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Creative strategies for lab managers.

In the past year, we have all been paying close attention to the effects of prospective payment. Medicare's DRG system, however, is only the beginning of the health care industry's full-scale switch to a competitive mode. The future will bring very different priorities, and lab management formulas that worked in the past are already becoming obsolete.

Managers determined to succeed must start readjusting now. Those who perceive DRGs as a purely negative force will have to begin viewing them as a challenge to grow in knowledge, skill, and responsibility. Let's face it: Some of us have gown complacent in familiear routines and forgotten what it feels like to institute change through creativity and innovation.

Our professional evolution will require the skills of authentic management and a good measure of political savvy. We will explore these two important areas in depth.

Authentic management is real, not phony; trustworthy, not unpredictable; and flexible, not rigid. It is a style based on openness, responsivess, and constructive action. How can you tell whether you ae an authentic manager? Look to your employees' reactions for the answer. Your management is perceived as genuine:

* If employees consider some conflict as a normal part of decision making, and if conflict is handled openly. This indicates that you have created an atmosphere in which people feel free to communicate their needs and problems with a reasonable hope of resolution.

* If the staff attacks problems informally without worrying about your reaction.

* If employees view frustration and dissatisfaction as an opportunity for solving problems and take responsibility for doing so.

* If they work as a team and feel entitled to a role in planning and setting standards.

* If you recognze and encourage expressive or intuitive behavior as well as stricitly task-oriented action.

These hallmarks of authentic management all focus primarily on human resources--the most valuable channel to higher productivity. Begin to develop this kind of management style by recognizing your primary responsibilities to your department. These can be analyzed as seven basic functions: planning, organizing, directing, controlling, coordinating, evaluating and appraising, and communicating. Some of those terms may sound similar, but each represents a vital component of creative management. In the future, we will ignore any one of them at our peril. Let's examine each more closely.

1. Planning. We plan in order to avoid crisis management. Short- and and long-range strategic planning forms the backbone of an organized, responsive work environment. Plans for each laboratory area should integrate departmental and institutional concerns. In other words, consider the laboratory as part of a total system and not as an isolated special-interest group.

Involve supervisors and bench staff in making plans and setting objectives. Most important, keep yourself well versed on coming trends and outlooks in health care; on new procedures, technology, and testing sites; and on changing employer attidues toward the use of personnel.

This involves some homework. The future of the hospital laboratory has been thoroughly dissected in major medical and hospital management journals and the popular business press. If you haven't been following these articles, you have a lot of back reading to do before you can lay meaningful plans for the lab. You must plan for what will be, not for what was.

Expand your inerest beyond the lab, and read what the decision makes read. Your library should include books like "In Search of Excellence," "Megatrends," "The One Minute Manager," and "Putting the One Minute Manager to Work," in addition to standard lab management texts.

2. Organizing. Organization begins with a careful evaluation of existing systems and their relevance to the demands of patient care and prospective payment--demands that can sometimes conflict. A new organizational mentality is emerging in health care. These days, we must examine the delivery of lab services in terms of outcome rather than concentrate on process alone. Clinical laboratories have always been strictly process-oriented. Our quality control and review systems, as well as actual test procedures, are all processes. Now we must expand that focus to see what each process costs and yields.

Review your department's written policies to judge their impact on efficient service and employee job expectations. Poorly formulated policies and position descriptions hurt productivity. Make sure that each position description is appropriate to the job and that it includes adequate performance standards to measure employee competence.

Develop supportive relations with other depatments. At the same time, your lab as a cost center must compete with them for a share of the pie. You will need new ideas and a willingness to depart from tradition in order to keep ahead of the game.

Get staff members involved at all levels of any reoganization effort. This is the basic principle of "Theory Z," the much-touted Japanese management style. It is basically a commonsense principle: Problems are best solved by those who encouner them on a daily basis.

3. Directing. The director of a play offers guidance to bring out the best in each performer and the best production as a whole. The role of direction in management is similar, and it is a lot easier when the staff participates in decision making. Delegate authority in fact, not just in word, by assigning important tasks and the responsbility for accomplishing them. Employees respond best when they know they will be accountable for the results.

Learn to operate with a realistic awareness of cost limitations, and instill this awareness in the staff. Work on establishing effective time management techniques, and encourage employees to do likewise. Deal with conflict directly. Trying to avoid or suppress it will depress morale. and when changes must be made, involve employees right from the start.

4. Controlling. Control extends to the department's major financial and business of decisions. You will needs a comprehensive financial management system that includes realistic productivity measures, micro cost accounting, budget and expense monitoring, and purchasing and inventory control.

Learn to prepare comprehensive departmental reports of laboratory activities and staff contributions. Monitor whether personnel are being used effectively. Keep employees involved in and informed about the lab's financial affairs.

5. Corrdinating. An effective coordinator is a mover, not a doer. Here your role is that of a facilitator and gatekeeper of department activities. You also serve as a public relations representative, a catalyst for other supervisors, and a leader in applying staff talent to the search for greater efficiency.

6. Evaluating and appraising. The point may sound familiar, but it is terribly important: An effective structure of employee recognition, reward, and discipline is based on objective-oriented, competency-based position descriptions with measurable standards of performance. Appraisal forms should reflect these standards, emphasizing growth and development rather than punshment. There are many resources available to help you develop these essential documents. In addition to individual employee appraisals, consider a performance auditing system to evaluate your department's overall delivery of services.

Whatever system you use, it should focus on employee recognition and job enrichment. If you can take time to correct employees' mistakes, you can also take time to tell them when they have done a good job. None of us is so secure that we cannot benefit from some praise now and then. Many scientists tend to be somewhat reluctant to give praise, especially to employees who merely satisfy job requirements. These very people, however, may be most badly in need of encouragement in order to excel.

When employees help develop their own paths to job enrichment, it deepens their commitment to self-improvement. Offer them encouragement by supporting continuing education attendance and by acknowledging their competence assurance activities.

7. Communicating. All your managerial prowess is worthless without effective communication, especially now as workplace cooperation becomes increasingly vital. Establish an intra- and inter-departmental information system that is open, clear, and comprehensive. Extend lines of communication to your peers in other areas of the hospital.

Pay special attention to verbal and writing skills, because the way you package your information is just as important as the message itself. A scientific and technical background seems to have prevented many laboratory professionals from developing a clear, direct writing style. You can't sell your ideas without being able to write an effective report, memo, or letter.

Build a high profile for yourself and your department. Try creating a system of troubleshooting rounds with all nursing units and other departments. Get involved in institutional activities, committees, and community organization. Stay active in professional organizations that serve as advocates for your profession and help influence regulatory agencies. You will not only grow professionally but also tap into an excellent intelligence network for upcoming changes.

These are the major elements of authentic management. In a perfect world, honing them would be enough to guarantee a smooth-running department. But as well all know, effective managers hae to be smart and savvy as well as competent. Over the years, I have put together my own definition of political savvy. Managing is not just what you do; it's also how you do it. Getting to know your bosses, their management styles, how they judge you and see your role--all contribute to your political success. You must learn to speak their language and understand their power plays.

That's why it is so important to keep abreast of hospital journals. Don't be reluctant to send pertinent clippings to directors or administrators to indicate your interest or alertness. Respect the credo of bosses: "Don't bring me your problems. Bring me solutions." Your imagination and initiative can make their job easier.

Learn how your supervisors will judge you. Here are some of the areas that hospital administrators tank high in priority when rating the worth of a department head, plus a checklist of questions on how you measure up:

* Relationships within the department. Do they contribute to smooth and efficient functioning?

How good is your technical competence and your ability to relate to employees? Does pertinent information travel freely upward and downward?

Are you fully informed of your department's functions and processes, and how they relate to the institution as a whole?

* Relation with other departments and personnel. How well do you interact with other departments and staff members?

Do you resolve imterdepartmental conflict on a one-to-one basis or seek help from the administrator?

* Official relationships with outside personnel. How do you relate with personnel outside the institution, such as patients, families, agencies, and vendors?

Are you sensitive to others' concerns, and do you respond accordingly?

* Creativity and initiative. Do you constantly seek opportunities to streamline procedures and improve operations in the lab and the parent institution?

Do you establish a creative work atmosphere that movitates employees to seek improvement?

Are you open to suggestions, or do you feel threatened by worthwhile proposals from others?

Are you myopically traditional or willing to change long-standing practices?

* Dependability. Are you willing to volunteer extra effort and time when needed?

Can you perform well under adverse circumstances?

Do you maintain and upgrade your management skills though continuing education?

Can you demonstrate your managerial competency by certification or graduate-level courses in management?

* Ability to work independently. How much time must your administrator spend to monitor your department's operations?

Do you keep administration informed of major decisions, while not bothering them with trivial problems?

Do you reliably convey vital information to and from upper management?

* Institutional loyalty. Do you measure the value of activities from the institution's standpoint or from a narrow outlook of departmental self-interest?

Do you balance support for your own departmet with an appreciation of the problems of others?

Do you help employees understand and appreciate the institution's problems and interests?

* Accurate position description. Does yours accurately reflect your duties and responsibilities?

Does it clearly state accountability and authority levels?

Are standards of performance relevant to job requirements?

Does the description reflect the institution's goals and expectations as well as yours?

This checklist emphasizes the need for today's health care manager to combine technical, financial, and interpersonal skills. Technologists in a management role may face many stressful situations, such as making potentially unpopular decisions, implementing unwelcome changes, and facing greater accountability than ever before.

On the positive side, this is an exciting time of opportunity for professional and personal growth for those willing to keep pace. Managers who are reluctant to change will join the dinosaur club. Those willing to try new and unfamiliar problem-solving paths have a far better chance of success. So will those able to project sincerity, goodwill, and a strong commitment to quality.

Others must accept you as a person before they will accept what you stand for. Don't hesitate to start thinking, looking, and acting like a manager. Begin by obtaining business cards if you don't already have them. If the hospital won't bear the cost, have them printed yourself. Their effect on your professional image is amazing.

These reflections on the emerging role of the laboratory manager were confirmed in a recent article in The Hospital Manager. The drive for greater productivity, it stated, fuels the two major trends that affect the role of the hospital middle manager. The first trend is toward a broader span of control, as the size of middle management contracts. The second is a decentralization of authority, bringing managers more influence in decision making, resource allocation, and organizational direction.

"Both these trends will require more sophisticated supervisory skills, technical knowledge, and coordinating talents than were required in the past," the article said. Managers will have to get "people smart" to handle the growing move toward meritbased pay systems, more sophisticated performance appraisals, and legal pressures in the workplace, it concluded.

Obviously, these challenges won't be easy, and some of us will decide not to meet them. Every decision involves risks, but risks also involve rewards. I believe the rewards will outweigh the risks for dedicated and talented people in this field. Someone will have to run our clinical laboratories, after all. Will it be you--or someone else who saw the opportunity and took it?
COPYRIGHT 1985 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1985 Gale, Cengage Learning. All rights reserved.

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Author:Barros, Annamarie
Publication:Medical Laboratory Observer
Date:Mar 1, 1985
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