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Management ideas for 1991.

Management ideas for 1991 My job takes me across the country to serve as a consultant and present workshops and seminars. My services help laboratory management improve their operations and expand their supervisory skills. But I also learn from those I serve. I then share with other labs the ideas I have seen concerning ways to increase efficiency and productivity.

Following the concept of MLO's column dedicated to tips on technology, I am going to devote this month's Viewpoint to tips on management. I have selected wa|aral ideas that have helped improve operations in laboratories I visited. You might want to try them in yours.

* Microbiology relief. One university-affiliated lab I visited makes good use of its centrally located receiving and distributing area. Here, all patient specimens are received, centrifuged, and aliquoted before being distributed to the appropriate department. What's unique is the way microbiology specimens are handled.

Those that do not require special treatment are plated on designated initial culture media, stored in an incubator, and delivered to the microbiology department at intervals. Lab assistants assigned to this job have been specially trained for it. When not handling micro specimens, they perform other duties. A refrigerator holds enough media for a day or two.

Placing these functions in the specimen collection area has three advantages: It centralizes specimen handling, increases the lab assistants' flexibility and utilization, and relieves the microbiology department of interruptions.

* Creative scheduling. An innovative approach to scheduling pickup rounds enabled one lab to lower the number of excess Stat orders, speed turnaround time, and reduce workload dramatically. The method eliminated physicians' complaints about long TAT and the need for Stat orders to obtain timely test results.

The laboratory began what they call the "midnight sweep." At midnight, the collection staff begins to gather specimens. Specimens for patients in critical condition are picked up first and for those in least critical condition last, but no later than 6 a.m. The bulk of the work is completed and on the charts by 7:30 a.m.

The first study of the results of the new schedule showed that fewer employees were needed to do most of the testing, except for microbiology and special chemistry. One day, for example, the staff collected only 16 specimens between 7 a.m. and noon.

The system was not free of glitches. It took about a year to correct problems, win acceptance by the medical, nursing, and other key departments, and convince the lab staff of its benefits. The day shift was the most reluctant to accept the system because they felt it might reduce their staffing needs. Preliminary data showed that they might be right.

A new schedule made it easier to implement the system. The third shift in the lab worked seven 10-hour days on and seven days off. The third shift overlapped the second by one or two hours and the day shift by two or three hours. Staff members work 70 hours and are paid for 80. Ten technologists are scheduled, five of whom work on any given night. Some support personnel work part time; others work eight-hour shifts.

The program was further enhanced by the medical staff's overwhelming acceptance and by a gradual phasing in to assure the nurses of its value. This unusual plan has had dramatic results.

* Restricting interruptions. The productivity of a large independent lab was severely hindered by receiving endless telephone calls for results and having to enter them into the computer. A shortage of technical personnel compounded the problem.

The laboratory manager created a team of data entry clerks and trained them to enter all test results, including microbiology, for procedures not reported by instruments connected to the LIS.

Telephone calls are no longer transferred to bench areas. Office personnel search the computer for requested test results. If they can't find them, they transfer the call to a supervisor.

The new policies have freed technical personnel to concentrate their time and effort on producing test results. With a check-and-balance system assuring the validity of data entered, even the microbiologists are satisfied.

The author is a management consultant and educator; director of Health Management Analysts, Los Gatos, Calif.; and laboratory operations adviser, Ernst & Young, Great Lakes Region, Cleveland.
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Author:Barros, Annamarie
Publication:Medical Laboratory Observer
Article Type:column
Date:Dec 1, 1990
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