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A time to reexamine values.

Values in our field long seemed to be a Gibraltar, the rock on which quality health care was founded. Now the ground is shifting.

Today's clinical laboratory must begin to operate as a cost center, instead of as the favored, high revenue producer it was before DRGs. This complex new environment is challenging the professional values of managers and employees, as wella s the values of their organizations.

What are our professional values? For most of us, they are the deep-seated standards that influence moral judgments, decisions, and commitments to individual and group goals. Organizations, on the other hand, have their own values, history, rituals, and traditions, which form the so-called organizational culture. This culture reflects an institution's philosophy and affects the way employees perceive their roles and set their goals.

Of course, people and organizations work best when they share the same values. Achieving this harmony will do much to secure our success under the Government's restructured payment system. Since values influence our levels of effort, dedication, and satisfaction, it's vital that we know and support the values of the organization we work for.

The new hospital economic environment places a premium on productivity, innovation, and willingness to take risks, rather than on conventional values like seniority and risk avoidance. But organizations can't rush these cultural shifts. They must recognize employees profound psychological attachment to traditional and symbolic activities.

Prospective payment shakes up some of our priorities in delivering quality patient care. In the past, hospitals have run on a regulatory value system based on organizational structures and policies. Now, with efficiency as a watchword, we need a more flexible, humanistic system that respects and recognizes the worth of individual contributions.

Most important, all of us must cooperate with our institutions and work toward mutual goals and shared values in order to survive in the world of tightening budgets. In the process, we will gain deeper satisfaction from our work lives and enhance our awareness of qualities like loyalty and responsibility.

It won't be easy to update our values. First, we must overcome any vested interests that inhibit our freedom to change. A vested interest implies that you are not really free to change, reform, or give up beliefs and ideas that maintain your reputation or position. No group likes to see its turf threatened, but our professional concerns must grow beyond narrow self-protection for our own long-range good.

Then we must build a new agenda for laboratory staff and management. For lab managers, that means taking a less authoritarian stance, and involving employees in decision making through systems like quality circles and management by objectives. Supervisors and managers must communicate more, keeping the staff up to date on top-level plans and changes through regular meetings.

Objective-oriented performance appraisals support this approach by informing employees of management's expectations through competency-based job descriptions, measurable standards, and clear lines of accountability. Standards and objectives should be mutually acceptable to employees and managers.

Finally, members of laboratory management should participate actively in nonlaboratory activities. They can polish the profession's image by volunteering for hospital committees and seeking other outside areas in which to use scientific and managerial skills.

Laboratory employees, in turn, must expand their base of knowledge and take aninterest in learning how other departments function at a staff level. By interacting with personnel from other disciplines, they can share information about the various health care professions.

Technologists and other staff members can also reinforce their roles on the health care team by communicating in person with nurses and other colleagues. And they can demonstrate their interest in the institution through participation in employee committees and hospital social activities. Beyond the hospital, they can become more public relations-oriented and spread the good word about the profession through community groups.

At the same time, they should increase their involvement in total laboratory operations. Volunteering to help supervisors cut costs and increase productivity is really part of a technologist's job.

Some of these suggestions are just extensions of our present laboratory work values. Others demand changes in attitude and practice. These times call for change, and if we don't comply voluntarily, we will eventually be coerced. VAlues are the life blood o fany organization. When you support them, you become part of the solution instead of part of the problem.
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Author:Barros, Annamarie
Publication:Medical Laboratory Observer
Date:Jun 1, 1984
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