Lab Management (MLLM-401)

1. Lab Management (MLLM-401) By Dr. HodaZaki Prof. Hospital Administration Chair Department of Health Administration &Behavioral Sciences High Institute of Public Health University of Alexandria Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

2. Lecture What is lab Management? Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

3. Intended Learning Outcomes (ILOs) By the end of this lecture the student will be able to : • Define the management. • Identify the different section of lab. • Know the importance organization in lab. • Identify the element of lab organization. Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

4. Lecture content • What is Management? • Managerial Functions • Organizing Clinical Laboratory • Clinical Lab Departments • Clinical Laboratory Personnel Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

5. Course Description The Laboratory management courses address basic issues in the areas of : • Lab organizing & planning • staff selection /Hiring of staff • leadership • Team development • Communication • Management of conflict • Problem solving . Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

6. Course Description The practical exercises: • Discussion group • Role- play Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

7. Overview • Clinical Lab is : • Lab that performs tests used to aid healthcare professionals diagnose and treat patients • Clinical Laboratories are a key component of modern medical care. • Along with Surgery and Imaging, they generate the bulk of an Institution’s revenue. • Labs are filled with expensive specialized equipment. Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

8. What is Management? • It is a science of / It is an art of: • Getting things done through people. • Achieving objectives through others • Achieving objectives of organization with people . • The effective use of resources to achieve the goals of the organization. Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

9. Cont., What is lab Management? • Laboratory Management. It is, therefore, “an on going process that seeks to efficient use of resources achieve the objectives of a medical laboratory”. The objectives of a medical laboratory are providing its customers (physicians on behalf of patients) accurate answers which help to clinical treatment”.. Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

10. Cont., What is lab Management? The main objective of a medical laboratory is satisfy Lab customers : • Internal customers: lab employees • External customers: patients, physicians, hospitals & insurance companies Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

11. Cont., What is lab Management? Lab Human resources & Non-human resources Lab Objectives Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

12. Managerial Functions • Organizing • Staffing • Planning • Directing • Controlling • Decision -making Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

13. Organizing Clinical Laboratory • It means arrangement of human & non human resources in such way that achieve lab objective with maximum efficiency. • It means dividing the activities of lab into specialized work units & positions & developing methods of coordination among them to achieve lab objective with maximum efficiency. Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

14. Organizing Clinical Laboratory • Lab Department (Lab Sections): • Lab divided into departments based on type of samples being studied. • Lab personnel: job specialization& task lists • Organization chart • Organization of lab services: • Between hospital • Within the same Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

15. Organizing Clinical Laboratory • Unity of command • Span of control • Equal authority & responsibility • Coordination Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

16. Clinical Lab Departments 1- Specimen Processing Receive, document & pre-process all samples 2- Chemistry Measure pH, ion & gas concentrations in blood & urine samples 3- Microbiology • Identify infectious microorganisms Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

17. More Clinical Lab Departments 4- Hematology Measure blood component concentration and function 5- Virology Identify & quantify viruses 6- Genetics Identify genetic disorders 7- Pathology • Collect, prepare and analyze tissue samples Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

18. Lab Departments • Specimen Collecting and Processing – includes phlebotomy

19. Lab Departments • Chemistry – body fluid components

20. Lab Departments • Urinalysis

21. Lab Departments • Microbiology – pathogenic microorganisms

22. Lab Departments • Hematology – whole blood analysis and coagulation

23. Lab Departments • Blood Bank (Immunohematology) – transfusion related testing

24. Lab Departments • Serology (Immunology) – antibody studies

25. Clinical Laboratory Personnel • Lab directors • Section supervisors • Medical technologists (MTs) • Medical laboratory technicians s (MLTs) • Phlebotomists & specimen processors • Clerks, medical secretaries &archivist • Laboratory information system (LIS) manager • Quality Audit personnel Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

26. Lab Director Qualification of lab director • He/Shemust be a pathologist or a doctoral scientist . • If a non-pathologist physician or doctoral scientist appointed as director , he/she must be has to be trained & has experience in areas of analytic testing offered by the lab . • He/She must have sufficient training and experience in clinical medicine , sciences basic to medicine , clinical lab sciences. Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

27. Responsibilities of Lab Director 1- interpretation , correlation , and communication of lab data 2- interaction with physicians and/or medical staff , patient , administration . 3- monitoring of standard of performance , QC , QI. 4- provision of education programs , planning , research. Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

28. Responsibilities of Lab Director • ensuring sufficient personnel with adequate documented training and experience to meet the needs of the lab . 6- he/she must be decision-maker in the selection of all lab equipment and supplies . • N.B.: If the lab director has delegated some responsibilities to others , there must be documentation of which individuals are authorized to act on his /her behalf for specific activities . Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

29. GENERAL SUPERVISOR Qualification : • Bachelor degree in chemical or clinical lab / medical technology science with at least one year experience Responsibilities: • Is responsible for day-to-day supervision of the lab operation , as well as personnel performing testing and reporting test results. Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

30. Medical technologists (MTs) Qualification : • Bachelor degree in medical technology Responsibilities: • Quality control • Preventive maintenance • Lab safety Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

31. Medical laboratory technicians s (MLTs) Qualification : • Responsibilities: Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

32. Phlebotomists & specimen processors Qualification :……………. Responsibilities: • procure blood specimens Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

33. Clerks, medical secretaries & archivist Qualification :……………. Responsibilities: • Receive specimens • Register outpatients • Send specimen to reference lab • Sort patient report Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

34. Laboratory information system (LIS) manager Qualification :…… Responsibilities: • Implementation & maintenance of the LIS • Management of all lab database Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

35. Quality Audit Staff Responsibilities • Performs quality audits • review all aspects of the facility and work performed • Reports findings to lab director.

36. Clinical Lab Personnel • There must be an organizational chart for the lab . • Personnel policies must be documented and available to all employees • The lab should have a complete , functional in-service continuing clinical laboratory education program . • Personnel records must be maintained on all current employees , the ideal location of personnel files in the lab . Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

37. Clinical Lab Personnel • Technical personnel records must include of all of the following : 1- summary of training and experience . 2- description of duties . 3- records of continuing education . 4- health record . 5- incident records . The lab must conduct an annual performance review of all employees. • New employees must be reviewed within 6 months of employment . Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

38. Clinical Lab Personnel • Some elements of competency assessment of each person : 1- Direct observation of routine patient test performance , including patient preparation , specimen handling , processing and testing ; 2- Monitoring the recording and reporting of test results ; 3- Review of intermediate test results or worksheet , QC results records ; PT results ; and preventive maintenance . Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

39. Clinical Lab Personnel 4- Direct observation of performance of instrument maintenance and function checks ; 5- Assessment of test performance through testing previously analyzed specimens , internal blind testing samples or external PT samples . 6- Evaluation of problem solving skills . Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

40. Organization of lab services a)Shared versus stand alone services b) in-house versus outsourcing c) Satellite lab Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

41. Organization of lab services • Shared services means the provision of clinical laboratory testing to several hospitals to save cost without reducing the quality of services. What are the advantages of shared services? • Stand alone services: provide of clinical laboratory testing to only one hospitals. • What are the advantages & disadvantages of stand alone services? Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

42. Organization of lab services • in-house lab services provide essential services ( expensive to operate & assets are under-utilized) What are the advantages & disadvantages of in house lab services? • Outsourcing lab services : select one or more lab to provide the required investigation; What are the criteria of outsourcing lab selection? Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

43. Organization of lab services c) Satellite lab : Located close to an emergency unit or other acute care units. Offers a specialized list of lab tests. What are the advantages of satellite lab? Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

44. Assignment • What are the organization Chart? • Prepare a presentation shows three different organization chart for labs. Name of students: • Aisha khadr Ahmed • SoraEftkhar Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

45. Study Questions: • What is Lab Management? Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

46. Suggested readings: • M. Harmening. Laboratory Management: Principles and Processes Denise.  2nd ed.2008 Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration

47. Thank you Prof.Dr.Hoda Zaki (MD PHD) Prof. Hospital Administration