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Helping staff excel: career growth without a ladder.

A labwide incentive program has reaped many rewards for the staff of a North Carolina hospital laboratory, including first prize in MLO's 1992 Article Awards Contest.

RETAINING a loyal, motivated lab staff can often be a monumental task. Many clinical laboratory professionals are offered little room for advancement. In a small lab like ours, management-level positions are rarely vacant. Despite these limitations, most of our 60 employees are highly qualified and devoted to their jobs. In 1989 we were determined to offer our valued staff more opportunities for professional growth.

Our lab management has always listened to employees' concerns. We frequently conduct surveys asking how staff members feel about their jobs and what they hope to achieve in the future. Usually they request upward mobility and opportunities to contribute to changes in policies and protocols. To meet their needs, we wanted a recruitment and retention tool that would be applicable to everyone, including phlebotomists and secretaries.

Our lab director gathered a committee consisting of lab management staff and a supervisor from our referral laboratory. Employees at that site would be able to participate in the program.

* Gearing up. We conducted an internal survey asking staff members what kind of program they envisioned, in what ways it should enrich them personally and professionally, how it might improve the work environment, what potential short- and long-term benefits it should provide for the laboratory and hospital, and whether they would participate. To encourage candor, we allowed participants to return the questionnaires anonymously. About one-third of the staff returned responses, which we continued to consult as we developed the program.

While the survey was being processed, we reviewed many articles on career paths and career ladders in health care. Local hospitals were contacted for information on existing job enrichment programs we could tap for ideas.

Until the program had a name, we felt it would not belong to us. A contest among the lab staff yielded a number of ideas. The winner was "Excel--The Laboratory Challenge for Excellence."

* Setting goals. Armed with a base of information, our committee prepared a list of objectives. These had to be compatible with our hospital's mission and goals statement; to benefit our laboratory, hospital, and community; and to meet employees' needs. After much discussion, we carved out the following mission statement for our program: "To recognize and compensate individuals who assume increased responsibility, enhance their clinical and/or technical competencies, and maximize the efficiency and quality of the laboratory through professional growth."

In spite of statements we had read in the literature, we knew that a formal career ladder program would not satisfy our special needs. In fact, we feared that such an approach might actually undermine our intended goals. We wanted a system that measured employees' achievements objectively.

* Achievement checkpoints. Under Excel, employees are encouraged to accomplish tasks in any or all of the program's seven categories: technical research and development, enhanced responsibilities, continuing education, service activities, hospital relations, innovative and creative ideas, and formal education and certification. Each category is divided into subcategories, which are further broken down into specific assignments. Points are assigned for every category, subcategory, and task.

Points accumulate on four levels. Participants who earn 25 to 49 points by the end of the year (Level I) receive a certificate of achievement. Those earning 50 to 74 points (Level II) are awarded $500; 75 to 99 points (Level III), $750; and 100 points or more (Level IV), $1,000.

Completing the first activity under a specific category gains points separately for entering the category, selecting a subcategory, and completing the task. Under the category of service activities, for example, holding an office in an approved professional organization gains 5 points for entering the main category, 3 points for choosing the subcategory (professional activities), and 2.5 points for the task. If the same employee performs another task under the same subcategory, such as chairing a committee or task force, one more point is earned. To encourage diverse experiences, the points for entering categories and subcategories are high but awarded only once.

The number of points awarded for each task depends on whether it was done at work or on the employee's own time, the value of the activity to our laboratory, and how long it took to complete. The total number of hours (points) earned is divided by 10. Completing a simple activity in one hour, for example, earns 1 point, which is translated into 0.1 points toward Excel totals.

The Excel package includes a diary in which participants record information related to completion of DD (diary-documented) projects, one of the three kinds available. For DD projects, such as evaluating a new method or training new employees in a departmental duty, a staff member receives the full point value if the task is done after working hours but half that amount if it is done during the person's regular shift. A combination is allowed; for instance, an employee who does half of a 20-hour project at work and half after work receives credit for 15 hours (1.5 points).

A second kind of project is called SD, or supervisor determined. These include assuming responsibility for a specific bench and teaching a portion of a job-related class. The supervisor who proposed each such activity assigns the number of Excel points it will earn according to its value to the section and the time required to complete it. Participants can ask for more points by submitting a written justification to the appropriate supervisor.

Fulfilling the third kind of assignment earns a stated value that does not change. Two such tasks: preparing and presenting a CE program to the lab staff and teaching a specific computer function to a new employee.

* Applicant requirements. To be accepted into Excel, an employee must hold a budgeted position in our department or referral laboratory; have worked in a clinical laboratory for at least three years and in ours for at least two; and have received a positive performance evaluation within the last year. No disciplinary action may have been taken against the person within the last year. A letter of recommendation from a supervisor, manager, or pathologist in our laboratory must be provided as well.

On the Excel outline, applicants indicate the tasks they plan to complete within 11 months and the level of accomplishment they wish to achieve. Our committee approves the proposals before the beginning of each fiscal year. Employees are expected to fulfill their commitments. A person who intends to reach Level 4 by the end of the year but attains only Level 2, for example, receives no points.

When 11 months have passed, each participant submits a final outline listing the activities completed and the points earned. For DD projects, the diary and any additional documentation is attached. During the last month of the fiscal year we confirm point scores and plan a ceremony at which the certificates and checks are awarded.

* Successes. Excel completed its first year in August 1991. The 16 participants exemplified the goals of the program through their accomplishments. Staff members shouldered supervisory duties they might otherwise not have attempted, such as writing technical procedure manuals, coordinating proficiency testing, and devising personnel schedules. During a major computer upgrade, staff members helped with the training of personnel and in the testing and verification of software. They joined committees that plan activities for National Medical Laboratory Week and the hospitalwide United Way campaign. Three technologists attained specialist certifications in hematology, chemistry, and blood banking. In all, Excel participants completed 274 hours of continuing education and conducted 11 CE classes for their coworkers.

In Excel's second year, lab employees more than doubled their efforts, completing an amazing 575 hours of CE. The staff learned about new instruments in the lab and studied how to upgrade and repair personal computers. Participants ran 14 CE programs for our technologists and phlebotomists on topics such as quality control fundamentals, blood banking and microbiology case studies, total quality management, and specimen collection for blood cultures.

The Excel category "innovative and creative ideas" has sparked many enterprising contributions from our staff. One participant enrolled the lab in our state Adopt-a-Highway program; a sign declaring us watchdogs of a section of a community highway stands at that site. Another staff member established a fund for break room supplies, party refreshments, and flowers sent to employees who have had a death in the family. In addition, we now have a computer menu dedicated to phlebotomy and a computer program to help us monitor Stat turnaround time. New reference sheets listing normal and therapeutic ranges placed near every telephone help us respond to telephone queries. Having a mailbox for each employee facilitates the distribution of interdepartmental communication.

* Meeting expectations. As participation in Excel continues to increase, its revitalizing nature remains evident. Our third year has brought increased participation from our employees in pathology and phlebotomy and in our satellite and outreach referral laboratories. Excel has more than satisfied our intent to provide an atmosphere of freedom for independent and unharnessed thinking. Its dynamic nature allows our staff to grow with the program as the program grows with us.

Sorrell is hematology section supervisor and McMinn is assistant manager of laboratory services at High Point Regional Hospital, High Point, N.C.

Excel program objectives

* Recruit and retain laboratorians through an equitable, ongoing career development program

* Encourage commitment to the hospital

* Improve the quality of the lab and hospital through CE and professional growth of employees

* Enhance the lab's image in the hospital and community by promoting good relationships with physicians, other hospital departments, and community organizations

* Offer a challenging work environment

* Establish opportunities for motivated employees to raise self-esteem and reach a high level of self-actualization

* Encourage involvement in the field through professional organizations, seminars, and workshops

* Increase quality assurance and productivity by supporting innovation, creativity, and entrepreneurial activities

* Recognize the achievement of employees who earn advanced degrees or specialty certifications

* Provide ways for capable, interested employees to grow into new jobs

* Reward and recognize employees who meet criteria

Sample components

I. Technical research and development (5 points)

A. Research development (3 points)

1. Research and write an article for MEdical Staff News or Reference Point (hospital publications) (0.3)

2. Research, write, and submit an article for a professional publication (0.1)

3. Publish an article (DD)

B. Technical procedures (3 points)

1. Review literature with emphasis on maintaining current technology and practice (e.g.,read and summarize an article) (0.2)

2. Evaluate a new test or instrument (DD)

3. Parallel test a new procedure (SD)

4. Write a new procedure (SD)

5. Complete a major procedure revision (SD)

6. Prepare supplementary material for procedures (e.g., flip cards, flow charts, card files) (DD)

III. Continuing education (5 points)

A. Presentations (3 points)

1. Prepare and present a seminar at a state or national meeting (2.0)

2. Prepare and present a CE class to lab employees based on meetings attended (0.5)

3. Prepare a written summary of meetings attended (0.2)

4. Prepare and present a lab CE lecture, includinng case studies and advanced testing (0.5)

5. Prepare and present information for a section meeting (0.2)

B. Technical or nontechnical workshop or seminar attendance (3 points)

Points assigned according to CE credits earned:

1. Attend a job-related seminar

2. Attend a management or supervisory seminar

3. Attend an instrument school

4. Attend a personal enrichment seminar

C. Courses (nonmatriculated) (3 points)

1. Complete a self-improvement course (semester hours or contact hours earned)

2. Complete a job-related course or program (semester hours or contact hours earned)

3. Complete an ASCP Tech Sample or equivalent

D. Preparation for an ASCP or NCA categorical or specialist exam (20 points)

Employees earn points toward financial rewards in seven categories, of which two are listed here. Each supervisor-determined (SD) project is scored by the supervisor who proposed the activity in light of its value to the lab and the time needed to complete it. Diary-documented (DD) projects are scored according to the time taken to complete them and whether they are prepared during work or after hours.
COPYRIGHT 1993 Nelson Publishing
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Copyright 1993 Gale, Cengage Learning. All rights reserved.

Article Details
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Author:Sorrell, Deborah I.; McMinn, Margaret
Publication:Medical Laboratory Observer
Date:Jan 1, 1993
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