Lab management

1\. Administration

2\. Patient care service

3\. Research

4\. Teaching

Activities in clinical laboratories are divided into four categories

Clinical laboratory

among the hospital services that produce some of the revenue needed to offset hospital costs for which patients are not billed.

● It performs complex analyses and examinations such as the following:

1\. To confirm clinical impression or establish diagnosis.

2\. To rule the diagnosis

3\. To monitor the therapy (management guide)

4\. To establish prognosis

5\. To screen for or detect disease.

MANAGEMENT

the art of getting things done through people

a distinct process consisting of planning, organizing, leading, and controlling, which are performed to determine and accomplish the objectives by the use of people and resources.

is the effective motivation of men and the efficient utilization of resources for the attainment of a predetermined objective.

a process, which includes both interpersonal and technical aspects through which the objectives of an organization are accomplished using resources efficiently and effectively.

1\. Mission- goal of the organization or sub-unit expects to accomplish.

2\. Authority - needed to direct the team toward the goal.

3\. Resources - includes people, equipment, supplies and money

4\. Responsibility - for achieving the goals assigned

5. Accountability- for using the resources established.

Ingredients of Management

Management as ART

results from the accomplishment of objectives by the use of human efforts. It requires skill and careful study of its application.

Management as SCIENCE

because it is a systematic body of knowledge. It gathers and analyzes facts and formulates general law or principles from these facts.

Management as an ART and SCIENCE

management seeks to integrate into a unified, coordinated whole of all the essential factors that make up an organization

1\. Planning

2\. Organizing

3\. Directing

4\. Controlling

FUNCTIONS of MANAGEMENT

PLANNING

● It is a mental effort by which executives anticipate the possible causes or factors that may affect or change the activities and objectives of a particular organization.

● It controls the nature and direction of change and determines what measures or actions are necessary to accomplish predetermined goals.

● In planning, efforts should include several possible alternative courses of action that may be taken under the circumstances.

● Relative activities are as follows:

a. Forecasting = estimate future > vision

b. Set objectives - determine results desired

c. Develop and schedule of programs = define activities needed and set time frame.

d. Preparing the budget = allocate resources

e. Establish policies and procedures = establish definite courses of action and methods.

ORGANIZING

● Also included are the following activities:

a. Set up organizational structure = identifying groupings, roles, relationships.

b. Determine staff needed and maintain staffing patterns = distribute in areas needed.

c. Develop job descriptions = define qualifications and functions of personnel

d. Establishment of relationships taking into consideration the organizations principles such as:

1\. Unity of commands

2\. Limited span of control

3\. Delegation of responsibility

4\. Homogeneous assignment

5\. Integration of work

DIRECTING

● Refers to the way of getting all personnel in an organization to accomplish what management desires. It is telling what each man should do and making him like doing it.

● It involves both motivation and communication.

● Also includes the following activities:

a. Effective utilization of executive ability

b. Delegates duties and responsibilities

c. Supervise harmonize goals through guidance

d. Coordinate - unite personnel and services

e. Communicate - ensure common understanding of various routes.

f. Develop people - provide staff development

g. Decide - making judgment

h. Securing the cooperation of all personnel

CONTROLLING

● It means checking the work accomplished against the plans or standards and making adjustments or corrections when new developments or unforeseen circumstances necessitate.

● The bases for controlling are standard quantity, standard quality, standard cost and standard time. Three aspects are involved namely planned performance, measure of actual performance and corrective measures.

● It also includes the following:

a. Performance appraisal = assess, interpret, correct and apply discipline.

b. Determination of performance standards = specify criteria and standards.

c. Measurement of performance

d. Monitor and evaluate performance

Scientific Management

a scientific or systematic approach to the study of organizations. It states that management work can be scientifically done to increase work production output, which includes proper selection of workers, training of selected workers and giving workers adequate tools to start his tasks. This also applies to the concept of cause-and-effect analysis. Important advocator of this concept include:

a. Frederick Taylor (1856-1915)

b. Henri Fayol (1861-1925)

c. Frank Gilberth (1868-1915)

d. Mary Parker Follett (1868-1933)

e. Lyndall Urwick (1891-1983)

Frederick Taylor (1856-1915)

\- the Father of scientific management where he broke down each task into segments that could be analyzed for ways to improve efficiency.

Henri Fayol (1861-1925)

management is an orderly process of tasks and duties of which planning is the most important.

Frank Gilberth (1868-1915)

developed method analysis. The performance standard used by the College of American Pathologist is dependent on this.

Mary Parker Follet (1868-1933)

pointed out that management is coordination.

Lyndall Urwick (1891-1983)

introduced the role of management consultant and attempted to classify and codify the work done on management theories.

Bureaucracy Management

examines the organizational aspects of the laboratory and its workflow to explain how institutions function and how to improve their structural process. Management principles that stem from this is the "scalar principle" which deals with the chain of command in an organization and states that each person should always have one boss. Advocators are:

a. Adam Smith (1723-1790) - concept of specialization

b. Peter Ducker (1909) - concept of efficacy and effectiveness

Behavioral Science

\- focuses on the performance and interaction of people within the organization. This approach uses concepts of psychology and sociology. Prominent advocator include:

a. Elton Mayo (1880-1949) - study the origin of this theory; concerns about job satisfaction through participation and recognition.

b. Douglas McGregor (1906-1964) - developed the assumptions of the basic nature of man. He states that management involved 2 assumptions:

1\. Theory X

● states that an ordinary person is lazy, not intelligent, not inspired, not motivated; he dislikes work and avoids responsibilities; he needs to be coerced and threatened to work.

2\. Theory Y

● states that an ordinary person regards work as natural and play; he seeks his own responsibilities. C. Resis Likert (1903 - 1981) - encouraged managers to be supportive in their relationship d. Barnard - managers should encourage a climate of cooperation

Systems Analysis

an outgrowth of management science, which views the organization as a continuous process interacting itself and with its environment.

Person

● Manager is first and foremost a person.

● Managers have similar fears, dreams, hopes, difficulties, potentials, expectations and weaknesses as well.

● Some seem to be “natural leaders” with inborn skills, however, without an understanding of the management process, they soon fail when put in situations that require exacting attention to details.

● Managers are made not born!

Servant

Managers must become a supporter of their staff and provide the means for the staff to meet the needs of their patient and customers. This is necessary for the organization to function well

Representative

The manager is a paid representative of the owners of the people by supervising and presenting their concerns to the owners.

manager

an individual whose job is to guide the organization to attain its objectives. He performs the function of planning, organizing, directing and controlling the work of his subordinates. The term manager is commonly confused with director, administrator and supervisor.

director

directs the affairs of an organization by establishing goals and priorities that determine the direction the organization will take. The director might not directly supervise or manager in a technical sense since his roles are primarily one of broad policy making.

administrator

administers or runs an organization within the framework of the various directives and policies given to him.

supervisor

oversees the activities of others to get them to accomplish specific tasks or to perform scheduled activities most efficiently

manager

takes charge of the management or oversees the functioning of an activity to achieve a set of goals or purposes. His strength is in his ability to use all of his resources to get things done properly. In reality, everyone who has responsibility for a section, an office, a laboratory, any activity-functions as a manager

Motivation

– the manager’s value is in direct proportion to his ability to motivate himself and his workers.

Vision

every manager is a supervisor. The word supervision carries the connotation of someone possessed with super vision; hence one capable of seeing over and beyond the obvious.

Decision-making ability

a manager who cannot take decisions must yield authority to one who can

Good Health

it embodies more that physical fitness. It means living a balanced life physically, emotionally and spiritually as the best antidote to tensions, illustrations, strains and effort.

Humility

this implies the recognition that we have shortcomings, that we are not self-sufficient and that we need the help of our subordinates just as much as they need our help.

1\. Appearance – conspicuous obesity and extreme emaciation are negative marks.

2\. Personality style – you can learn manners and poise, adopt diplomatic approach and act with difference.

3\. Articulateness – this is increasingly important because even if you have the proper educational 3 background, superb dress and manners, good looks etc.

4\. Energy, drive and ambition – easy to recognize, through the quick stride, fresh appearance, superb physical health.

5\. Positive attitude – without being an utter fool, you can beat the pessimist by consistently displaying a constructive, cheerful outlook in life.

6\. Thoughtfulness – no one wants a “yes” man. An intelligent man and woman usually weigh a question for a second or two before responding.

7\. Overall composure – the nail biter, hair twirler, foot topper or chain smoker goes beyond an initial interview unless his or her credentials are so outstanding that allowances must be made for nervous habits.

8\. Aura-leadership – an erect carriage, a heel held high, an agreeable manner and self-confidence connote leadership qualities. You must be sure of yourself to lead others. Important is that you inspire trust and are likable.

9\. Bright, informed, a bit sparkle – if you are intelligent and well rounded, you will come across as such. A degree of humor adds sparkle.

10\. Breadth of interests – without being the least bit pedantic, you can learn a little about many fields – art, music, architecture, politics, travel, language, economics, literature, etc.

ATTRIBUTES OF THE MANAGER

Henry Mintzberg (1973) provides one of the first comprehensive studies of the nature of managerial work. He found out that one-third of a manager's time is spent in dealing with subordinates, about one-third of their time is dealing with external matters and another one-third in a variety of activities, including contacts with supervisors, tours of the workplace and thinking

Mintzberg groups ten basic roles performed by the managers: Interpersonal, Informational and Decisional.

ROLES OF MANAGERS

1\. A manager is a symbol or a figurehead. This role is necessary because of the position occupied and consists of such duties assigning certain documents required by the law and officially receiving visitors.

2\. A manager serves as a Leader – that is, hires, trains, encourages, fires, remunerates and judges.

3\. A manager serves as Liaison between outside contacts – such as the community, supplier, and others and the organization.

INTERPERSONAL ROLES

1\. As monitors, the manager gathers information in order to be well informed.

2\. Managers are disseminators or information flowing from both external and internal sources.

3\. Managers are spokespersons or representatives of the organization. They speak for subordinates to superiors and represent upper management to subordinates.

INFORMATIONAL ROLES

1\. Managers as entrepreneurs are initiators, innovators, problem discoverers and designers of improvement projects that direct and control change in the organization.

2\. As disturbance handlers, managers react to situations that are unexpected, such as resignation of subordinates, firings or loss of customers.

3\. A third decisional role is that of resource allocation.

4\. Finally, managers are negotiators when conflicts arise.

DECISIONAL ROLES

Technical Skills

– is the ability to use the equipment procedures and techniques of specialized fields. The manager needs enough “technical skills” to accomplish the mechanics of the particular jobs he’s responsible for.

Human Skills

is the ability to work with, understand and motivate other people, either as individuals or as a group. Managers need enough of this human relation’s skill to work with other organization members and to lead their own group

Conceptual Skills

is the mental ability to coordinate and integrate all the organization’s interests and activities.

Organizational Skills

ability to conceptualize and apply the management process systemizes workflow, make decisions and communicate with co-workers.

People Skills

ability to manage people well, understanding their needs and work motivation necessary to accomplish the goals of the individual and the organization.

Financial management skills

ability to account and use the assets of the company effectively.

Technical skills

ability to put in operational parameters (lab results/service) the physical resources (supplies, equipment, facilities)

1\. Organizational Skills

2\. People Skills

3\. Financial management skills

4\. Technical skills

Specialized Skills of the Manager include:

Technical Skills

Human Skills

Conceptual Skills

MANAGEMENT SKILLS

1\. Inability to maintain and adequate staff. The deficiency may be due to an insufficient number 4 of trained workers or efficient use of the personnel available.

2\. Recurring or persistent misunderstanding with hospital administration.

3\. Frequent or recurrent confusion concerning requisitions or reports of laboratory work.

4\. Frequent “rush” orders for supplies.

5\. Low morale in the laboratory.

6\. Requests for deserve pay raised by competent workers (when funds are available).

7\. Excessive cost of operations.

8\. Ignorance of the cost of operations.

9\. Expenditure of much manager's time in making minor decisions.

10\. Inability to do more tests when a key individual has a day off.

Indication of Lack of Management Skills

First Line Managers

– this is the lowest level in an organization responsible for the work of others. They direct operating employers only; they do not supervise other managers. (Supervisors / Training Officers)

Middle Managers

this can refer to more than one level in an organization. They direct the activities of other managers and sometimes also those operating employees. Their principal responsibilities are to direct the activities that implement their organizations policies and to balance the demands of their supervisors with the capacities of their subordinators. (Chief MLS/MT and Pathologist)

Top Managers

this is composed of a comparatively small group of executives. They are responsible for the overall management of the organizations. It established operating policies and guides the organization's interactions with its environment. (Medical Director

1\. First Line Managers

2\. Middle Managers

3\. Top Managers

Management Levels

Efficiency

\- ability to get things done correctly.

○ Input-Output Concept

○ Managers who are able to minimize the cost of the resources they use to attain goals are acting efficiently.

Effectiveness

ability of the manager to choose appropriate objectives

1\. Follow well-thought-out plans and long-term goals.

2\. Be based on a collaborative agreement between manager and employee.

3\. Be within the power of the individual to accomplish

4\. Be person-specific

5. Be measurable

MANAGEMENT BY OBJECTIVES

1\. Managers must set the goals and objectives for the organization in order to have a clear picture of what they wish to accomplish.

2\. Objectives should be shared within the staff. Employees should be given the opportunity to develop their own priorities from the guidelines presented by the managers.

3\. The manager and each employee must meet and come into mutual agreement on the goals and objectives of the individual. There should be a clear understanding of what is expected and how the employee’s work will be evaluated.

IMPLEMENTATION OF MANAGEMENT BY OBJECTIVES

Henri Fayol

first proposed that the management process was a continuum of functions that the manager must perform to ensure smooth operations of the organization.

Peter Drucker

also established the five basic management operations which include :

1\. Setting objectives

2\. Organizing

3\. Motivating and communicating

4\. Establishing standards or measurements of performance

5\. Developing people including managers themselves.

Planning

Organizing

Directing

Controlling

Four Main Functions of Management Process

PLANNING

– “work out in advance.” This is the thinking and analyzing portion of the management process. During this phase, managers attempt to anticipate the future and either shape it to their own ends to prepare for the coming changes.

Organizing

gather together the necessary resources and people and develop an organizational structure for putting the plan into action.

Directing

is leading where one sees the day-to-day tasks necessary to ensure smooth running of the laboratory. The human factor stage where leadership and management skills play a significant role.

Controlling

Measurement and feedback mechanism of the objectives. A process of checking up the goals/objectives established during the planning phase. Determine the success or failure and/or identify needed modifications.

1\. Identifying the goals

2\. Evaluating the current situation.

3. Establishing time frame

4. Setting Objectives

5. Forecasting Resource Needs

6. Implementing the Plan

7. Creating Feedback Mechanism

Steps in Planning

● To achieve the objective of any organization, planning has to take place.

● Competent planners make long-range plans (LRP), visualizing what goals must be realized at certain future dates.

● These long-range plans are broken into short-range plans (SRP), for time duration like daily, weekly, monthly, and annually, with the end in view of carrying out the long-range plans of the organization.

● Should deviations or changes are necessary, corrective measures are taken so that the long-ranged plan is achieved to accomplish the objective of the organization.

Nature and Importance of Planning

● To offset uncertainty and change

● To focus attention on objectives

● To gain economic operation

Importance of Planning

1\. The achievement of the objective of the organization in the most efficient and economical manner, thus maximizing profits.

2\. The use of efficient methods and the development of standards necessary for accurate control.

3\. Integration of activities of the different units in the organization toward goal-directed actions.

4\. The reduction of emergency and unexpected problems.

Values Derived from Planning

1\. Late submission of results/reports.

2\. Idle machines

3\. Materials wanted.

4\. Some machines do jobs that should be done by smaller machines.

5\. Some laboratory personnel are overworked, others are underworked.

6\. Skills workers doing unskilled work.

7\. Laboratory personnel fumbling on jobs for which they have not been trained.

8\. Quarreling, bickering, buck-passing and confusion.

Indicators of Poor-Planning

1\. Good judgment, imagination, foresight and experience.

2\. Ability to evaluate laboratory opportunities and hazards.

3\. Proficiency in the determination of the objective.

4\. Ability to accept changes

Qualities of Good Planning

1\. Purpose or mission

2\. Objectives

3\. Strategies

4\. Policies

5\. Procedures

6\. Rules

7\. Programs

8\. Budget

Types of Plans (Hierarchy of Plans)

Strategies

denotes a general program of action implying commitment of emphasis and resources to attain broad objectives.

Policies

– general statements of understanding which guides or channel thinking and action in decision making

Procedures

plans that established a required method of handling future activities. Instructional document provides step-by-step directions.

Programs

they are complex of goals, policies, procedures, task assignments, steps to be taken, resources to be employed and other elements necessary to carry out a given course of action

Purpose or mission

organization’s purpose or fundamental reason for existence. Broad Declaration of the basic, unique, purpose and scope of operations that distinguishes the organization from others of its type.

Objectives

are the end toward which planning, organizing, staffing, leading and controlling are aimed.

RESOURCE

is the means by which goals are attained; it involves the use of money, manpower, materials, machines, spaces and market.

BUDGETING

is the planning document used by an organization that forecasts both relationships between funds and expenses. There are two approaches in budget namely:

a. Capital Expenditure–land and major equipment, “puhunan”

b. Manpower–salary and fringe benefits

c. Operational budget – minor equipment and salary needed by the organization.

COMPONENTS OF INSTITUTIONAL BUDGET

a. Fix-ceiling budget–uppermost spending limit set by organization.

b. Open-ended budget–dangerous type because it has no specific amount declared.

c. Flexible budget – one can adjust.

d. Sunset budget – self destructing and cessational budget.

e. Zero Based Budget–start from nothing.

f. Contingency budget – used during emergency

TYPES of BUDGET

● Budgeting applies to a process of planning, forecasting, controlling, and monitoring the financial resources of the organization.

● Operational Budget deals with the process of planning for the laboratory as an ongoing business concern auditing for everyday needs and expenditures.

Laboratory Budgeting Process

1\. Capital Budget – it is the process use by the organizations to plan, evaluate, and choose between future investment opportunities. It is the mechanism where the laboratory selects and authorizes the purchase of major equipment and building projects.

2\. Flexible Budget – a budgeting process that attempts to set expenditures based on a variable workload volume.

3\. Zero Based Budget – a method analyzes needs based on prioritizing of goals and objectives and NOT on past allocations.

Types of Operational Budget

1\. Time frame – budgets can be prepared to cover several time frames.

2\. Forecasting stage – based on the extrapolation of historical data, several factors must be considered in the forecasts:

● Shifts in patient mix or volume

● Changes in medical staff consumption

● Changes in business parameters such as inflation and reimbursement rates.

● Expansion or cutbacks in services offered by the hospital or laboratory. Population fluctuations brought about by changes in the local economy.

3\. Scheduling Stage – budget preparation schedule varies from facility to facility. The documents undergo several drafts, numerous meetings and negotiation sessions and many revisions. Some institutions start the process about 6 months before the beginning of the new budget year.

4\. Synthesis of Information – it is how the financial information is organized. It is presented logically in a way that it is useful to the manager of the organization.

Operational Budget Preparation

Cost Accounting

is to provide the manager with the information to operate the business.

Managerial Accounting

it is another name given to this branch of accounting because of its emphasis on analyzing and providing operational information. The most prominent document generated by cost accounting is budget.

1\. Statement of financial positions (balance sheet)

2\. Statement of income and retained earnings

3\. Statement of flow funds.

● Three main financial accounting statements:

Assets

are the resources that the firm uses to conduct its business. They are consumed or in accounting terminology, they are engaged in the day-to-day operation of the enterprise. Assets may be in the form of money as cash in the bank or accounts receivable or in the form of capital such as buildings or equipment.

Equities

it consists of two parts: Liabilities and remaining value Liabilities – consists of bills owed or other obligations.

Remaining Value

can be described as either stockholder equity or retained earnings, depending on the type of corporate structure.

Stockholders equity

– assets left over after all obligations are satisfied.

Retained earnings

the money or assets remaining after liabilities have been provided.

JOB COSTING

● The important determinant in forecasting the staffing needs for the budget year is the projected volume of work.

● With this information, the number of labor hours needed can be projected in ratios that calculate the test performed per paid hours and/or worked hours.

● Using the following data for the current year, it is possible to make annual and monthly projections:

Organizing

is a management function but provides the relationship between the people and the activities that they will undertake to fulfill their organizational objectives.

Organization

is an entity that results from people joining together in pursuit of a common cause.

Organizational System

defined as a self-contained collection of interacting and independent components, working together toward a common purpose. It has an input (receive instructions and resources from external sources), transformation (internal process) and output (finished products, lab. Results) mechanisms.

Input Mechanism

– process through which, needed resources are acquired and replaced. Supplies, knowledge, machinery and labor are required by money and replaced by delivery of service.

Transformation

internal process whereby resources received through the input channels are converted into the products and services produced by the organization.

Output mechanism

process of delivering the goods and service produced to the external environment.

1\. Holistic and synergistic with clearly defined boundaries

2. Have purposeful activity or primary task –

3\. Develop into Hierarchy of systems

4\. Organizations operate as open systems

5\. Seeks a state of stability and equilibrium

6\. Self-regulating

Characteristics of Organizations