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A strategic plan for staff development.

The streamlined, cost-conscious clinical laboratory of the future may well need fewer but better medical technologists. That's an unsetting prospect for management and staff alike. The laboratory of our 816-bed hospital, however, is doing something more constructive than awaiting layoffs or cutbacks.

The hospital's administration began a human resources planning program early this year and chose the clinical laboratory, including our transfusion service and serology section, as one of the first departments to participate. As it turned out, the program offered us the opportunity to enhance the staff's job security and satisfaction.

The project had three main goals. First, we wanted to establish a system for defining staff requirements that would anticipate the impact of prospective payment on personnel management. The second goal was to develop an orderly plan for qualified people to fill management openings. The third was to nurture individual career development plans for managers and highly talented staff members.

To introduce the program, our laboratory director and chief technologist conducted two 45-minute sessions explaining the possible effects of DRGs on the hospital's finances. They stressed the need for cost containment in every aspect of operation and outlined the current status of staffing and workload.

Afterward, everyone in the lab participated in an analysis of tasks, role expectations, staffing patterns, and personnel mix. Throughout the process, we tried to allay anxiety over feared cutbacks with honesty and openness. We made it clear that changes were inevitable and that both laboratory and staff would benefit most by taking the initiative in strategic planning.

At first, I was skeptical about the project's potential merit in a section like ours. The staff of the transfusion service, traditionally restricted to medical technologists, was a small one with low turnover, and we all communicate with each other daily about tasks and decisions. Since I intend to change careers myself in a few years, however, I had to admit that succession planning alone was a good enough reason to explore human resources development for the department.

We scheduled each phase of the project on a flexible four-month timetable, shown in Figure I. Although a six-week nurses' strike in the area delayed our plans, we have adhered quite closely to this schedule in practice.

Our first action was to distribute a basic questionnaire (Figure II) to the entire department, asking for their impressions of our present and future staffing needs. By tabulating and circulating the results, we allowed everyone to find out how their co-workers felt about current conditions and likely trends.

The results contained few surprises. Respondents seemed to feel that we were adequately staffed, with no room for cuts. Several mentioned a desire to expand their own responsibilities into teaching or supervisory tasks. The only unexpected findings, in fact, were that a couple of employees planned career changes in coming years.

Next, we compiled a list of all department tasks, from preparing reagents to answering the telephone. Staff members listed each duty they performed or shared with others. We gave special care to identifying duties assigned to a single staff member, including the supervisor.

After sorting these tasks into four categories--technical, bookwork, computer, and miscellaneous--we analyzed the time spent on each, and the level of expertise necessary for performance. The entire staff participated in the time analysis and skill level assessment, using job descriptions as guidelines. Technologists were candid about admitting that certain tasks could be performed by nontechnologist personnel. In fact, no one realized how much time was spent doing such basic, nontechnical tasks.

At this stage, we saw the first areas for potential change. Our time study indicated that an ideal staff mix would be a ratio of five technologists to two laboratory technicians--not the seven full-time medical technologists then employed. This projected mix has guided subsequent hiring decisions when staff members need replacement.

The list of special, one-person duties offered a vehicle for accomplishing the program's two remaining goals: to develop a management succession plan and help develop individual careers and talent.

In our lab section, the supervisor has traditionally performed a number of activities with minimal staff input: reviewing financial reports, preparing budgets, analyzing test costs, gathering statistics, recording CAP workload units, scheduling and evaluating personnel, and reviewing policies and procedures. Other individual responsibilities included management of our MT teaching program, in-house proficiency testing and in-service education, and computer projects and updates.

Each of these tasks could serve as a potential area of development for staff members. To match employees with appropriate opportunities, we asked them to complete a form indicating their career goals and any past experience in various job enrichment categories. The form shown in Figure III is a composite of typical responses. We also asked staff members to suggest a one-year, two-year, and five-year personal plan for additional training and experience in areas of interest.

Most of the technologists had a ready list of suggestions for job development in the next one or two years, such as assuming supervisory or educational duties. Fortunately, our staff members' interests were sufficiently diverse so that not everyone chose the same areas! The five-year plans tended to be less specific than the short-range goals, although several technologists expressed interest in being groomed for my position as supervisor. We plan to update the plans annually.

The completed plans helped employees crystallize their own career goals and provided me with a guide for delegating duties in areas needing more thorough coverage. After evaluating the plans, we assigned a number of new projects. To ease the transition, technologists used information packets covering various phases of on-the-job training and received one-to-one instruction from the supervisor. This fall, they will begin attending hospital-sponsored management workshops.

Several technologists participated in each task to encourage input and consensus on decisions and changes. For example, several staff members who expressed interest in teaching now assist the person responsible for our medical technologist education program. Other special functions include assistance with financial planning and revision of our standards for personnel evaluation. Some of these special functions are scheduled regularly, while others are performed during slack time.

Bench work is still the staff's primary activity, but we now have an organized system for tapping their talent for extra help when needed. We also know what kind of staff we'll need to survive the tight budgets of the coming years; the section has already replaced a departing echnologist with a medical laboratory technician. We will rely on this combination of attrition and strategic planning to spare us painful and arbitrary staff cuts in the future.

Meanwhile, the laboratory's human resources program will pursue a number of continuing goals. We will update the staff on important reimbursement-related changes such as the rise in outpatient surgery, increased marketing of lab services, and our new MLT teaching program slated to begin this year. We will also refine the way we measure the department's performance through workload monitoring, time studies, audits, and other methods, to keep schedules and staffing levels at optimum efficiency.

Technologists have not received salary increases for their new responsibilities, nor have we had the opportunity for any promotions so far. However, the staff seems to appreciate the chance to broaden their range of skills and value on the job market. Teamwork and understanding have improved, and lab management has laid the groundwork for effective promotions from within.

Most important, we've demonstrated our commitment to making the best possible use of our most important resources--the human ones--under growing economic pressure.
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Title Annotation:1984 MLO Article Awards Contest prize winner
Author:Biddle, Anne M.
Publication:Medical Laboratory Observer
Date:Jan 1, 1985
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