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A lab management tool the rest of the hospital wants.

Quick, name one administrative activity whose handling puts the laboratory light years ahead of most other hospital departments. Can't think of any? How about productivity measurement?

When cost containment became a survival theme of the 1980s, hospitals began struggling to come up with a system that would gauge the effectiveness of their greatest operating expense-labor. Meanwhile, most of us in the lab have sat by smugly with our own well-established productivity measurement systems.

This column is an appreciation of the most widely accepted of these systems, the College of American Pathologists' laboratory workload recording method. Although we in laboratories may take it for granted, others don't. In their efforts to develop hospitalwide productivity systems, hospital and management engineers today look to the CAP method as a model.

All parties within the laboratory and hospital administration must understand and be committed to a system like CAP workload recording for it to be truly effective . Otherwise, they will collect a lot of meaningless data.

In the lab, we must be willing to live and die by our productivity data. That means, for example, transfering or even eliminating positions when workload drops below established limits for an extended period of time. Conversely, hospital administration must be willing to fund additional staff when the data show that the laboratory staff is overburdened, working at levels beyond peak efficiency. Neither the lab nor administration should quote CAP data only when it suits a need.

Is the system perfect? No, CAP workload units represent averages compiled from data generated at a variety of laboratories. Sometimes the data points are limited and may vary greatly from lab to lab, particularly in the case of emerging technologies.

There is no law that saySS you have to accept CAP data at face value. If your laboratory operation has a particular nuance, develop your own units by conducting a time management study and submit them to the CAP for inclusion in its database.

Of course, data are only as good as the way they are collected . If you operate under a manual system and rely on medical technologists to input the data, make sure they are aware of the purpose of the system and how it may affect their jobs.

I remember that years ago, when I was a bench technologist, my boss told me to keep a daily log of tests, standards, controls, and repeats. Had I known I was collecting productivity data that would have a significant impact on my job, I would have taken a keener interest in what I was doing.

If you count workload units through your computer system, make sure you regularly review values and update them when you change methodologies.

Beyond productivity measurement, the CAP system is useful for establishing relative value units in cost-accounting the labor component of test procedures, justifying acquisition of new instruments, scheduling, and so on. Since what each laboratory considers a test can vary greatly, CAP units also serve as a standard to measure the size of your laboratory operation against others.

Managers often run into trouble with the CAP method when they accept the data unquestioningly, without considering other variables that may affect the lab's productivity levels. For example, each particular section may participate in many non-workloaded activities such as teaching or developmental work, which would tend to lower productivity. Managers should also consider workload trends over a long period of time instead of reacting to shortterm variances caused by such factors as a change in bed census or a staffing shortage.

The CAP workload recording system represents a valuable tool for lab managers, one that colleagues in other departments would dearly love to have. You need to keep in mind, however, that it is not a perfect system. But when it is properly understood and utilized, it can be of valuable assistance in monitoring laboratory operations.

The author is Administrator of the clinical laboratories at Thomas Jefferson University Hospital, Philadelphia.
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Copyright 1989 Gale, Cengage Learning. All rights reserved.

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Title Annotation:College of American Pathologists' laboratory workload recording method
Author:Maratea, James M.
Publication:Medical Laboratory Observer
Article Type:column
Date:May 1, 1989
Words:654
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