LABMAN SEMINAR 1 RECALL Flashcards
A place where tests are performed on clinical specimens in order to get information about the health of a patient with regard to the diagnosis, treatment and prevention of disease
Clinical Laboratory
Laboratory that cater both in-patient and out-patient
Hospital-based laboratory
Laboratory that cater only out-patients
Free-standing laboratory (non-hospital based)
Clinical Laboratory must be headed by a
Pathologist certified by the Philippine Board of Pathology
Classification of clinical laboratory according to institutional character
Hospital-based laboratory
Free-standing laboratory (non-hospital based)
Classification of clinical laboratory according to function
Anatomic Pathology
Clinical Pathology
Sections under Anatomic Pathology
Surgical Pathology
Cytology
Immunohistopathology
Forensic Pathology - Autopsy
Sections under Clinical Pathology
Hematology
Immunohematology
Clinical Chemistry
Microbiology
Clinical Microscopy
Molecular Biology
Immuno-Serology
Parasitology
Toxicology/TDM
RA No.4688, otherwise known as
Clinical Laboratory Law of 1966
Classification of clinical laboratory according to service capability
Primary Laboratory
Secondary Laboratory
Tertiary Laboratory
Minimum service capabilities of Primary Laboratory
CBC
Urinalysis
Fecalysis
Blood typing and quantitative platelet count for hospital-based laboratories
Primary Laboratory must have an area of at least
10sqm
Service capabilities of Secondary Laboratory
Service capabilities of a primary laboratory
Routine Clinical Chemistry (sugar, BUN/Crea, BUA and T. Cholesterol)
Crossmatching (hospital-based)
Secondary Laboratory must have an area of at least
20sqm
Service capabilities of Tertiary Laboratory
Service capabilities of a secondary laboratory
Special hematology
Special chemistry
Immune-serology
Microbiology
A type of laboratory suitable to be a training ground for interns and externs and site of scientific research
Tertiary Laboratory
Tertiary Laboratory must have an area of
60sqm
It has discrete sections in hematology, chemistry, microbiology, and blood bank,
generally separated into rooms or sections
Traditional ‘Closed’ Laboratory
The discrete services are placed in one large room with portable walls that can be adjusted as needed based on volume
‘Open’ Laboratory
A common type of consolidation has been hematology and chemistry laboratories (‘chematology‘)
Core Laboratory
Advantages of Core Laboratory
Handling stat requests
Improving offshift workflow
Avoiding chronic staffing problems
Specific low-volume or expensive laboratory services currently provided by more than one regional hospital laboratory, that are consolidated into one hospital
Regional Laboratory
Laboratory testing that is brought to the patient’s bedside
Point-of-Care
Rapid response laboratory that is often located in or near an emergency department or surgical suite
Stat Laboratory
STAT means
Short Turn-Around-Time
Laboratory provides limited menu of routine and/or specialty services on a stat or non-stat basis
Limited Service
Traditional full service laboratory that handles all types of testing, especially esoteric tests
Reference Laboratory
The National Reference Laboratories in the Philippines is established through
D.O. No. 393-E s. 2000; and additional designations through D.O. No. 2009 5148, December 21, 2009
Reference Laboratory for Clinical chemistry and Anatomic Pathology of Pulmonary Diseases
Lung Center of the Philippines
Reference Laboratory for Hematology, Immunohematology and Immunopathology, Anatomic Pathology for other Organ Diseases other than Lungs and heart
National Kidney and Transplant Institute (NKTI)
Reference Laboratory for Environmental and Occupational Health Toxicology and Micronutrient Assay
East Avenue Medical Center
Reference Laboratory for dengue, influenza, TB & other mycobacteria, malaria and other parasites, bacterial enteric diseases, measles and other exanthems, mycology, enteroviruses, antimicrobial resistance and emerging diseases. Also for confirmatory testing of blood donors and blood units
Research Institute for Tropical Medicine (RITM)
Reference Laboratory for HIV-AIDS, Hepatitis and STDs
San Lazaro Hospital
Reference Laboratory for Anatomic Pathology for Cardiac diseases
Philippine Heart Center
Phases of the testing process
Test Ordering
Collection
Transportation
Sample Receipt
Sample Processing
Testing
Reporting
It is of paramount importance in any workflow analysis
Data
Data necessary in order to validate results
Supplemental data
Mapping needs for the staff working on the particular section
Sample Mapping
Mapping needs for the instrumentations used on the particular section
Test Mapping
The most fundamental data collection technique
Analyze the distribution of samples and tests over time
Sample and test “density” should also be considered as samples and tests in the inpatient department is higher than in the outpatient. True or False?
False, tests in the outpatient department is higher than in the inpatient
Tube Analysis is also known as
Tube labor
Tube Analysis workload includes:
SCAR MURLS
Sorting of Tube - according to color
Centrifuging
Aliquoting
Racking
Unracking
Loading & unloading of samples in analyzers
Manual dilutions & reruns
Retrieving tubes - for additional testing
Storing of tubes
Tube analysis is mostly needed in
Immuno-Serology
Immunodiagnostics
Clinical Chemistry
Non-technologic solution in troubleshooting tube analysis
Altering laboratory rerun/review criteria to reduce the number of tubes flagged for rerun
Technologic solution in troubleshooting tube analysis
Acquiring a new analyzer or upgrading the specs of the analyzer to better its performance against the workload of the laboratory
Goal of workstation analysis:
To understand where, when, and how the work performed
Instrument throughput
Number of test/hour
This information can be very useful in identifying processing bottlenecks and assist in redesigning workflow
Labor considerations
Running one test for multiple samples
Batch Testing
Running multiple tests for one sample
Parallel Testing
Randomly access sample and reagents and can accommodate an emergency sample at any time
Random Testing
Breakthrough technology:
a. Changes fundamental workflow
b. Consolidates workstations
c. Saves labor
d. Improves service
e. Sets new performance standard
f. Premium pricing
Operation that best meets the clinical needs and financial goals of the organization
High quality at Low cost
Optimizing performance is an ongoing process that requires one to constantly assess and reassess workflow and needs. True or False?
True
The means employed to encourage all personnel in the organization to accomplish whatever assignments may be given them by management in order to achieve the objectives in the manner they were planned and organized
Leading
Leading can only be effective if it is preceded by a well-designed strategy developed in the planning and organizing stages of the management process, and if it is followed through with a strong controlling phase. True or False?
True
Most active part of the directing function
Leadership
Leadership employs _____ to accomplish the work of an organization
Management skills
People skills
Vision
Purpose of Leadership
To produce change by establishing direction, aligning, motivating, and inspiring people; provides direction of where one (or an organization) is going
Leadership Responsibility
a. Develop and maintain effective relations with medical and hospital staff and administration
b. Encourage free-flow and exchange of ideas
c. Assure an awareness by all personnel of current trends and practices
d. Formulate and develop policies and procedures
e. Effectively communicate the plans to all personnel
An individual whose job is to guide the organization to attain its objectives.
Manager
A manager must possess essential characteristics that will make him/her a successful manager such as:
Motivation
Vision
Decision-making skills
Humility
Good health
Roles played by managers in an organization
a. Represents the organization
b. Holds formal authority
c. Develops & implements strategies to accomplish mission & goals of the organization
d. Manages personnel (e.g., evaluation, hiring, promotion)
e. Manages financial responsibilities (i.e., budget, revenue, expenses)
f. Facilitates communication
g. Motivates employees
h. Implements time management strategies
i. Oversees customer service
j. Implements innovative ways to expand services, expand customer base, & fulfill the bottom-line
10 Characteristics of a Leader
- Good listener
- Confident
- Self-discipline
- Good self-esteem
- Optimism
- Likes everyone
- Ambitious
- Good memory
- Accessible
- Good sense of Values and Sound Judgement
Self-centered Leadership Style
Autocratic
Characteristics of Autocratic Leadership Style
a. Self-centered
b. Makes decisions without the consultation of subordinates
c. The manager’s way is the best, & employees need not to think of another way to complete the task
d. Inhibits employees from thinking for themselves; they lose interest & initiative
People power; shared authority Leadership Style
Democratic
Characteristics of Democratic Leadership Style
a. People power; shared authority
b. Employees take part in decision-making
By the book Leadership Style
Bureaucratic
Characteristics of Bureaucratic Leadership Style
a. Exercise of control on the basis of knowledge
b. Focuses on rules & regulations set by the hierarchy of authority; leaders work “by the book
Delegating Leadership Style
Laissez Faire
Characteristics of Laissez Faire Leadership Style
a. Delegating leadership
b. To let people do as they choose
c. Leaders have a back seat role in the organization
d. The employees (experts) are allowed to decide on their own
Leadership Style where leaders encourage certain behaviors in others by force of personality, persuasion, & eloquent communication
Charismatic
Four (4) Key Leadership Styles
- Supportive Leader - Physical and personal resources to accomplish duties
- Directive Leader - Rules, order, or defined instructions
- Coaching Leader - High support and direction
- Delegating Leader - Low support and direction
“The art and science of getting things done thru people”
Management
Management as an art
It results in the accomplishment of objectives through the use of human efforts
Management as science
It is a systematic body of knowledge. It gathers and analyzes facts and formulates general laws or principles from these facts
Functions of Management
Planning
Organizing/Delegating
Leading/Directing
Controlling & Evaluating
The mental effort by which executives anticipate the possible causes or factors that may affect or change the activities and objectives of a particular organization
Planning
The process of identifying and grouping of work to be performed, defining and delegating responsibility and authority and establishing relationship for the purpose of enabling the people to work most effectively together in accomplishing objectives
Organizing
Refers to the way of getting all personnel in an organization to accomplish what management desires
Leading/Directing
Means checking the work accomplished against plans or standards, and making adjustments or corrections when new developments or unforeseen circumstances necessitate
Controlling and Evaluating
Directs the affairs of an organization by establishing goals and opportunities that determine the direction the organization will take
Director
Runs an organization within the framework of the various directives and policies given to him/her
Administrator
Oversees the activities of the others to get them accomplish specific tasks or to perform scheduled activities most efficiently
Supervisor
An individual whose job is to guide the organization to attain its objectives
Manager
Qualities of being a Manager
Decision-making ability
Good health
Humility
Motivation
Vision
The qualities that top management contenders possess
a. BRIGHT, INFORMED, A BIT OF SPARKLE
b. POSITIVE ATTITUDE
c. ARTICULATENESS
d. THOUGHTFULNESS
e. AURA OF LEADERSHIP
f. BREADTH OF INTEREST
Manager that has the lowest level in an organization who is responsible for the work of others
First-line managers
What does First-line managers do?
They direct operating employees only and are concerned about completing the day‘s work
Examples of First-line managers
Supervisors
Team leaders
Chief Technologists
Managers that direct activities of other managers and also those of operating employees
Middle managers
What does Middle managers do?
They direct activities that implement their organization‘s policies and to balance the demands of their supervisors with the capacities of their subordinates. They engaged in a variety of technical and non-technical activities
Examples of Middle manager
Operation manager
Division head
They are composed of a small group of executives
Top managers
What does Top managers do?
They are responsible for the overall management of the organization
Examples of Top managers
Directors
CEO
Specific skills of first-line managers
Possess mostly human skills
Specific skills of middle managers
Focuses on technical matters
Specific skills of top managers
Mostly involved in making key decisions
Provided one of the first comprehension studies of the nature of managerial work
HENRY MINTZBERG (1973)
He grouped the basic roles performed by the managers
HENRY MINTZBERG (1973)
Roles described by Henry Mintzberg
Interpersonal Roles
Informational Roles
Decisional Roles
A manager is symbol. This role is necessary because of the position occupied and consists of such duties as signing of documents required by the law and officially receiving visitors
Interpersonal Roles
Managers gather information in order to be well informed. Managers are disseminator of information flowing from both external and internal sources
Informational Roles
Managers as entrepreneurs are initiators, innovators, problem discoverers, and designers of improvement project that direct and control change in the organization
Decisional Roles
He identified three basic types of skill needed by all managers
Robert L. Katz
Three basic types of skill needed by all managers as described by Robert L. Katz
Technical Skills
Human Skills
Conceptual Skills
It is the mental ability to coordinate and integrate all of the organization‘s interests and activities
Conceptual/Organizational Skill
It is an understanding of the basic theories of human needs and work motivation
Human/ People Skill
It involves the synthesis of a specialized skill and the management of physical resources into the operational parameters unique to each organization
Technical Skill
Suggested that managerial performance can be measured by “Efficiency” and “Effectiveness”
Peter Drucker
Doing things right or ability to get things done correctly
Efficiency
Doing the right thing or the ability to choose appropriate objectives
Effectivity
Indicators of Lack of Management Skills:
Frequent “rush” orders of supplies
Excessive cost of operation
Recurring or persistent misunderstanding
Inability to maintain adequate staffs
One of the mostly widely known approaches to dramatizing leadership style
The Managerial Grid
Who developed The Managerial Grid?
Robert Blake & Jane Mouton
Two dimensions of the Managerial Grid
Concept for production
Concept for people
It is conceived as the attitudes of a supervisor toward a wide variety of things such as the quality of policy decisions, procedures and processes, creativeness of research, quality of staff services, work efficiency and volume and output
Concept for production
Includes degree of personal commitment toward goal achievement, maintaining the self-esteem of workers, basing responsibility on trust rather than obedience, maintaining good working conditions and having satisfying interpersonal relations
Concept for people
He proposes that leadership behavior is based on the manager‘s assumptions about the nature of people
Douglas McGregor
Proponent of Theory X - Theory Y model
Douglas McGregor
The Theory X Managers believe that people:
a. Are inherently lazy and dislike work
b. Must be coerced into performing their duties by constant supervision and maintenance of tight operational control
c. Have no ambition and little interest in improving their efficiency on their own and must be prodded to produce.
Managers who hold X theory philosophies tend to be
Autocratic and Dictatorial
The Theory Y Managers believe that people:
a. Work is a natural part of life
b. People have a high degree of ingenuity and creativity that they are eager to apply to the job
c. Worker potentially is only partially tapped by the company
d. Workers are self-learners and seek responsibility for their performance
e. Workers exercise self-control and self-discipline if they are committed to a goal, and the strength of this commitment depends on the reward associated with the achievement.
Managers who hold the Y philosophies tend to be
Participatory in their leadership style; actively seeking advice and counsel form their co-workers and allow employees to share in the decision making process.
4 Extreme Styles of Management
Impoverished Management
Team management
Country club Management
Authority-Compliance Management
Leaders in this position have little concern for people or productivity, avoid taking sides and stay out of conflicts. They do enough to get by. Often referred to as Laissez faire leadership.
1, 1 or Impoverished Management
Managers in this position have great concern for production and little concern for people. They desire tight control in order to get task done efficiently. They consider creativity and human relations unnecessary. Also called Authority-obedience Management or Autocratic Task Management
9,1 Authority-Compliance Management
Leaders in 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. Sometimes called “Organization Man Management”
5, 5 or Middle-of-the-road 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
1,9 or Country club Management.
This style of leadership is considered to be ideal. Such managers have great concern for people and production. They work to motivate employees to reach their highest levels of accomplishments. They are flexible and responsive for change, and understand the need to change
9,9 or Team management
According to Contingency Theory, the success of the manager as the leader is contingent on 2 factors:
Leadership style of the manager
Favorableness of the leadership
There are 3 components that establish favorableness:
a. Leader-member relations – the level of confidence and trust between leader and members of the staff. This is the most important factor according to this model
b. Task Structure – the amount of formal structure imposed on work assignments.
c. Position power – the degree of influence that the manager exerts on the reward and punishment system of the institution.
According to Contingency Theory, Leadership can be either:
i. Relationship-oriented
ii. Task-oriented
Management style can be plotted on a continuum from authoritative to democratic. Managers could move along the continuous line, adjusting their leadership style to fit the situation
Continuum of Leadership
Proponent of Continuum of Leadership
Robert Tannebaum and Warren H. Schidmit
Provides normative guidelines and recommendations for the way a leader should make decisions in a specific set of workplace conditions
Normative Theory
Proponent of Normative Theory
Victor H. Vroom and Phillip W. Yetton
Normative Theory classifies decision-making methods as
Autocratic
Consultative
Group Oriented
The 5 possible behavior styles identified by Vroom and Yetton
i. A-I- Manager makes decision based on the current information available
ii. A-II- Manager seeks necessary information from subordinates before making a decision.
iii. C-I- Manager shares the problem with selected individuals before making a decision.
iv. C-II- Manager shares the problem with all the members of the group but makes the final decision
v. G- Manager shares the problem with the group and a decision is reached by consensus.
3 Factor involved in Leadership:
Leader
Follower
Situation
Supervisors with the best productivity levels had strong ties to their employees, spent more time in actual supervision rather than production in work, supervised less closely while allowing workers more latitude in performing their duties, and demonstrated concern for their people both on and off the job
Employee-oriented Leadership Style
Supervisors who tended to emphasize high productivity at the expense of all other factors. They viewed their workers as only tools for use by the company in the manufacturing process and spent the majority of their time on production-related problems
Production-oriented
Marked by 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 the procedures to be followed and personally deciding what and how work will be done
Initiating Structure
Manager’s effort to explain their actions, treat workers as equals, listen to subordinates’ concerns, look out for their personal welfare, give advance notice to changes and be generally friendly and approachable
Consideration Behavior
The process in human relations of passing information and understanding from one person to another
Communication
Communication is most frequently conducted by
Written or spoken word
Gesture
Manner of dressing
Personal appearance
General behaviour
It is the transmission of information between among departments
Interdepartmental Communication
It is the transmission of information within the department
Intradepartmental Communication
Why does Intradepartmental Communication is better?
Because of proximity, similar education, related duties, and common goals among co-workers
Communication typically serves the following purposes:
- Exchange of knowledge
- Expression of feelings
- Expression of ideas and thoughts
- To attempt to influence another’s thoughts and actions
- To meet social expectations
Barriers to Effective Communication
- Culture differences
- Nonverbal expression
- Para verbal issues
- Environmental
- Overcommunication
- Undercommunication
It is the most fundamental form of communication.
Informal talks
Ways to Communicate
- Informal talks
- Planned appointments
- Telephone calls
- Interoffice memos
- Letters
- Reports
- Informal staff meetings
- Planned conference
- Mass meeting
- Bulletin board notices
Categories of Communication
Upward Communication: Employee to Supervisor
Downward Communication: Supervisor to Employee
Diagonal Communication: Employee to Employee
Predetermined course of action intended to facilitate the accomplishment of a task, work or mission
Plan
The methodical selection of a series or set of complementary actions for the purpose of pursuing an improved position
Planning
Nature and Importance of Planning
To achieve the objective of any organization
Visualize what goal must be realized at a certain time in the future
Long range plans
Visualize what goal must be realized daily, weekly, monthly, or annually
Short range plans
Indicators of Poor Planning
- Late submission of results
- Some laboratory personnel overworked, others are underworked.
- Some machines doing jobs that should be done by smaller machines.
- Quarrelling
Benefits of Good Planning
- Jobs turn out on time
- Good relationship with other departments
- Equipment in good shape
- Materials available
Qualities of a Good Planner
- Good judgement, imagination,foresight and experience.
- Ability to evaluate laboratory opportunities and hazards.
- Proficiency in the determination of objective.
- Ability to accept changes
Is a statement of the organization‘s reason for being. It is a final and ultimate goal
Mission
Is the non-specific directional and motivational guidance for the entire business
Vision
Are goals through which an organization aims to achieve
Objectives
Are specific statements of anticipated results
Goals
Denotes general program of action implying commitment of emphasis and resources to attain broad objectives
Strategies
Are general statements which guide or channel thinking and action in decision-making
Policies
Establishes a required method of handling future activities
Procedures
Are required actions chosen from among alternatives
Rules
Are complex of goals, policies, procedures, task assignment, steps to be taken, resources to be employed necessary to carry out a given course of action
Programs
Is the statement of expected results expressed in numerical terms. It is also referred to as ―Numerical program
Budget
Refers to the totality of an organization’s awareness based upon the prior observations and participations of its membership
Past Experience
Known or estimated expenditures for given services in a given locale or as projections of these expenditures contingent upon specific plans and anticipated developments
Market Potential
An analysis of most market potential areas will usually disclose a relatively consistent set of competitive forces
Competition
Are difficulties and problems that results between those responsible for providing laboratory services and those accountable for administering overall hospital policy
Hospital/Laboratory Relations
Are regulations and performance standard bodies
Regulatory & Accrediting Forces
Series of events constituting a pattern that suggests both origin and probabilities for continuation
Laboratory trends
Pattern of tests requests is as useful indicator of the relative value with which the physician perceives the wide range of laboratory services
Medical Trends
Events which affect hospital laboratory operation like include the legislation of unions, equal job opportunity, etc.
Socio-political Trends
Concerned with the identification of the mission and of those objectives that will permit its most efficient pursuit
Strategic Planning
Requires an operational or technical skill and is generally a logical responsibility of the supervisory staff
Tactical Planning
The process of identifying and grouping the work to be performed, defining and delegating responsibility and authority, and establishing relationship for the purpose of enabling the people to work most effectively together in accomplishing objectives
Organization
The subordinates follow the leader who yields exclusive power to decide and enforce unquestionable obedience in his subordinates
Herd Concept
Direct delegation of authority and definition of the area of responsibility of the superior to the subordinate
Man to Man Concept
The superior and the subordinates are members of the team. The relationship is no longer man to man but man to his group
Social Concept
A diagram that identifies the major operational units of an organization and their attending job position
Table of Organization
The single most concise representation of the organization and also provides membership of an understanding of their station and how they relate to one another
Table of Organization
Are written declarations of a given job positions
Job descriptions
This is the position summary
Job specifications
The process which an existing organization undergoes that brings about changes in the size and shape of the organization structure
Reorganization
Encourage all personnel in the organization to accomplish whatever assignments may be given to them by management in order to achieve the objectives in the manner they were planned and organized
Leading/Directing
Entails responsibility for assuming that policies and procedures are followed
Supervision
Involves measuring, restraining and correcting performance to accomplish an objective as it was planned
Controlling
Control in management:
Setting standards
Measuring actual performance
Taking corrective actions
Types of Formal Control:
Pre-action control
Post-action control
Controlling by means of personal supervision and utilization control checks consisting of procedures for any given task or function
Pre-action control
Controlling as the task or function is being performed or may have been performed and corrective deviations from standards or plans
Post-action control
Basic Control Process
a. Determination of Standards
b. Performance Standard
c. Appraisal or Measurement of Standards
d. Correction of Deviations
It is a selective point in planning performance at which performance is measured, so that managers can receive signals about how things are going
Performance Standard
An item against which the performance or behaviour of an employee can be compared to obtain a relative measurement
Performance Standard
Involves a systematic process of assessment of strengths and weaknesses of workers as basis for administrative decisions and development
Appraisal or Measurement of Standards
Appraisal or Measurement of Standards can be done through:
Criteria-based Evaluation
Competency-based Evaluation
