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Department of Pathology
(Laboratory) The term laboratory has been in
popular use, the Pathologist prefersto use the term Department ofPathology/ClinicalPathology/Laboratory Medicine
Primary Function:Confirming or rejecting a diagnosis
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Providing guidelines in patientmanagement.
Establishing a prognosis. Detecting disease through case
finding or screening.
Monitoring follow up therapy.
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Secondary function:
> Education and Research- Participation in the programs ofmedical staff, staff committees andclinical dept
- Continuing education program forthe MT
- Residency Program
- Cooperates with the hospital andmedical staff in conducting variousprograms
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LABORATORY MANAGEMENT
(Management Principles) The Director of Pathology is responsible in
the Professional and Administrativematters of the department.
In general, the Pathologists competence inprofessional matters can only be assumedbecause the education has been exclusivelyin the field for the past decades; but with
continuous modification in the field ofPathology the administrative concept canbe assumed as a function.
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Management principles are an affirmation of the conceptthat anything worth doing is worth doing well.
One Can summarize the Principles as follows:
Define the Problem, apply an analytical method whichreveals the basic facts and devise a solution
Not all, but at least some problems may be solved, orconsiderable improvement made.
Even if not solved, the analysis of the problem increasesknowledge or appreciation, in themselves useful.
- Kenneth L. McCoy, MD
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SCHEMATIC OUTLINE OF ACTIVITIESIN
PATHOLOGY AND LABORATORY MEDICINE
Leadership and Management Administration
----------------------------------------------------------------Indications and Technology and Interpretation and
Selection Generation Translation
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TEACHING
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RESEARCH--------------------------------------------------------------------------------------------
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Organization and Operation of the
Laboratory The operation of a clinical laboratory and
effective delivery of service to clinicians,patients, and the public, require a complex
interdigitation of:1. Expertise in medical, scientific and
technical areas
2. Resources in the form of personnel,
laboratory and data processing equipment,supplies, and facilities
3. Skills in organization, management, andcommunications
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Organization and Operation of the
Laboratory All laboratory personnel, especially
those in the leadership and
management, must be aware ofcurrent accreditation andgovernmental regulations and evolvingpractice guidelines that relate not only
to laboratory services but to personnelmanagement, and marketing practices.
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The efficient operation andeffective delivery of laboratory
services are dependent on modernequipment, well trained staff,adequate and well designedphysical environment and a goodmanagement team.
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LEADERSHIP VERSUS MANAGEMENT:GOALSINDICATE DIRECTION AND
OBJECTIV
ES
LEADERSHIP---------------------------------------------
Goals: Where
---------------------------------------------MANAGEMENT
---------------------------------------------Objectives: HOW steps
1. Organize2. Plan
3. Direct
4. Control
5. Staff
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Leadership - is providing direction ofwhere one ( or an organization) is
going.
Management is providing the stepsof how to get there.
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BASIC MANAGERIAL
RESPONSIBILITIES- used in responseto many of the responsibilities facinglaboratory managers.1. Quality leadership2. Personnel management
3. Policy and Procedure manuals4. Criteria based-job descriptions5. Recruitment and Staffing6. Orientation7. In-service and continuing education8. Staff meetings9. Personnel records
10. Performance evaluation/ appraisals11. Discipline and dismissal12. Legislative/regulatory issues13. Medico-legal concerns14. Financial management15. Marketing16. Benchmarking
17. Productivity assessment
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QUALITY MANAGEMENT PROCESS OF
TOTAL QUALITY MANAGEMENT (TQM)
1. Find a problem or process to improve
2. Organize a team
3. Clarify what is known about the process4. Understand causes of theproblem/variation
5. Select the way the process is to be
improved6. Plan implementation of improvementsto be made
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7.Do what is appropriate to implement
8. Check data collected from monitoring customer outcome
9. Act to maintain and continue theprocess
One particular instrument used inestablishing quality management is the:
F O C U S P D C A
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FACILITY DE
SIGN PROCE
SS
Phase: Preparation Needs assessment
Staffingneeds/requirements
Technologic changes,current andanticipated
Identify team players(architect, lab staff,
med staff, interiordesigner, etc
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FACILITY DE
SIGN PROCE
SS
Phase: Function Activities to beperformed
Flow of people andmaterials
Storage
Equipment used
Utilities Laboratory
sectional needs
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FACILITY DE
SIGN PROCE
SS
Phase: SchematicDesign
Structural design
Identify constructionmaterials
Architectural design Cost
System options(plumbing, electricity,heating, ventilation,etc)
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FACILITY DE
SIGN PROCE
SS
Phase: Designdevelopment
Phase: Construction
Interior design
Bidding/
Negotiating contracts
Legal documentation
Actual construction
Completion andoccupancy
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- QUALITY
SYSTEM
S-
Quality, in all aspects of medical care and services, isthe primary goal of clinical laboratories.
Components of a Quality system are:
1. organizational structure
2. responsibilities
3. policies
4. processes
5. procedures6. resources established by executive management to
achieve and ensure quality
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A Quality system includes:
> Quality Control(QC)> Quality Assurance (QA)
> Quality Improvement (QI)
The broader-based systemsapproach ensures application ofquality principles throughout the
organization (use of such approachis changing the focus of qualityissues from detection to prevention)
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LABORATORY SAFETY Universal Precautions Consider ALL patients blood and body fluids to
be bio-hazardous regardless of diagnosis.
Always wash hands before and after contact withpatients.
Wear gloves when handling blood, body fluids,tissues or contaminated surfaces.
Wear gloves and waterproof aprons, masks andgoggles if splashing can occur or duringprocedures (e.g. dialysis, postmortem).
Dispose of all needles in puncture-proof boxes.
Minimize mouth-to-mouth transmission by
keeping mouth pieces readily available. Clean blood and body fluids spills with a solution
of bleach (10%) and water or with a hospitaldisinfectant.
Immediately report all needle sticks, accidentalsplashes and contamination of wounds by bodyfluids.
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LABORATORY SAFETY Personal Hygiene Wash promptly whenever a chemical has
contacted the skin.
No sandals, open toed shoes or clogs shallbe worn by laboratory personnel.
Clothing worn in the laboratory should offerprotection from splashes and spills, shouldbe easily removable in case of accident.
Laboratory clothing should be kept cleanand replaced when necessary.
Lab coats are not to be worn outside thelaboratory, especially in rest room or breakfacilities.
Do not rink, eat, smoke, or apply cosmeticsin the laboratory or chemical storage areas.
No food, beverage, tobacco, or cosmeticsproducts are allowed in the laboratory or
chemical storage areas at any time.
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LABORATORY SAFETY Housekeeping
The area must be kept as clean as the work allows. Each laboratory employee shall be responsible for maintaining the
cleanliness for his/her area. Reagents and equipment items should be returned to their proper
place after use. Chemical, especially liquids, should never be stored on the floor,
except in closed door cabinets suitable for the material to bestored.
Stored items or equipment shall not block access to the fireextinguisher(s), safety equipment, or other emergency items.
Stairways, hallways, passageways/aisles and access to emergencyequipment and/or exits must be kept dry and not be obstructed inany fashion, including storage, equipment, phone or other wiring.
No combustible material such as paper, wooden boxes, pallets,etc., shall be stored under stairwells or in hallways.
All working surfaces and floors should be cleaned regularly. All containers must be labeled with at least the identity of the
contents and the hazards those chemicals present to users
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LABORATORY SAFETY Electrical Safety
All electrical equipment shall be properly grounded.
Equipment, appliance and extension cords shall be ingood condition.
Extension cords shall not be used as a substitute forpermanent wiring.
Electrical cords or other lines shall not be suspendedunsupported across rooms or passageways.
Multi-outlet plugs shall not be used unless they have
a built-in circuit breaker. Most of the portable multiple outlets are rated at 15
amps.
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LABORATORY SAFETY GENERAL SAFETY EQUIPMENT
Fire Extinguishers
Ventilation Hoods Storage Cabinets
Safety Shields
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