is the most visible aspect of the personnel process. Both the institution and the employee are reminded of this fact every payday. The goals and objectives of the wage and salary administration program include:

a. Recruiting highly skilled and qualified staff.

b. Maintaining a stable workforce.

c. Maximizing productivity through incentive plans that reward desired behavior.

d. Controlling labor costs.

e. Complying with legal regulations

f. Meeting social and cultural expectations and goals.

1\. Wage and Salary Administration

a. Paycheck – represent the amount of money the employee can take home.

b. Benefit package – important part of total compensation package and are supplements to the cash payment of salary and wages.

1\. Medical, disability, and life insurance

2\. Retirement plans include contributions from both employer and employee.

3\. Paid time off for sickness, vacations, holidays, and continuing education

4\. Tuition reimbursement

Total compensation package consists of three elements:

Minimum wage rate

Minimum wage rate

– wage and hour laws that require employers to pay overtime to employees who work more than 40 hours in a 7-day calendar period

Overtime pay

40-hour rule:

8/80 hour rule

Overtime pay:

– a special provision to the wage and hour law that allows health care employees to work extended periods of time outside the 40-hour rule and set overtime pay when they exceed 80 hour in a 2 week calendar period or work more than 8 hours in a single day

Point System

Overtime pay

– this method is the most popular because it attempts to consider all the components of a job in comparing one job to another. The typical model allocates points to four broad groups of factors: skill, effort, responsibility and working conditions.

Factor comparisons

Overtime pay

– this method focuses on determining the relative worth of a job by comparing it to other jobs in the organization on scale that assigns a monetary value to each factor and is then totaled to give the wage rate for a specific job.

a. Determine the number and type of personnel needed.

b. Recruiting

c. Interview

d. Induction/orientation

e. Hiring – pre employment testing, physical exam (mandatory), selection/placement and evaluate for permanent position

● An important part of employee development is feedback, whether negative or positive. This can be accomplished thorough random meeting, memorandum to the full or through a structured evaluation system.

● The latter offers the opportunity for the employee and supervisors to take time to review past performance, as well as to project future expectations. It provides the framework within which constructive criticism can be given and provides the vehicle by which relationships can be refined.

● For fairness and uniformity, the format should be used for all employees.

Steps in the Staffing Processes:

Adaptability

ability to change the behavior, attitude and work methods to meet demands of the situation

Attendance

faithfulness in coming to work and conforming the assigned job duties

Quality of Work

accuracy thoroughness and precision of work performed.

Job Knowledge and skills

the employee’s of his training and experience in performing the assigned job duties.

Quantity of Work

amount of work performed in comparison with normal amount expected

Work relationships

Quality of relationships with coworkers, supervisory staff, patients and the public.

● It is desirable to have a regular continuing education session for laboratory staff.

● Laboratory staff can develop this, and the head of the laboratory with outside participants are needed.

● The staff should be given time and encouraged to attend, appropriate medical staff meetings in the institution as well as continuing education programs in the laboratory medicine elsewhere.

● Documentation of attendance at such meetings, as well as topics covered should be maintained to meet accreditation requirements

In Service Continuing Education

Intralaboratory communications

enhanced and crisis minimized regularly scheduled meetings of laboratory heads, associates, supervisors, and staff held.

● All institutions maintain some personnel records on employees, but the laboratory may wish to keep a duplicate set of records for their use.

● If so, consideration should be give to what information should be, and legally can be kept in these records.

Personnel Records

● Some employees will fall short of expected standards. When the situation arises, decisive action is imperative. No action is not acceptable approach how much to take will depend upon the type of infraction and the circumstances surrounding it.

● Examples of failure of performance of duties req. disciplinary actions

1\. Incompetence

2\. Negligence

3\. Physical or mental incapacity

4\. Habitual and improper use of SILs.

5\. Failure to maintain satisfactory and harmonious relationships

● All of these have in common the failure of the employees to meet standards related to the quality of work.

● When a disciplinary action becomes necessary because of failure of performance of duties, the following steps are usually considered essential. Following steps are considered essentials:

1\. Oral warning

2\. Second oral warning with letter

3\. Written formal warning

4\. Notice of dismissal

Discipline and Dismissal

1\. Conviction of felony

2\. Willful damage, destruction or theft of property

3\. Falsified job information to secure a position

4\. Possession of unauthorized firearms or lethal weapons on the job.

5\. Insubordination

6\. Reporting to work under the influence of alcohol or non-prescribed drugs, or partaking of such on the job.

Some examples of job-related personnel conduct requiring disciplinary action:

Written specification

detailed descriptions of required equipment

● For budgeting purposes, products that meet specific time and price criteria are classified as supplies. Items that fall outside the criteria are classified as capital items. Moreover, supplies may be classified as:

a. Items that are consumed within 1 year or have a shelf life of less than 1 year.

b. Items below a certain price level, as established by the controller even though their shelf life exceeds 1 year.

Purchasing of Supplies

1\. Only authorized staff members who are familiar with the quality of service and reliability of supplies should place orders.

2\. Delivery schedules are a major factor in determining whether a purchasing system in in or out of control

3\. High-use items should be delivered frequently.

4\. Excellent methods of doing this and can save the laboratory time and money is through the purchase orders.

Following considerations in purchasing supplies:

Purchase order

document authorizing the purchase of a product or service from vendor

Release orders

contracts in which company agrees to deliver goods at a predetermined prices as notified by the laboratory

Standing order

annual contract in which the company agree to deliver goods at a predetermined price and on an established schedule.

● Goods should unpacked and inspected as soon as possible to ensure that every things is delivered or that some acknowledgement of back ordered is made.

● Damaged or defective goods should identified early in order to assure replacement credit.

● Three pieces of information must agree before the company’s bill will be paid by the most accounts payable systems.

1\. The purchase request must agree with the invoice.

2\. The invoice must agree with the packing slip.

3\. They must all agree with the final bill from the company.

● Any non-payment between the figures results in payment to the company being withheld.

Receiving and Accounts Payable

Inventory management:

1\. Perpetual system – keep account of the inventory each time a product is used.

2\. Periodic system – is more common at the bench department level.

3\. Random checks – such as the annual inventory are used to document the value of supplies at a specific time

is a continual process of checking stock levels, rotating stock to ensure freshness or ordering supplies in sufficient quantities to meet current needs, and minimizing the cost of carrying order inventory. An inventory check is performed at least once a year.

There are three methods of tracking inventory levels namely:

1\. The low level is a point on which on hand supplies are sufficient to carry the laboratory through until goods are received.

2\. The upper limit is that level which will meet the laboratories requirements for a longer period of time, such as several months or a year.

Inventory levels are set at low and high points:

Minimum-Maximum

Stock Replenishment Technique

Determining when and how much to reorder is to establish a set point (minimum) at which inventory is to be recorded and a “reorder to” (maximum) level to be maintained.

Just in-time

Stock Replenishment Technique

This is a commitment of the supplies to guarantee the delivery of the item at the exact moment of need. This limits the financial costs associated with stocking and storing inventory items. This technique is more opportune in manufacturing, in which costs of failure is limited to monetary loss.

Economic ordering quantity

answers the question of how much to order

Economic ordering point (EOP)

also referred as reorder point (ROP), which provides the base or safety level of reordering inventory.

Optimal reorder time (ROT)

which helps to establish the best times to order to take advantage of the EOQ ad EOP.

● In order to determine the EOQ, EOP and ROT, managers must understand certain underlying concepts relating to inventory.

a. Annual usage – determining level of inventory needed is based on the workload of the laboratory. Historical ordering data based on the actual purchases and usage as well as predictions of future volume influences the anticipated level of supplies that must be ordered.

b. Average Daily Usage – this information can be obtained by dividing the amount of supplies ordered in a year by 365 days.

c. Cost of Ordering – the cost of running a centralized purchasing department is directly tied to the number of purchase orders placed and the associated works involved with keeping track of invoices as products are received and shipped.

d. Annual Holding Cost – it involves decisions based on bulk orders, space utilization and whether it is better to have the product on hand or in the supplier’s warehouse.

e. Cost per Unit – is a straightforward calculation once the decision has been made as to the best price available. Factors such as quantity discounts and container size (e.g. box case, truckload) affect this decision. Dividing the purchase price by the container size provides this value.

f. Lead time – also known as advantage notice, needed between placing an order and its arrival is an especially important consideration. It influences the minimum inventor that must kept in stock, as well as the quantity that needs to be requested

Quality Assurance

The right result, at the Right time, on the Right specimen, from the Right patient, with result interpretation based on Correct reference data, and at the Right price

Quality Assessment

involves Internal Quality Assessment and External Quality Assessment.

Quality Control

evaluation and validation of the test; Internal quality control; and Equipment evaluation and validation.

1\. Quality Assessment

2\. Quality Control

Elements of Quality Assurance

A system designed to increase the probability that each result reported by the laboratory is valid and can be used with confidence by the physician making a diagnostic or therapeutic decision.

What is Quality Control in Clinical Laboratory?

● The goal of QC is to detect errors and correct them before the patient’s results are reported.

Monitoring the Quality of Laboratory Measurements

● Clinical laboratories perform qualitative, semi-quantitative, and quantitative tests on a variety of biological specimens.

Purpose of Quality Control

1\. QUALITATIVE Quality Assurance

● These are tests in which a particular characteristic of the specimen is determined to be either present or absent. These are called binary discrete variants.

● Ex. Blood typing or Microbiologic identification in specimen.

● Results are in the nature of Positive or Negative; Reactive or Nonreactive.

● Examination shows what particular characteristics are present or absent in specimen.

2\. SEMI-QUANTITATIVE Quality Assurance

● These are the test in which the degree of positivity or negativity is roughly estimated, usually by visual identification.

● Example is urine dipsticks, chemical test such as benedicts etc.

3\. QUANTITATIVE Quality Assurance

● These are the test in which some instrument measures the amount of particular substances, property and the result is expresses numerically. Example is Chemistry and Hematology Tests.

● Shewhart set the basic principles of industrial quality control in 1931.

● Measurements were made of items produced by a machine or sequence of machines and theaverage value and range of values of the measurements were determined. ● Tolerance limits are an acceptable product than were established, and product uniformity could be assured by continual surveillance of their critical measurements to detect deterioration of machine performance and by correction of problems as they become evident. ● Most quantitative analytical procedures involved several operations or steps and each operation is subject of some degree of inaccuracy or imprecision to the possibility of mistake. ● The attainment of these intra- and inter-laboratory aims require that all laboratory personnel-technologists, supervisors and directors be knowledgeable of the causes of analytical inaccuracies and of the techniques that are available for their detection, correction and control. ● Knowledge is required of the degree of the inaccuracy and imprecision allowed if analytical values are to be clinically useful

● Quality is like love, everyone knows what it is, but no one knows exactly how to describe or measure it.

● To develop a plan to assess and ensure the quality of the services delivered by the laboratory, the manager must have a full understanding of both the history and philosophy of quality as well as knowledge of specific statistical technique and their application to the laboratory.

Quality Concepts

1\. Quality Control (QC)

● Study of errors and focuses on the test procedures.

● Refers to the standards and techniques the measure the quality of the product in the isolation from the needs of the customer or patient.

● It relies heavily on quantitative statistical methods that focus on the final product as defined by standards set by the producer.

● It refers to specific activities directed toward monitoring the individual elements of care (ex. Instrument and test procedure).

● Example, if the laboratory tests fall within the acceptable QC ranges established for the items (QC Model), the technologists are secured that they are turning out a high-quality result.

● Quality control in Laboratory Medicine has been defined as the study of those errors, which are the responsibility of the laboratory and the procedures used to recognize and minimize them.

● Quality Control Programs have been an integral part of the inspection systems by the Health Facilities and Services Regulatory Bureau (HFSRB), Department of Health. The supervising pathologist should insure that the quality is organized for periodic review or every major portion of the clinical laboratories and that the program can be documented for the inspector.

2\. Quality Assurance (QA)

● Overall activities conducted by the institution that are directed toward assuring the quality of services provided.

● Quality assurance focused on the recipient – the patient. Furthermore, QA focuses on the monitoring of outcomes or indicators of care.

3\. Total Quality Management (TQM)

● Quality management program includes each component (customer, producer, and supplier) in the creation process from the acquisition of supplies to active follow-up after the product or service have been received by a delighted customer.

● JACHO and ISO – organizations that conducts continuous performance improvement program.

4\. Quality Assessment and Improvement (QAI)

● It focuses on the success of the organization in designing and achieving its set of goals and objectives (continuous performance improvement). JACHO established nine dimensions of the performance improvement plan such as

a. Efficacy

b. Appropriateness

c. Availability

d. Timeliness

e. Effectiveness

f. Continuity

g. Safety

h. Efficiency

i. Care and respect

1\. PHILIP CROSBY

Major Figure in Quality Management :

● Evangelist of Quality Management by preaching, “Quality is Free.” He propounded that:

a. Quality is Free. Poor Quality is expensive.

b. Do things right the first time

c. Zero defects is the only legitimate goal of quality program.

2\. W. EDWARDS DEMING

Major Figure in Quality Management:

● Proposed the 14 TQM points to bring about a “delighted customer”

1\. Create constancy of purpose toward service improvement.

2\. Adopt the new philosophy

3\. Cease dependence inspection to achieve quality.

4\. End the practice of awarding business solely on the price tag

5\. Constantly improve the process of planning, production, and service

6\. Institute training on the job

7\. Institute leadership for people and systems improvement.

8\. Drive out fear in order to encourage employees to work together.

9\. Breakdown barriers between Departments and work areas.

10\. Eliminate slogans, exhortations, and producing targets.

11\. Eliminate numerical quotas for management and the workforce.

12\. Remove barriers to pride of workmanship

13\. Institute vigorous programs of education and self-improvement for everyone in the organization.

14\. Put everyone in the organization to work accomplishing the transformation.

3\. JOSEPH DURAN

Major Figure in Quality Management:

● He established the concept that QUALITY is a continuous improvement process that requires managers active pursuit in reaching and setting goals for improvement.

● He was the leader in promoting PARTICIPATORY management styles. He pointed out that it was necessary for all employees to be included in and committed to the continual process of designing and producing a quality product.

4\. JAMES O. WESTGARD

Major Figure in Quality Management::

He propounded the MULTI-RULE SYSTEM in the evaluation of the quality control data in the medical laboratory, particularly the multi-ranged controls used in Clinical Chemistry (Westgard Rules).

ACCURACY

– the closeness of the result to the true or actual value of an analyte when running the test; more commonly called “hitting the bulls-eye.”

PRECISION

how well a procedure reproduces a value.

DATA POPULATION

a term used in statistics to describe and define the items that are being studied at a particular time.

POPULATION SAMPLE -

part of a population that is used to analyze the characteristics of that population.

● Slovin’s Formula

● Lynch et.al. Formula

● Cochran’s Formula / Modified Cochran’s Formula

GAUSSIAN DISTRIBUTION

describes the statistical phenomenon whereby members of the population are usually evenly disbursed around the population mean.

● Also called BELL SHAPE CURVE, NORMAL DISTRIBUTION FREQUENCY POLYGON, and LEVY JENNINGS CHART.

● Uses the criteria of Westgard rules and the performance limits of Levey-Jennings Charts.

Example:

68\.2% are within 1SD of the mean

95\.4% are within 2SD of the mean

99\.7% are within 3SD of the mean

MEAN (X) –

– the arithmetic average of all data contained in a sample population or an algebraic test.

STANDARD DEVIATION

– a measurement of precision or the tendency of the values in each population to cluster center or scatter around the mean.

COEFFICIENT OF VARIANCE (CV)

– the standard deviation expressed as a percentage of the mean; considered a measurement of precision and variability.

CIRCLE or PIE CHART

GRAPHICAL PRESENTATION IN STATISTICS:

– circular figure with areas marked off. Shaded or sketched according to percentage or each component compared to whole

BAR GRAPH

GRAPHICAL PRESENTATION IN STATISTICS:

helpful in resenting comparative interpopulation and intrapopulation factors.

LINE GRAPH

GRAPHICAL PRESENTATION IN STATISTICS:

useful for plotting and tracking data over a period of time. This is very adaptable for displaying historical data