Addressing management issues.

In Memoriam 

It was a sad day at MLO when the news came about our dear Editorial Advisory Board member, Chris Frings. By now, in one way or another, you may have heard this news, but it is still very fresh in our minds and hearts. Larry Crolla, one of three Management Q&A panelists, notified me on Independence Day that Chris died July 3rd on his way to the hospital to do his long-running magic show for the sick children there.

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In June, Chris had read through a cystic fibrosis article for MLO and, afterwards, sent me the following message: "I work with the cystic fibrosis patients at Children's Hospital in Birmingham about 45 Wednesday nights each year from 5:30 to 9:00 p.m. I volunteer my services as a magician to the kids there. I started my fifth year in April. Some of these kids spend half of their lives in the hospital. I love them, and they love my magic. I am the official Children's Hospital magician."

I spoke with his wife, Roberta, in Birmingham the day after she lost Chris, and she thought that donations to a cystic fibrosis organization in Chris' name would be more in keeping with his wishes than floral tributes at his memorial service and upon his grave.

Chris and I were to meet for breakfast on the morning of July 30 in Washington, DC, at AACC as we have for the last five years. The two of us usually met around 8:00 a.m., then had other MLO editorial advisory board members and staff join us later. During our early morning private conversation, Chris wanted always to ascertain if he had been doing a good job and whether there was any little thing he could do better. Working with Chris was always effortless. He met his deadlines; he had all of his material together; he asked for confirmation of receipt of anything of importance that he sent to me; and he always let me know his schedule in the event that we needed him. This is his last column.

He was a popular presenter at industry conventions and trade shows. His business card made note not only of his vocation as a time-management expert but also of his avocation as a magician. But his first love was his family, and except for mentioning his trips to and fro to visit his children and grandchildren, that part of Chris' life was private.

I know that you will join me in mourning our loss and praying for Chris' family: his neighbors and clients; his professional colleagues, including "Management Q&A" panelists Alton, Larry, and Marti; and for his special little friends at the Children's Hospital who will miss him terribly.

Chris truly was a magic man.

--CB/Editor

Non-complaint lab employee

Q A long-term employee is constantly non-compliant with policies and procedures to the point that he has compromised the quality of patient results. Although multiple occurrences have been reported to the lab manager--and administration is well aware of what is going on--the manager appears to be enabling this employee, who is still in the lab. The unfortunate aspect of this situation is that employees of good standing and integrity are left to continuously monitor and report his infractions. Apparently, heavy workloads are not enough for the rest of us, since babysitting a non-compliant co-worker has been added to the mix. Any suggestions?

A Alton Sturtevant points out, "As a laboratory director, this type of behavior would not be tolerated in my laboratories if I knew about the problem. I would consider it mandatory for an employee with knowledge of policy violation by a fellow employee to report it to the laboratory manager and for that manager to report the violation(s) to me. If the manager had not been available to receive an employee's complaint, then I would expect the employee to report the problem(s) directly to me. If the manager had already reported the offense(s) to me, and then the knowledgeable employee came to inform me, too, I would thank him and tell him that I was aware of and dealing with the situation. I would also ask him to tell me of any future violation(s) he might observe. I would not reveal to him what was being done relative to the offending employee but would let him simply know that action was being taken. I would certainly speak to the manager to ensure that our action plan was being implemented and that an unnamed employee had expressed concern about the situation.

"My advice is to document and report the information through the chain-of-command. If the director and manager are not reacting to the issue, then speaking with HR is certainly warranted. It sounds as if the incidents have already been reported through the proper laboratory channels, so it is time to move up the line to Human Resources (HR). Ask HR for advice on how to address this issue. Ensure that the HR personnel understand the significance of the issue; the errors and omissions of this lone offender could result in damage to patient(s) and/or in legal action on behalf of the patient(s)."

Marti Bailey recommends, "You state that the employees of good standing are left to monitor the non-compliant employee and report infractions, and you mention the added burden of 'babysitting' a non-compliant co-worker. Anyone who takes on this burden is guilty of enabling. You might monitor the work of a new but certainly not a long-term employee.

"How do you know that the lab manager has not already taken some action with this employee? There are not a multitude of offenses that are reason enough for immediate dismissal. Most performance problems are handled by discussion, re-education, and a performance-improvement plan--all handled confidentially, so you would not necessarily be aware that action had been taken.

"I suggest that you back off. You have already notified the lab manager multiple times. It is now that person's responsibility to determine if there are performance problems that need to be corrected. If you find specific incidents of incorrect results, failures to run quality control when required, false documentation, and other non-compliant issues then, certainly, report these in writing to your lab manager. You should not be, however, looking for these."

Bottom line. Your staff's concerns in working with such an individual are understandable. You are not going to solve the problem by monitoring the work of someone who should be working independently. What you are actually doing is allowing 1) the perpetuation of this person's behavior, and 2) your manager to continue to overlook the problem, if that is really what is happening.

Fair firing over voicemail message?

Q The day he returned from a two-week vacation, our PhD toxicologist was fired by the hospital administrator. Despite the lab director's request that all of us make our outgoing messages user-friendly for the physicians in our 750-bed teaching hospital, his outgoing message said, "I am either on the phone or away from my desk. Please leave a message, and I will return it as soon as possible." The day he went on vacation, he had not changed that message. Our chief neurologist called him about a therapeutic drug value that she did not believe. In her voicemail, she asked that he call her as soon as possible because the matter was urgent. She left the same message four hours later and again the next morning. By then, her patient was in trouble. She subsequently called the lab director who explained that the toxicologist was on a two-week vacation and should have indicated in his outgoing message that he was unavailable until a specific date. Next, the doctor reported our toxicologist to the hospital administrator. Do you think this was fair to all involved?

A Marti Bailey advises, "In my opinion, your administrator overreacted. Anyone can forget to change his voicemail message or to enable the rule in his computer that notifies e-mail senders of time away. The real fault is the chief neurologist's failure to follow up in a timely manner after not receiving the expected return phone call. Unless your toxicologist is the only one in the department, other resources would have been available to handle the problem. Even if it were a one-person department, some arrangements would have had to be made for coverage. By letting the problem go unaddressed overnight, the neurologist created the crisis. Had she called the lab director sooner, that person would have been able to arrange for the issue to be handled by someone other than the vacationing toxicologist."

Larry Crolla opines, "This action is severe for the offense; a reprimand could have been given. The real issue here is whether 1) everybody who does not change their voicemail is going to be fired, or 2) others have been fired in the past for not changing their voicemail. You cannot single out one individual with an administrative policy, so I think the individual involved should seek some legal counsel. It sounds to me that one of two things occurred-- the voicemail was just the overt situation needed to eliminate this person, or there is more to the situation than you have knowledge about. If I worked at this institution, I would opt out of voicemail. There is also another issue here--the same issue as for e-mail, because these are both high-tech tools--and that is the use of voicemail or e-mail carries no guarantee that the intended recipient ever got the message. I also bet there is not a policy in your employee manual that one must respond to voicemail or e-mail in a prescribed time frame."

According to Alton Sturtevant, "What you describe relative to the toxicologist was a serious breach on his part. In my opinion, whether or not it was a 'firing offense' is certainly up for serious debate. As a manager, I insisted that my supervisors change their phone message each day to correctly reflect their status. Additionally, I expected them to change the message multiple times during the day if they are going to be unavailable for longer than one hour. During the course of my normal day, I would call many of my direct reports for business purposes; and, if their phone messages did not correctly reflect their situation, then I would personally discuss it with them. I would also periodically discuss the issue by e-mail or in our staff meetings. The staff knew that I was serious about this issue and expected them comply with this policy."

Dr. Sturtevant adds, "I will say that many managers (not reporting to me) including senior managers (e.g., vice presidents managing hundreds of people) do not manage this part of their job well, and it is common for me to hear, 'I am either on the phone or away from my desk. Please leave a message, and I will return it as soon as possible." Their phone message never changes. I still feel strongly enough about the issue to remind them about their oversight whenever possible.

"The physician, in the end, had the responsibility of getting proper care for her patient and should have spoken with another physician, hospital pharmacist, medical director, section supervisor, or appropriate individual to get resolution to the medical problem. She should have never relied on a voicemail message for a resolution in such a critical situation."

Bottom line. Do personnel policies speak to this issue? Was the toxicologist personally counseled relating to the issue in the past? The toxicologist's error was serious, and counseling was needed, but the patient's misadventure was not caused by the toxicologist but by the neurology chief. I certainly do not think that termination was appropriate in this case unless the toxicologist had repeatedly offended and had write-ups placed in his personnel file.

MLO's "Management Q & A" provides practical, up-to-date solutions to readers' management issues from a panel of laboratory management experts. Temporarily, readers may send questions to the MLO editor at [e-mail]. Unless otherwise noted as "confidential" by readers, all queries will be considered for publication without further notice to them, Names, institution, city, and state will be removed before publication. The following panel of laboratory directors, managers, and supervisory technologists have provided their input in the answers given in this column: Marti K. Bailey, MT(ASCP), work unit leader, Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA; Lawrence J. Crolla, Ph.D, consulting clinical chemist, Departments of Pathology and Respiratory Care, Alexian Brothers Hospital, EIK Grove Village, IL, West Suburban Medical Center, Oak Park, IL, and Northwest Community Hospital, Arlington Heights, IL; and Alton Sturtevant, PhD, laboratory director, LabCorp, Birmingham, AL.

Edited by Christopher S. Frings, PhD. CSP