Laboratory Management

Lesson 1: INTRODUCTION TO MANAGEMENT

Laboratory

 Provide physicians and other health care professionals with information to (Kurec, 2000):
1. detect disease or predisposition to disease; 70% of all medical decisions are
2. confirm or reject a diagnosis; based on laboratory results!
3. establish prognosis;
4. guide patient management; (education &research) (ex. ER it directly decides what
to perform laboratory
5. monitor efficacy of therapy
procedures)

Management

 “Working with and through people to accomplish a common mission.”

 Has changed from supervision of "factory" workers to coordination of knowledge
workers.
 Conditions for Management to succeed (5)
o Mission
o Leaders (the one who leads)
o Resources
o Responsibility (each and everyone in group, leader, employee)
o Accountability (stands up in their respossibility)
4 Major Management Theories

1. Scientific Management
2. Bureaucracy Management
3. Organizational Behavior Management
4. Systems Analysis Management

Scientific Management

 Systematic or scientific approach to the study of organizations

a. Cause-and-effect analysis
b. Functions of management Fayol
c. Management is an orderly process, planning is the most important according to
Fayol
d. Management is essentially coordination Follet
e. Introduction of the management consultant Urwick
 Has many subdisciplines

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Bureaucracy Management

 Focuses on the Organizational Structure and work flow

(Hierchy)
o Explain how institutions function and how to improve
their performance
o Attention given to rules, regulations, impersonality and division of labor

Organizational Behavior Management

 Uses concepts from psychology and sociology

o Managers be supportive in their relationships
Likert

o Executives should encourage a climate of

cooperation Barnard
 OBM looks at the performance and interaction of
people within the organization.

Systems Analysis Management

 interchange and  The analytical view of an organization as a complete,

renewal self-contained unit that interacts within itself and with its
environment in a continuous process of

Frederick W. Taylor- Scientific Theory( Father of

Scientific Management)

Henri Fayol - AdministrativeTheory

Max Weber - BureauticTheory Elton Mayo – Human Relations Theory

Theory

Douglas McGregor – X & Y Theory

Ludwig Von Bertalanffy - SystemsTheory Theory

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 4 types of Management Process
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H  A continuum of functions that the manager must perform to ensure the smooth
operations of an organization.

Basic Roles of a Manager

PERSON SERVANT REPRESENTATIVE
Talent and knowledge Performs the task and Representative of the
Managers are made work of the institution owners or BOD
not born! Provide means for the Represents those they
Responsible for and to staff to meet the needs supervise
other people of their patients and
customers

Leader Versus Manager Traits

“Management is Different from Leadership”

LEADER MANAGER
Administrator Implementer
Organizer and developer Maintains control
Risk taker Watches bottom line
Inspiration Is a good soldier
Thinks long term Thinks short term
Asks what and why Asks how and when
Challenges status quo Accepts status quo

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 Does the right thing Does things right
4 Management Skills
Organizational Skills

 Conceptualize and apply management process

 Systematize workflow •Make decisions
 Communicate with co-workers
People Skills

 Understand basic theories of human needs

 Work motivation
Financial Management Skills

 Effective use and accounting of monetary assets

Technical Skills

 Synthesis of first three skills

 Management of physical resources (supplies, equipment, facilities) to operational
parameters (products/ services)

4 Basic Management Responsibilities

Operations Management

 Quality assurance  Legislation/regulation s/HIPAA

 Policies and procedures compliance
 Strategic planning  Medico legal concerns
 Benchmarking  Continuing education
 Productivity assessment  Staff meetings

Human Resource Management

 Job descriptions  Personnel records

 Recruitment and staffing  Performance evaluation/appraisals
 Orientation  Discipline and dismissal
 Competency assessment
Financial Management

 Departmental budgets  Compliance regulations

 Billing  Test cost analysis
 CPT coding  Fee schedule maintenance
 ICD-10 coding
Marketing Management

 Customer service  Outreach marketing

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  Advertising  Client education
 Website development
Management Levels
Hierarchy: Any group of objects ranked so thatTop
everyone but the topmost is subordinate to a
specified one above it. Managers
• Set
objectives
• Scan
environme
nt
•Plan and
make
Middle Managers
decisions
• Allocate resources
• Oversee first-line managers
• Report to top managers
• Develop and implement activities
First-line Managers
• Coordinate activities
• Supervise employees
• Report to middle managers
• Involved in day-to-dayoperations

Top-level Managers

 Responsible for controlling and overseeing the entire organization.

 Develop goals, strategic plans, company policies, and make decisions on the direction of
the business. (outside resource) – Accountable to shareholders and general public
o Board of directors, president, vice-president, and CEO

Middle-level Managers

 Responsible for executing organizational plans which comply with the company’s
policies.
 Act at an intermediary between top-level management and low-level management.
o General managers, branch managers, and department managers

First-level Managers Low-level managers provide:

 Focus on controlling and directing.  Basic
 Serve as role models for the employees they supervise.  supervision
o Supervisors, section leads, and foremen  Motivation
 Career planning
 Performance feedback
 Staff supervision
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 Laboratory Management
Lesson 2: MANAGEMENT PLANNING

Planning

 Developing pathway(s) to accomplish the organization's mission and goals using

resources and time
 Thinking and analyzing portion of management process

STRATEGIC TACTICAL OPERATIONAL CONTINGENCY

4 Hierarchy and Types of Planning

- High level - Tactics/steps/implementing - Low level - Something

decision/Top level the organizational managers unexpected
managers strategy/Administrative or - 1 yr/ 1 one happens
- How the institution will operational decision budget - Dasig maka
work? - Middle level managers period cope up
- 20yrs(Long term - 1-5yrs - Handled - Mostly crisis
projections - Short range planning routines,m in abrupt
- Supports strategic plans akes changes
Strategic Planning procedure
 Process by which high level decisions are made
- Designed and executed by top-level managers
 Usually based on long-term projections - (ex. How they
o Maps out the course of an organization for approximately 20 perform esr
years tests,efb test,
 Defined as Lifshitz, 1996 decides & make
1. deciding on the objectives of the organization and the need to procedure ang
modify existing objectives if appropriate; dfs(direcfical
2. allocating resources to attain these objectives; and smears)
3. establishing policies that govern the acquisition, use, and
disposition of these resources
Tactical Planning

 Supports strategic plans

o Works toward meeting the long-term strategic goals that have been set.
o Responsibility and functionality of middle-level managers

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  Consists of the detailed, day-to-day operations
needed to meet the immediate needs
 Aka short range planning
o Cover a 1- to 5-year period

Operational Planning

 Made by low-level managers

 Focused on specific procedures and processes
 May cover one year or one budget period

Contingency Planning

 Made when something unexpected happens

 Helpful in circumstance that call for a change

7 Steps in Management Planning

1. Identifying goals GOAL: A broad, long-term ambition of the organization
2. Evaluating the current situation
3. Establishing a time frame -Where you want to be in the future?
4. Setting objectives OBJECTIVE: A specific, short-term standard that allows
5. Forecasting resource needs the manager to achieve the desired goal
6. Implementing the plan
7. Creating feedback -It does not explain how you plan to get there?
mechanisms(analyze mog d was it Ex.lose weight by Christmas(GOAL) to reach your goal
success?) u need to have objectives - follow kettle diet,cardio
GOAL VS OBJECTIVES exercise (OBJECTIVES)

Identifying Goals

 Written goals allow all employees to

work toward a common result.
 Questioning process
o Where, or what, does the
institution wish to be

Evaluating the Current Situation

 Knowing where you are and how you got there is essential in determining where you are
going!

a. Include all personnel involved

b. Understand what resources are available S- Certain ka sa goal mo, no grudges
c. Inventory the assets
M- mafinish mo within certain period of time

7|Laboratory Management A- Realistic..no beyond imaginary vision

millieeeabss T- di malawig finish in certain period of time
Establishing a Time Frame

 Key element in determining if a plan is realistic Take note:

 Set an acceptable period in which to achieve goals
Time factor is the key element in
determining a plan is realistic.
Setting Objectives

 4 basic characteristics of a good objective

1. Clearly defined and understood
2. Obtainable and realistic (maubra mo bala or nde ang isa ka bagay?)
3. Has a strict time period in which it is to be accomplished
4. Measurable
 Objectives are written using action verbs.
Forecasting Resource Needs

 Deliberation of current resources and obtaining additional assets

 Principle vehicle for accomplishing this task is development of laboratory’s budget.
(MONEY MATTERS)

Implementing the Plan

A. Tools of Persuasion (Talks about the people itself)
 Working with and through people
 Keywords: communication, involvement, inclusion, education, training, cooperation,
building confidence, support, consultation, feedback, sharing information,
responsibility
B. Tools of Control (BUDGETING)
 Allocation of financial resources through budgeting
 Process of staffing and scheduling, or job assignments

Creating Feedback Mechanisms

 Requires collecting data for evaluation

1. Formal meetings between managers and coworkers
2. Monitored standards of performance can be set
3. Informal meetings and conversations with staff and customers
4. Analysis of the nature and types of problems that are encountered can be
undertaken

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 Management by Objectives (MBO)

 MBO is a program for managing an organization by setting and monitoring performance

objectives (PETER DRUCKER)
 Planning, directing, controlling, organizing, and operating

Characteristics of Objectives in MBO Programs

Objectives should:
1. Follow well-thought-out plans and long term goals
2. Be based on a collaborative agreement between supervisor and employee
3. Be person-specific
4. Be within the power of the individual to accomplish
5. Be measurable
6. Have a designated time frame
7. Provide feedback and information to responsible employees soManager andhow
they know eachthey are
employee must meet
progressing
Managers mustand
set can make timely and independent adjustments.
Objectives should be and come to a mutual
the goals and
shared with the staff agreement on the
objectives
goals and objectives
Implementing an MBO Program (3 phases) of the individual

Group Work

 Use the seven steps of management planning in order to achieve the given goal. 7
 Goal: Improve turnaround time (TAT) for morning lab test

Essential Factors in Laboratory Planning

1. Objectives and tasks – what should be done
2. Responsibilities – who will get the job done, who will be responsible;
3. Timeline – when will each task be worked on, when will it be completed; Is it achievable?
4. Budget and resources needs – additional staff, training needs, facilities, equipment,
reagent and supplies, quality control materials;

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 5. Benchmarks – essential for monitoring progress in implementation.

Effects of Bad Planning (6)

1. Poor time management
 Project will not be completed on time and the result will be a shoddily done work
2. Poor clear definitions of objectives
 Team members will not know what exactly they are working on and this will make
them not to work efficiently for the project. Their productivity and output will be
very low, leading to the failure of the project.
3. Budget not set out
 ` Funds will be misused and wasted. The completion of the project will record
tremendous losses and the project will have failed.
4. Dissatisfied customers
 Poor planning of a project will not meet the expectations of the customers. They
will be dissatisfied with the work that has been done and they will not consider
the business for any job in the future.
5. Lack of support from stakeholders
 If the planning is poor, the stakeholders will not support the project. People who
intended to sponsor the project may not do so because they do not have a clear
picture of what they are sponsoring.
6. Failing to plan exposes the project to unpredicted high risks and problems
 This leads to time wastage in trying to figure out how to solve the challenges that
the project faces. Time is money
TIMEhence the funds of the project will be used in
solving the issues that arise from the project due to poor planning.
Laboratory Errors Cost in…
PERSONNEL EFFORT

PATIENT OUTCOME

SWOT Analysis INTERNAL FACTORS

S: Strengths of the organization
 In order to plan for the future, one must first determine where the organization stands
W: Weaknesses of the organization
 Performed to determine both internal and external factors
EXTERNAL FACTORS
O: Opportunities available to the organization
T: Threats to the organization
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SWOT Analysis for a New Hospital Outreach Program
STRENGTHS OPPORTUNITIES WEAKNESSES THREATS

1. Use current 1. Opening of a new 1. Staffing shortage 1. Competition from

technology/ physician health care 2. Morale issues other local hospital
instrumentation facility 3. Inadequate courier laboratories
2. Have excess 2. Department of system 2. Competition from
technical capacity Health mandates lead 4. Need to hire national reference
3. Increased test testing on all children additional pathologist laboratories
volume will decrease younger than 2 years 5. Limited experience 3. Reimbursement
cost per test old in providing decreasing
4. Strong leadership 3. Have access to multihospital/client 4. Three local
support hospital marketing LIS services hospitals have
5. Financial department 6. Turnaround times consolidated their
4. Hospital X is are marginal services, including
bankrupt; laboratory laboratory
will close 5. Several new
patient service
centers (phlebotomy
stations)already
opened

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 Laboratory Management
Lesson 3: ORGANIZING AND STAFFING THE LABORATORY

Organizing

 Gathering of necessary resources and people and developing an organizational

structure for putting the plan into action (Collecting needed things for plans ex. Materials)
 Process of structuring activities, materials, and personnel for accomplishing
predetermined objectives.

6 Characteristics of Organizational Systems

1. Holistic and synergistic with clearly defined boundaries System: A self-contained
2. Purposeful activity and a primary task collection of interacting and
3. Hierarchy of systems interdependent components,
4. Operates as an open system working together toward a
5. Seeks a state of stability and equilibrium common purpose.(ex.
6. Self-regulating Laboratory) open systems-
interactions

Functions of Organizational Systems

External Environment

INPUT TRANSFORMATION OUTPUT

People Test Performance
Test Results
Test Requests Personnel
Consultation
Specimens Instruments
Information Expertise
Salaries
Supplies Information
Financial Resources Wastes

Input Mechanism: The Transformation: The

process through which internal process whereby Output Mechanism: The
needed resources are resources received process of delivering the
acquired and replaced through the input goods and services
channels are converted produced.
into the products and
services produced by the
organization.

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 Chief Technologist/
Laboratory Manager

Asst. Asst.
Manager Organizational Charts
Manager
 Formal written presentation of the structural plan of the organization
Section Section Section Section
 Visual depiction of the organization
Supervis Supervis Supervis Supervis
or 1. Indicates
or positional authority
or o
2. Helps to clarify workflow, reporting lines, and areas of responsibility
Senior 3. Shows
Senior the relationship ofSenior
the members to eachSenior
other
Tech Techs Techs Techs

Staff Staff Staff Staff Staff Staff Staff Staff

Traditional Organizational Chart Format (tall-structure design)

 has many management layers

Chief Technologist/
Laboratory Manager

Section Section Section Section

Supervisor Supervisor Supervisor Supervisor

Staff Staff Staff Staff Staff Staff Staff Staff

Traditional Organizational Chart Format (flat-structure design)

 has few management layers

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 Quality
Managem
Hematolog ent
LIS
y

Safety
Chemistry Managem
ent
Manager

Special Microbiolo
Support gy

Phlebotom
Histology
y
Blood bank

Alternative Chart Formats

 Sample shows a different structure, one that focuses on organizational interdependence,

rather than on the segregation and division of each department

The organizational structure is based on: (3)

1. AUTHORITY
a. Formal: Assigned by organization or administration
b. Informal: Gained informally through competence or leadership qualities
2. RESPONSIBILITY: employee's duty to perform assigned task or activities.
3. ACCOUNTABILITY: obligation or willingness to accept responsibility for one's
actions.

2 Structure of Organizations
Formal Bureaucracy

 The officially sanctioned lines of authority assigned by the owners of the organization
 Hierarchy of group works, job assignment and line authority

Informal Groups

 Develop from the interaction and allegiance of people with common interests
 Friendships, social groupings at lunch and after hours, “grapevine”

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Formal and Informal Group Characteristics

Group Traits Formal Informal

Leaders Appointed Charisma
Followers Recruitment incentives Personal Attraction
Purpose Profit or social goals Peer motives
Shared opinion of how Organizationally driven Social norms and mores
things should be done
Performance and Job and task standards Issue-focused
commitment expectations
Sanctions Organizational rewards and Peer pressure
punishment policies

Authority

 The empowerment by formal job classification of an Coterminous with

individual to make commitments and act on behalf of the “appointment” and
organization “responsibility”
 Used synonymously with “power”, “influence”,
“knowledge”, and “control”
3 Types and Roles of Authority
Line Authority

 Supervisory responsibility assigned through the

formal delegation of authority
Staff Authority

 Influence exerted through the control of support

services, which provide recommendations to the
line manager and set institution-wide policy
Functional Authority

 Given to specific staff personnel with expertise

in a certain area

Delegation of Authority

 The temporary assignment of authority and responsibility to perform a duty normally

performed by a supervisor
 ASSIGNMENT
Reveal the confidence thatTRANSFER
managers have inACCEPTANCE ACCOUNTABILITY
themselves and in their people
4 Process of Delegation of Authority

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 TO
P
LEV
EL Delegation of Authority
MIDDLE LEVEL

LOW LEVEL

OPERATING LEVEL/ WORKERS

Principles of Organizational Structure and Authority

 Departmentalization: The grouping together of related activities to expedite the

production process
 Decentralization: The process of assigning the decision-making process to those who
are actually performing the work – (ensure people responsible enough and familiar with
observations, increase levels)
 Unity of Command: The process of ensuring that each individual reports to have only
one supervisor (only one boss) 2 in 1 boss
 Scalar Principle: A linear system of authority providing a direct vertical link form the
board of directors to the lowest-level worker ( similar with line authority or linear system)-
top level to low level worker ( termed chain of command or the career ladder)
 Span of Control: The theory that there is a definable limit to the number of people one
person can effectively supervise, within the limits of specific work parameters and
situations
 Exception Principle: The principle of referring for resolution by a supervisor only those
things that cannot be solved by the employees at their own level

Job Design

 Process involves analysis of the work that needs to be done and a plan to break the job
down into identifiable units that can be assigned to individual workers with specific skills
Factors to be considered: (9)

 Working conditions  Legal aspects

 Technology  Work flow
 Job specifications  Work itself
 Availability of labor  Work process
 Personal interaction

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 JOB ANALYSIS

3 Job description
steps of job design: 1. Analysis, 2. Job, Job
3. Assignment
specification
- Job title - Qualifications
- Job location - Experience
- Job summary - Training
- Reporting to - Skills
- Work Conditions - Responsibilities
- Job duties - Emotional Characteristics
- Machines to be used - Sensory Demands
- Hazards

Job Description

 A written statement that designates the tasks, duties, working conditions, and reporting
relationships for a specific job
Employee Objectives:
- Identify the duties, tasks, and responsibilities of the job
- Provide orientation to the organization
- Give guidelines and directions
- Set the limits and boundaries or responsibility
- Assign the authority to act in performing duties

Organizational Objectives:
- Decrease or minimize confusion about job duties
- Recruit and select qualified personnel
- Design orientation, training and developmental programs
- Assign staffing and work schedules
- Determine performance standards and appraisal
- Meet legal, professional and labor contract obligations
- Establish the right corrective actions when performance below job requirements
- Set uniform company policy, wage and salary systems and fair treatment of all
employees .
Writing the Job Description
1. Identification and headings
 Name of facility, location (department, section), short descriptive title of the position
2. Job specifications
3. Reporting relationships
 To whom the employee reports, supervisory responsibilities of the job
4. Duties
 Duties, tasks, responsibilities, and functions that define the job
5. Authority scale
 Clarify the latitude the individual has in carrying assignments
6. Performance and evaluation criteria
7. Approval signatures
 Person who wrote the job description, manager, administrator, etc.

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  Date signed and effective date date

Job Specification

 A summary in abridged form of the formal education, skills, and experience required to
perform the duties of the job; also included are any unusual physical requirements or
working conditions
Staffing and Scheduling
Staffing
Assignment of individuals to responsible positions identified in a management plan
How many and what types of personnel are needed?

Scheduling
Assigning an appropriate number of workers to the jobs during each day of work.
Who will work at a specific time?

Staffing

 Ensuring that the laboratory has the appropriate personnel to deliver a timely, high-
quality service that meets the needs of its patients
 Staffing must address the following issues:
1. Set the types of personnel needed by the laboratory
2. Determine the number and placement of each type needed.
3. Ensure that the staff is suitably trained to perform its duties
4. Project long-term variations in personnel needs

Scheduling

 Matching the people now working in the laboratory with current workload requirements
 Issues and Factors Influencing Schedule Decisions
1. . Availability of Staff
 Skill of worker, paper qualifications, employees’ flexibility in work hours,
total number of persons
2. Type and volume of Work Performed
3. The Workplace
 Involves instrumentation, methodology, organization and facility lay-out

Traditional Work Schedules

1. 40-hour work week
 5 days on and 2 days off
2. 8/80-hour work cycle
 10 days on and 4 days off during a 2-week calendar period

Alternative Work Schedules

1. Compressed work cycle/ Creative scheduling program

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  Individual may work multi-shifts or extended time periods within a 40-hour
calendar work
 (10-, 12-, or 16-hour shifts)
 7 days on, 7 days off
 Five 8-hour days, and four 10-hours day the next
 Double (16-hour) shifts no double shift straight 16 hrs
(they have a fluid process, w/out restrictions in employees)
2. Flexible working hours (recognize responsibility, an alternative work schedule
that is very VERY RARE in the lab)
 Employees are responsible for a set amount of work but are not allowed to
establish their own hours around a core period
3. Job sharing
 Two individuals share the responsibilities and benefits of a position usually filled
by one worker
4. Exempt and professional status
 Employees are exempted by salary levels or professional classification from the
overtime provision of wage and hour laws
5. Work-at-home programs
 Data entry, transcription, and information analysis
6. Off-site testing
 Satellite laboratories, POCT (Point of Care Testing)
7. Freelance employment
- Employees can be called anytime
9 Steps in Preparing a Schedule
1. Select type of schedule 5. Set posting time frame
2. Establish staffing levels 6. Prepare skeleton stage
3. Develop staffing personnel pool 7. Complete routine scheduling stage
4. Determine format, terminology, and 8. Fill in gaps
schedule keys 9. Post schedule

Management of Work Flow

The three W’s

 What test should be done?

 Where should these tests be performed?
 When should these tests be performed?
Types of Micromanagement of Work Flow (2)

 Workload priority (completing test priority, ex. STATs specimens from ER)
 Bulk or Bottleneck Management (requires unusual large amount of time, ex. Difficult
phleb,) set aside mostly… obrahon any ang iban nga easy tpos kun take up time kag
difficult amo lng ina pagperform

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 As a Laboratory Director it is Important to:
1. Hire an appropriate number of staff to cover workload.
2. Verify that items on the job application are correct.
3. Develop complete and thorough job descriptions for each employee.
4. Train each employee in their specific duties.
5. Provide orientation for new employees. Even with a credible background, differences
between laboratories are common, so a manager needs to assure new employees have
adequate orientation and training.
6. Conduct and record competency assessments on all personnel. It is management’s
responsibility to verify that trained employees are sufficiently competent to do their work.
7. Provide opportunities for continuing education; new techniques or updates for existing
methods can be introduced using continuing education courses.
8. Conduct annual employee performance appraisals.

8 Ways to Help Your Employees Manage Their Workload

1. Throw the Idea of Multitasking Out of the Window 
2. Prioritize the Work
3. Flexibility and Adaptability Will Serve You Well
4. Electronic Planning
5. Communicate and be Clear
6. Be Reasonable
7. Keep the Door Open
8. Distribute the Difficult Tasks First.

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 Laboratory Management
Lesson 4: DIRECTING AND SUPERVISING THE
LABORATORY

4 Primary Management Functions Henry’s

1. Planning and prompt decision-making
2. Organizing
3. Leading
4. Controlling
Directing

 Most visible of all management functions

 Persuading employees to perform the tasks
 Guiding, inspiring, overseeing and instructing people towards
accomplishment of organizational goals.
 Human factor stage
o Both leadership and managerial skills come to the forefront
 Leadership is the most active part of the directing function
o Successful managerial leadership creates a climate in which both
the needs of the individual and the goals of the organization can be
met

Directing can be effective only if:

1. It is preceded by a well-designed strategy
2. It is developed in the planning and organizing stages of the management process
3. It is followed through with a strong controlling phase.

✔ Neglect in any of these areas will sabotage (maguba) the entire program

Techniques of Directing
Authoritative(Bossy, la hatagan chance for opinion)

 Encompasses issuing orders and telling someone what to do. It

does not allow employee to decide how best to accomplish task.
Coaching (allowsconfience and motivation in task), guidance in improvement

 Allows the instilling of confidence and motivation in to an employee about

accomplishing a task. The employee has more "say-so” in how to accomplish
a task.
Empowerment

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  Employees are allowed to be creative and innovative to solve problems.
Employees are allowed to take risks without fear of admonishment for failing.

22 | L a b o r a t o r y M a n a g e m e n t
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Leadership

 Exercising responsible authority, while providing motivation and vision

 Influencing and encouraging staff to good performance
 Purpose: Leadership produces change.

Leadership is different from Management

 MANAGEMENT involves planning and budgeting, organizing and staffing,

controlling, and problem solving.
 LEADERSHIP involves establishing direction, aligning, motivating, and inspiring people.

Leadership Systems/Management Styles

EXPLOITATIVE & AUTHORITATIVE

 Managers view workers only as tools and means of production and feel no further
obligation to them
BENEVOLENT & AUTHORITATIVE

 Paternalistic approach.
 Managers feel they know what is best for their employees and need only inform
and direct their actions, without seeking any feedback
CONSULTATIVE

 The manager feels the opinions and advice of the staff are useful, but all decisions
remain exclusive purview of the manager
PARTICIPATIVE

 Input and responsibility for decision making and performance are placed directly on the
staff, or as close to the production process as possible, with only general guidance and
oversight from management

Leadership Models

 Leadership is not a one-way  Four key leadership styles

relationship o Supporting
 3 factors involved in Leadership o Directing
o Leader o Delegating
o Follower o Coaching
o Situation

Personal Traits of Leaders

 When common personal traits proved elusive, attention turned to how leaders treat their
coworkers
o Clue to successful leadership was in the work environment or support network.
Qualities of “successful leaders”

 Intellectual  Social
 Physical  Psychological
LEADERSHIP BEHAVIOR
i. Employee-oriented Versus Production-oriented Leadership Styles
ii. Structure Versus Consideration Leadership Styles
iii. The Managerial Grid
iv. Theory X – Theory Y model
v. Associated Theory Z model
Employee-oriented VS Production-oriented Leadership Styles
EMPLOYEE-ORIENTED

 Supervisors with best productivity levels had a strong ties to their employees, spent
more of their time in actual supervision rather than in production work
 Supervised less closely while allowing workers more latitude in performing their duties
 Demonstrate concern for their people both on and off the job
PRODUCTION-ORIENTED

 Tend to emphasize high productivity at the expense of all other factors

 They view their workers as only tools for use by the company
 Spent the majority of their time on production-related problems
Structure Versus Consideration Leadership Styles
INITIATING STRUCTURE

 Emphasis on actively directing the staff toward getting the work done
 Paying attention to assigning particular tasks, specifying and clarifying what is
expected of subordinates and the uniformity of procedures to be followed
 Personally deciding what and how work will be done
CONSIDERATION BEHAVIOR

 Typified by mangers’ efforts to explain their action, treat workers as equals, listen
to subordinates’ concerns, look out for their personal welfare, give advance notice
of changes, and be generally friendly and approachable.
High High High OHIO STATE
Consideration Consideration LEADERSHIP
and Low and High QUADRANTS
Structure Structure
Leaders who score high in
Low High Structure both dimensions usually
Structure and and Low demonstrate the best
Low Consideration overall performance
Consideration
Low High
Initiating Structure
 The Managerial Grid

1,1 Impoverished management Leaders in this position have

little concern for people or
Or Lazy Fear Leadership productivity, avoid taking sides,
and stay out of conflicts. They
do just enough to get by. Often
referred to as laissez faire
leadership.

1,9 Country club management Managers in this position have

great concern for people and
little concern for production.
They try to avoid conflicts and
concentrate on being well liked.
To them the task is less
important than good
interpersonal relations. Their
goal is to keep people happy.

9,1 Authority-Compliance Managers in this position have

management or Authority great concern for production
-obedience management and little concern for people.
They desire tight control order
to get tasks done efficiently.
They consider creativity and
human relations to be
unnecessary

5,5 Middle of -the -road leadership Often termed middle of -the

or Organization man -road leadership. Leaders in
management this position have medium
concern for people and
production. They attempt to
balance their concern for both
people and production but are
not committed to either.

9+9 Paternalistic "Father knows best

management. In this style,
reward is promised for
compliance and punishment
threatened for noncompliance.

Opp Opportunistic "what's in it for me? "

Management. This style
depends on which style the
leader feels will bring the
greatest self -benefit.
This style of leadership is
9, 9 Team Management considered to be ideal. Such
 managers have great concern
for both people and production.
They work to motivate
employees to reach their
highest levels of
accomplishment. They are
flexible and responsive to
change, and they understand
the need to change .

 Devised by Robert R. Blake and Jane S. Mouton

 Shows the relationship between:
1. concern for people (consideration orientation)
2. concern for production (structure orientation)
 Shows that high concern for both factors is crucial to the successful manager
 Management style is influenced by five factors:
1. The attitude and assumptions of the manager
2. The policies and procedures of the organization
3. The day-to-day operational situation
4. The social and personal values of the manager
5. Chance
 To improve and strengthen leadership ability, the leader should go through the
following steps:
Encourage
Determine what management to
Decide for attitudes and develop the
Identify their themselves the behavior changes organizational
current style. best style for a are required to culture necessary
given situation. reach their goal. for the preferred
style to flourish.

The Pygmalion Effect

 Named after George Bernard Shaw’s play Pygmalion.

 The principle states that students tend to learn and perform in the manner anticipated by
the teachers
Theory X, Theory Y Model

 Proposed by Douglas McGregor in 1960

 Close simulation of the Pygmalion Effect
 Leadership behavior is based on the manager’s assumptions about the nature of
people, which, in turn, translate into the level of performance achieved by their
employees.

Theory X Managers Theory Y Managers

believes that people: believes that:
Work is a natural part of life
 People have a high degree of ingenuity and
creativity

Must be coerced into performing their Worker potential is only partially tapped by
duties the company
Workers are self-learners & seek
responsibility for their performance
Theory
Have X Managers
no ambition and little interest in Theory Y exercise
Workers Managersself-control & self
improving their efficiency
4 | L a b o ra t o r y M a n a g e m e n t discipline if they are committed to a goal.
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Participates in their leadership
Autocratic
style
Actively seek advice & counsel
Dictatorial from their co-workers
Allow employees to share in the
Allow little input from their staff decision making processes

Theory Z

 Characteristics of workers in theory Y is cultural

 Productivity and rewards are not the only objectives of people
 Quality of their work lives is also crucial to motivation

SITUATIONAL LEADERSHIP MODELS

 Circumstances in which the manager must operate contribute to the success of a

manager as a leader
 Three models:
1. Contingency theory
2. Continuum of leadership
3. Normative theory
Contingency Models

 Developed by Fred E. Fielder

o Effective leader must be able to analyze the situation and develop a satisfactory
strategy for intervention
 Proposes that success of a manager as a leader is contingent on two factors:
o The leadership style of the manager
o The favorableness of the leadership situation
 Leadership style can either be:
1. Relationship-oriented
 people emphasize good interpersonal relationships as an important means of
accomplishing work-related goals.
2. Task-oriented supervisors
 focus on completing a job first & taking care of people as secondary
to accomplishing their primary mission Favorableness is
 Three components establish the favorableness dimensions of a the amount of
situation: power, control, and
1. Leader-member relationship influence wielded
by a manager in a
 Level of confidence and trust between leaders and
particular set of
members
 Most important factor
Matching the right person
5|Laboratory Management who has the right leadership
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crucial management
responsibility
 2. Task structure
 Amount of formal structure imposed on work
assignments
3. Position power
 Degree of influence that the manager exerts on
the reward and punishment system of the
institution

Continuum of Leadership

 Developed by Robert
Tannenbaum and Warren H.
Schmidt
 Proposed a continuum of
leadership model
o Ranging from completely
autocratic to democratic.
o Managers could move
along this continuous
line, adjusting their
leadership style to fit
the situation

Normative Theory

 Also referred to as the Vroom-Yetton decision model

 Depicts the extent of participation allowed in the decision-making process.
 Similar to continuum theory
o Managers are capable of adjusting their leadership style to meet the
particular circumstances of a given situation
The Five Possible Behavior Styles (Normative Theory) (5)

 A-I: Managers makes decision based on the current information available

 A-II: Manager seeks necessary information from subordinates before making a decision
 C-I: Managers shares the problem with selected individuals before making a decision
 C-II: Managers shares the problem with all the members of the group but makes the
final decision
 G: Manager shares the problem with the group and a decision is reached by consensus
APPLICATION OF LEADERSHIP PRINCIPLES

 People who work in medical laboratory must constantly guard against making focus of
their work a tube of blood or a lab specimen rather than the needs of the whole patient
and the worker’s role in the delivery of health care.

Laboratory Management

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 Lesson 5: CONTROLLING
Four Main Function of Management Process
PLANNING • Identify goals • Establish Time Frame • Set Objectives • Forecast Resource Needs •
Implement plan • Obtain Feedback
- develop pathways to accomplish organizations mission and the goals using the resources and
time
ORGANIZING •Formal Hierarchy •Informal Relationships
- Gather necessary resources and all people and developing a organization structure for putting the
plan into action.
DIRECTING •Leadership •Time Allocation
- leading or persuading employees to perform the tasks that help the organization accomplish its
mission in the goals
CONTROLLING •Instructions •Follow-up •Modifications
- control in management which means setting the standard or measuring actual performance and
also taking corrective functions.

• Process of determining that everything is going according to plan.

• Comparing what has actually been accomplished with the Controlling is making
original master plan a in order to determine its success sure your employees
or identify needed modifications succeed.
• One of the best ways to prevent issues with employees is to be clear
about standards and expectations from the start
Managing a lab means
• It is equally important for lab standards to be maintained, or they will that there are times
not be followed when things go wrong
4 Types of Control and you are expected to
fix it.
Controls may be classified on the basis of: (4)
1. Timing
2. Designing 3. Management levels
systems 4. Responsibility

Controls on the basis of TIMING

1. Feedback Control
• This process involves collecting information about a finished task, assessing that
information and improvising the same type of tasks in the future.
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 2. Concurrent Control
• It is also called real-time control. It checks any problem and examines it to take action
before any loss is incurred (e.g. control chart)
3. Feed Forward Control
• Also predictive control. This type of control helps to foresee problem ahead of occurrence.
Therefore, action can be taken before such a circumstance arises (e.g. preventive
maintenance)

Controls on the basis of DESIGNING SYSTEMS

1. Market Control
• Control is based upon market mechanisms of competitive activities in terms of price and
market share.
2. Bureaucratic Control
• Bureaucratic control focuses on authority, rule and regulations, procedures and policies.
3. Clan Control
• The control systems are designed in a way that give way to shared vision, shared values,
norms, traditions and beliefs, etc., part of the organizational culture.

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Controls on the basis of LEVELS
1. Operational Control
• Used at the lower management; exercised almost every day (e.g. Quality control, financial
controls)
2. Structural Control
• Exercised by top and middle management.
• Are the different elements of organization structure serving their intended aims? Is there
overstaffing? Is the ratio of staff to line increasing?
3. Tactical Control
• Exercised by middle management levels; deals with the departmental objectives
4. Strategic Control
• Exercised by top level management; determine whether the effectiveness of strategies are
successful in helping organizations to meet its goals

Controls on the basis of RESPONSIBILITY

1. Internal control
• Responsibility rests with the person executing the things
• Permits highly motivated people to exercise self-discipline.
2. External control
• Control is in the hands of supervisor or manager and control is exercised through formal
systems.

Steps in Controlling

•EstabIishment of •Measuremen
Standards
•Comparison •Correctiv
t of actual of actual e action
perfromanc persformanc if
e e with the necessary
standars

Performance Standard

• An item against which the performance or behavior of an employee can be compared to obtain a
relative measurement
• Performance standards should satisfy four goals:
1. Be relevant to the actual job and tasks being done ( state area of responsibility)
2. Allow for fair comparison between different positions (states how tasks should be
performed)
3. Ensure consistent application of organizational programs for which the performance
appraisal system is used
4. Be objective —a goal of fairness and compliance with the law (measurable mechanism)
Examples of Performance Standards

• Preventive maintenance protocol, following lab instrument manufacturers' policies, are completed
as scheduled on the PARAMAX chemistry analyzer 100 percent of the time.
• FBS are reported to the nursing unit by 7:00 AM 90 percent of the time
• FBS are collected and in the chemistry section by 6:30 AM 90 percent of the time.
Measure Actual Performance
• Data can be collected through personal observation, statistical reports, oral reporting, written
reporting
• Two basic means of Performance Appraisal Performance appraisal: The
1. Using a scale formal communication
a. Quantitative rating — 1,2,3,4
system used by an
b. Qualitative descriptive terms — superior,
organization to assess and
needs improvement, below standard
provide feedback to
c. Narrative format
employees about job
2. Peer comparison
performance expectations
Appraisal Focus
Four Approaches/Orientations in Measuring Performance:

• Result-oriented approaches
a focus on achievement, as in MBO programs, quality assessment and improvement
(QA & I), and CQI
• Behavior-oriented methods
o includes tools that rate the worker against descriptions of predetermined behavior levels
• Skill-oriented methods
a attempt to measure the traits and skills of the worker (focus on the performer)
• Peer comparison
a Used to identify candidates for promotion, staff reduction and merit pay or recognition

Scale-rating Methods

1
• Forced-choice

• Critical incident

• Behaviorally anchored 3rating scales (BARS)

• Mixed-standard scales
4
Forced-choice Method

• Rater selects from among a group of predetermined descriptions of the statements that best and
least match the employee being evaluated
• Advantage: form is standardized and rater does not know the weight assigned to each statement
(no bias)
• Disadvantage: statements are not usually job specific & no place for feedback to the person being
judged

Critical Incident Method

• Requires appraisers to cite specific examples (i.e. critical incidents) of behavior, both positive and
negative
a Critical incident occurs when behavior in some aspect of the job results in
unusual success or failure

• Drawbacks:
o “Black book” implications of keeping records on all employees
o Time required to record entries
Behaviorally Anchored Rating Scales (BARS)
• Incorporates the critical incident method into a system that identifies key job dimensions or tasks
and develops a behavior description with graphic scale

Mixed-standard Scales

• Modified BARS. Instead of 1-7 rating, rating is plotted on a 3-point scale (3-2-1 or 2-1-0)

• Often used to identify candidates for promotion, staff reduction, and merit pay or recognition
programs

Four main methods

1. Ranking Method Supervisor/rater ranks staff from best to worst
2. Forced Distribution Employees are sorted into different categories (top, middle, bottom)
3. Point Allocation Method Appraiser is given 100 points that must be allocated among the staff
4. Paired Comparison Assessor compares each individual against every other individual

Who should do the appraising?

1. Immediate supervisor
2. Higher-level managers 5. Customers and suppliers
3. Employee (self-evaluation) 6. Independent experts
4. Coworkers 7. Subordinates (to gauge supervisors)
 Corrective Action

• The corrective action may be to maintain status quo (reinforcing successes), correcting the
deviation, or changing standards.

Awarenss

Troubleshooting
Verba
warning Written
warning
Suspension

Dismissal

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