Outline
Introduction Defining Lab & Lab
Services Types of Lab Lab Services Importance of Lab
Services Lab Equipment Lab Information System Lab Services Lab Medicines
Lab Safety Planning Staffing NABL Research & Training Policies Procedures Role of Administration Conclusion
A medical laboratory is a place where tests are done on clinical specimens and samples in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease
Laboratory Services include testing of materials, tissues or fluids obtained from a patient or clinical studies to determine the cause and nature of disease
Medical Laboratories
Clinical Pathology Clinical Microbiology Clinical Biochemistry
Haematology
Histopathology
Cytology
Routine Pathology
Bacteriology
Mycobacteriology
Virology Mycology
Parasitology
Immunology
Serology
Biochemical analysis
Hormonal assays
What are Laboratory Services all about?
Laboratory Services play a critical role in the detection, diagnosis and treatment of disease. Samples are collected and examination and analysis of body fluids, tissue and cells are carried out. Main services are:
To Perform diagnostic tests To Identify organisms, like E-coli bacteria To Count and classify blood cells to identify infection or
disease To Operate complex diagnostic equipment To Perform immunological tests to check for antibodies To Type and cross-match blood samples for transfusions To Analyze DNA
Services we provide..
• Microbiology
• Parasitology
• Virology
• Haematology
• Coagulation
• Clinical Biochemistry
• Toxicology
• Immunohaematology/Blood bank
• Urinalysis
• Histopathology
• Cytopathology
• Electron microscopy
• Genetics
• Cytogenetics
• Surgical pathology
• Immunology/Serology
Planning for equipments
• Basic instruments and equipments should be made available
• All vital equipment should be in duplicate or have an alternative arrangement
• Selecting the best instrument for the laboratory is a very important part of equipment management
Following element should be considered during management program in laboratory:
1) Selection and purchasing
2) Installation
3) Calibration and performance evaluation
4) Maintenance
5) Troubleshooting
6) Service and repair
7) Retiring and disposing of equipment
Lab equipments
Basic equipments for all types of routine investigations are:
1) Colorimeter/Photoelectric colorimeter:
Its a device that measures the absorbance of particular wavelengths of light by a specific solution
2) Centrifuge:
Is a piece of equipment, generally driven by an electric motor that puts an object in rotation around a fixed axis, causing denser substances to separate and by which lighter objects will tend to move on top
3) Water Bath: A device for regulating the temperature of anything subjected to heat, by surrounding the vessel containing it with another vessel containing water which can be kept at a desired temperature
Continued………………………….
4) Microscope- Mono Ocular/binocular:
Is an instrument used to see objects
that are too small for the naked eye
5) Hot air oven:
Are electrical devices used in sterilization
6) Autoclave:
Is a device used to sterilize
equipment and supplies by subjecting them to
high pressure saturated steam at 121 °C for around
15–20 minutes depending on the size of the loads
7) Ph-meter: is an electronic instrument used for
measuring the pH (acidity or alkalinity) of a liquid
Lab equipments
8) Incubator:
Is a device used to grow and maintain of course
microbiological cultures or cell cultures
9) Automated biochemistry analyzer:
Is an instrument designed to measure different chemicals and other characteristics in a number of biological samples quickly, with minimal humanassistance
11) Enzyme-linked immunosorbent assay(ELISA) -Reader :
Uses one sub-type of heterogeneous, solid-phase enzyme immunoassay (EIA)
to detect the presence of a substance, usually an
antigen, in a liquid sample or wet sample
Continued……..12) Microtome:
Is a tool used to cut extremely thin slices of material, known as sections.
Its used in microscopy, allowing for the preparation of
samples for observation under transmitted light or
electron radiation
14) Wax melting bath:
Its a device used for electric melting of glues, vinyl compounds
, waxes etc. with bottom valve discharge.
Heaters are positioned such that melter may be used 1/3,
2/3 and full capacity without overheating contents
15) Hot plate:
A hot plate is a portable self-contained tabletop small
appliance that features one, two or more gas burners
or electric heating elements
LIS
• A lab information system ("LIS") is a class of software that receives, processes, and stores information generated by medical laboratory processes. These systems often must interface with instruments and other information systems such as hospital information systems (HIS)
• A LIS is a highly configurable application which is customized to facilitate a wide variety of laboratory workflow models
• It is a complete management system that handles all business functions from patient management, results generating, to physician decision making
Key Features
• The lab machines including the auto analyzers are interfaced with the hospital information system and their complete operations are automated without human intervention
• HL7 standards incorporates the ability to receive data from other lab machines
• Sample management system creates barcodes and tracks the samples of blood, saliva, urine etc.
Continued…………………………..
• Assures that the technicians complete all the pending tests
• Generates automated results from various laboratory machines and updates patient records
• Ability to handle large number of specimens without compromising on safety
• Efficient tracking of specimens by usage of bar codes for the specimens
Benefits of Lab Information System
Doctors• The lab results of critical patients would be notified instantaneously to the
doctor• All the lab results would be submitted directly to the doctor
Patients• No delay in the execution of doctors’ orders• No need to make repeat visits to collect the results• No mix-up of samples of different patients at the lab
Lab Technician• Immediate receipt of the doctors’ orders to perform a lab test• Easier reporting of lab results of the patients
FUNCTIONS OF THECLINICAL LABORATORY
• Identify the chemical composition of blood and urine samples
• Identify and count the different types of cells found in blood and other body fluids
• Blood typing and determination of transfusion compatibility between blood donors and recipients
• The culturing and identification of bacteria and viruses from sites of infection in the body
The functional components of the clinical Laboratory
• A hospital laboratory work generally falls under the following divisions:
• Hematology• Serology• Clinical Chemistry/Biochemistry• Urinalysis• Microbiology• Blood Bank
Hematology
• Hematology :-The study of blood. This section counts and qualifies the different types of blood cells and other components found in blood
Serology
• Serology - The study of serum for its antibody content. Certain microorganisms (antigens) stimulate the body to produce antibodies during an infection. In the Serology lab, the antibodies react with antigens in specific ways that can be used to confirm the identity of the specific microorganism
Clinical Chemistry/Biochemistry
• Chemistry - Performs most chemical analyses including glucose, sodium, potassium, and cholesterol.
Urinalysis
• Urinalysis - The study of urine for the purpose of medical diagnosis. Urine is initially examined for such characteristics as color, odor, and specific gravity (density relative to water). It is routinely tested for its acidity level, as indicated by its pH reading, and screened for glucose (sugar)
Microbiology
• Microbiology - The study of microorganisms, including viruses, that can only be seen with a microscope.
Blood Bank
• Blood Bank - Collects, tests, types and stores blood donations used for blood transfusions
Functional planning An important decision in planning for a new laboratory is the
physical location in relation to other departments
• Functional planning covers the following activity:
Determining services to be provided for inpatients/outpatients, for other departments, smaller hospitals and private practitioners
Determining area and space requirement to accommodate equipment, furniture and personnel in technical, administrative and auxiliary functions
Dividing the area into functional units, hematology, biochemistry, microbiology, histopathology, urinalysis etc
Determining the major equipment and appliances in each unit
Safety Symbols
• Know safety symbols• They appear in your
laboratory activities• They will alert you
to possible dangers• They will remind you
to work carefully
Protect YourselfEye Safety
• Wear safety goggles when working with chemicals, flames, or heating devices
• If you wear contact lenses let your boss or teacher know
Eye Safety
• In case of emergency in which a chemical goes into one’s eye, use the eyewash station
• Flush in water for 15 mins. and notify the teacher
Proper Attire
• Keep all long hair tied back
• Do not wear loose clothing that could catch on fire
• Foot wear that completely covers the foot is required
Hand Safety
• If a chemical spills on your skin, rinse with water for 15 minutes
• Wash hands after every lab
• Handle glassware, sharp tools and heated containers carefully
Sharp Objects
• Always carry sharp objects with points and tips facing down
• Never try to catch falling sharp instruments
• Hold sharp instruments only by the handles
Electrical Safety
• Only electrical plugs are to be placed into an electrical outlet
• Unplug electrical equipment after use
• Keep all electrical cords, wires, and appliances away from water
Physical Safety
• Handle all equipment carefully • Do not place a cord where
someone can trip over it • Push all stools in out of the
way
• Keep books picked up out of walking isles
Heating Safety
• Tie back hair and looseclothes when workingwith open flames
• Never look into a container as you are heating it
• Never point the end of a test tube being heated at yourself or others
• Never heat in a closed container
Heating Safety
• Never leave a heat source unattended • Heated metal and glass looks
cool, use tongs or gloves before handling
• Do not place hot glassware directly on lab desk or in cold water
Chemical Safety
• Read all labels twice before removing a chemical from the container
• Only use the type and amount of chemicalinstructed to use
• Never touch, taste, or smell a chemical unless instructed by the teacher
• Never mix chemicals unless instructed to do so
Chemical Safety
• Transfer chemicals carefully!• Keep lids on chemical
containers when not in use• When diluting an acid, pour the
acid into water• Consider all chemicals
dangerous
Don’ts…
• Enter store room unless given permission
• Take any chemicals from lab or store room
• Touch any equipment, chemicals, or other materials until instructed to do so
• Engage in….– practical jokes – horse play – rough house
Continued…
In case of an emergency…
• Know the locations of:– fire extinguisher– fire blanket– body shower– eyewash
station– first aid kit
In case of an emergency…
• Know the locations of:– fire extinguisher– fire blanket– body shower– eyewash
station– first aid kit
In case of an emergency…
• Know the locations of:– fire extinguisher– fire blanket– body shower– eyewash
station– first aid kit
Remember to…
• Stay at your work station • Maintain a clean work area• Read and follow all directions• Report any spills, accidents,
or injury immediately• Clean and put away all equipment
at the end of the lab period• Dispose of waste products
according to instruction
Facility design ProcessStages activities
Situation analysis Needs assessment staffing needs ,requirements technologic changes , current and anticipated ,identify team players(Architect, Laboratory staff, Medical staff, Interior Designer etc…)
Strategic Planning Activities to be performed , flow of people and material storage, equipment to be used, utilities, laboratories sectional needs.
Structural designs Identify constructional material, architectural design , cost system options(plumbing , electricity, heating, ventilation , air conditioning)
Interior Design Interior Design ,Colour, Fabric,texture, finish
The planning of laboratory services depends on following
factors:-
Planning
Equipment and Facilities
Manpower
Infrastructure and work Place
Planning of Infrastructure
• Depends on type of services to be provided• Work load
Two types of Infrastructure:-
1) Traditional ‘Closed Laboratory’:-
It has discrete sections in Hematology ,chemistry ,microbiology, and blood bank generally separated into rooms or sections
2) Open laboratory:-
The discrete services are placed in one large room with portable walls that can be adjusted as needed
Core laboratory:-Hematology and chemistry(chematology)
Infrastructure Planning
Infrastructure
Location
ADMN area
Functional area
Auxiliary Area
Environmental consideration
Size
Ancillary Area
Central Lab unit
1) Administrative area:-• Office of pathologist•Record room•Administration Office•Patient Waiting Area•Seminar room
2)Auxillary Area:-•Glass washing room•Cleaning of Instrument•Equipment sterilization
3) Ancillary Area:-•Treatment and disposal of specimens•Janitors room•Chemical and reagent store
Continued….
4) Functional Area:-•Haematology area•Biochemistry•Stool and urine•Cytology•Microbiology•Histopathology•Virology and Immunology•Blood bank
5)Size:-• depends on the functions•Generally 1 square feet per 20 samples annually•Minimum requirement for each unit are 10 feet *20 feet
6) location:-Easily accessible from all hospital
Continued…
7)Environmental consideration:-• Floor should be strong,acid and stain resistant, grease proof• Walls washable light colour,water proof ,no crevices• As far as natural light• Adequate ventilation and exhaust system• Spot light , no extension cord• Sufficient electric point• Specific investigation area to be air conditioned• Working benches-sitting type-30 inches ht• Revolving stool –standing type-36 inches ht• 3^1/2 ft space between two benches• Water sinks , hot and cold water supply, compressed gas burner
Suggested dimensions for interior
Laboratory counter width 2feet 6 inches
Laboratory counter to wall clearance 4 feet
Laboratory counter to counter clearance 7 feet
Desk height 30 inches
Keyboard drawer height 25-27 inches
Human body standing 4 square feet
Human body sitting 6 square feet
Desk space 3 square feet
Floor PlanH AEMATOLOGy
Urinolysis
Biochemist
ry
Biochemistry
Histolpathology
Serology Bacterio
logy
Ancillary Area
Venipuncture cubicle
Exam and Test
Pathologist office
Record room
Administrative office
Waiting Area
Sterilization Glass Washing
And Cleaning
Tech Lockers
Tech Toilet
Infrastructure costing1 unit (land requirement) 200sqr feet
8 functional unit 1600 sqr feet
rest 1600 sqr feet
total 3200sqr feet
Rate of land per sqr feet 2500(Rs.)
Total cost 80,00000
Extra expendicture 20,0000
Total land cost 1cr
Cost of construction+interior 75 ,00000
Total sum 1.75cr
Lab equipment costing
Equipment Cost (Rs.)Colorimeter 25,000
Centrifuge 20,000
Water Bath 10,000
Electronic Microscope 3,25,000
Hot air oven 39,330
Incubator 1,30,000
Ph-meter 20,000
Automated biochemistry analyzer 2,00,000
Enzyme-linked immunosorbent assay(ELISA) -Reader
50,000
Others 200000
Reagents 70,000-80,000
Budget (per unit) 20,00,000
Total budget (8 units) 1.60 cr
Activity Planning
From Different Hospital
PatientsRegistration
Sample collection
Testing
Lab Management System
Sample analysis Quality Control
Result
Reporting
Impression
RESEARCH
• Research is an integral part of Laboratory system
• Various research projects pertaining to Lab’s functioning, equipment development, technology up gradation are a part of system management
PERSONNEL, TRAINING AND DEVELOPMENT
• Each laboratory should designate a Head of the laboratory and a Quality Manager
• The qualifications and experience of the staff outlined in NABL document 112 (2007) should be followed
• The strength of staff employed should be appropriate to the level of facility and the workload
• The roles and responsibilities of the staff should be clearly outlined
CONTinueD….
• A programme for technical training and updating of skills on a regular basis should be in place
• Laboratory should organize or conduct periodic staff evaluation, preferably once a year
• The laboratory should maintain a personal file of all the technical and nontechnical staff employed. Personal file should contain all information on:
Personal’s CV Copy of appointment letter Duly verified health information (physical fitness including color
blindness, immunizations received etc.) prepared at the time of employment and its regular updates
Performance appraisal Training certificates, awards/recognition received Disciplinary action if any taken by the management
QUALITY ASSURANCE
• Quality Assurance (QA) is the total process whereby the quality of laboratory reports can be guaranteed
• Incorrect Laboratory results may be due to errors occurring during pre-analytical stage, analytical stage/post-analytical stage
• QA encompasses procedures adopted for minimizing errors that may occur at any stage. Provision of precise and accurate laboratory results optimize medical management
QUALITY ASSURANCE PROGRAMME (QAP)
• QAP is a managerial process of maintaining high standards of performance and of improving standards where necessary
• While planning a QAP it is important to put effort at each step to prevent, detect and correct errors
• Quality Manager or designee or competent authorized person should review the quality control data and maintain record of evaluation
• The two important tools toward maintaining laboratory quality are-
Internal Quality Control (IQC) - for detection and minimization of immediate errors
External Quality Assessment (EQA) - for monitoring long term precision and accuracy of results
NABL
• NABL accreditation is a formal recognition of the technical competence of a testing, calibration or medical laboratory for a specific task following ISO/IEC 17025:2005, ISO 15189:2007 Standards. This is based on third party assessment
• Accreditation to a laboratory is given on the basis of its capability to perform test(s) / calibration(s) and provide accurate and reliable results. A laboratory may apply for accreditation from as little as one to as many tests / calibrations provided it is performing these in accordance with NABL criteria
CONTD…
• NABL Accreditation is currently given in the following fields:
TE
STING
LABS
• Biological
• Chemical
• Electrical
• Electronics
• Fluid-Flow
• Mechanical
• Non-Destructive
• Photometry
• Radiological
• Thermal
CALI
BRATION
LABS
• Electro-Technical
• Mechanical
• Fluid Flow
• Thermal & Optical
• Radiological
ME
DIC
AL LABS
• Clinical Biochemistry
• Clinical Pathology
• Hematology and Immunohaematology
• Microbiology and Serology
• Histopathology
• Cytopathology
• Genetics
• Nuclear Medicine
Responsibilities for managing the laboratory services
It includes:• Developing service-related policies and procedures• Managing relevant human resources functions (job
description, personnel evaluation, staff training)• Developing, co-ordinating, and monitoring the
required quality control and improvement
An individual with adequate training, skills, orientation and experience administer tests
and interpret the results.
For the laboratory services, is it sufficient that the laboratory director meets the
experience, education and training requirements???
Under CLIA,
NO, in addition the laboratory director must demonstrate active involvement in the laboratory’s operation and be available to the laboratory staff, as needed.
As per CLIA,
Laboratory Director must ensure that: the pre-analytic, analytic and post-analytic phases of testing are appropriate for the patientsphysical and environment conditions of the laboratory are adequate and appropriate for the testing performeda general supervisor is available to provide day-to-day supervision of all testing personnel each employee’s responsibilities and duties are specified in writing
Personnel positions
Moderate Complexity testing
Technical consultant
Clinical consultant
Testing personnel
High complexity testing
Technical supervisor
Clinical consultant
General supervisor
Testing personnel
Introduction to the Manual of Clinical Policies
• Operating Policy Manual• Policies and Procedures Health
Information• Policies and Procedures Environmental
Health and Safety• Policies and Procedures General
Operations• Policies and Procedures on the use of
ionizing radiation
General Standards
• Hours• Meetings/Communications• Specimen Handling• Specimen Storage• Panic Values• Reference Ranges• Lab Errors• Lab Results• Reportable Diseases• Patient Identifiers
In House & Reference Lab Specimen Labelling andSpecimen Collection Procedures
• “Routine” Specimens• Urine• Gynaecological Specimens• Blood Collection, Finger Stick and
Phlebotomy• Stool Occult Blood/O&P/C&S• Lab Specimen Containers
General Maintenance and Repair Responsibilities
• Lab Instruments• Preventive Maintenance• Refrigerator Maintenance• General Procedure Manual for Lab
Equipment• Continuing Education and In-services• New Employee Orientation Guidelines &
Proficiency• Documentation
• Patient Complaints• Personnel Responsibilities/Job Description• Reporting of Communicable Diseases
Daily Log of Tests Ordered: Procedure to Print and Computer
Data Entry Procedures
A. Patient Telephone Numbers• Entering Provider UPIN #’s• Bill Code Types
B. Employee Lab Work• 1. New Hires• 2. Introductory Period• 3. Under Insurance• 4. Workers’ Comp
C. Medicare Patients –
limited coverage tests• Certain Lab Tests & Additional Information• Results Procedure
General Policy
• ISSUE:• Duties of Medical Laboratory Assistant (MLA) or Lab
Assistant (LA)• BACKGROUND:• The Medical Laboratory Assistant is an integral member of the
health care team. The MLA is responsible and accountable for his/her professional actions and practices according to established standards of practice.
• The defined activities of a laboratory assistant are the ultimate responsibility of the Laboratory Director or designated qualified professional, but follow the curriculum of a recognized MLA training course.
POLICIES
• A medical laboratory assistant may, under the qualified laboratory professional, perform a list of tasks that are considered pre-analytic and post-analytic, and do not require interpretation or assessment. Specific work assignments should only be undertaken subsequent to thorough, documented training and instruction by qualified supervisory personnel
• Transfusion Medicine testing is restricted to persons trained in Transfusion Medicine.Examples of tasks may include: blood sample procurement
• Procurement may include, but is not restricted to patient identification; collection and labelling; accessioning/handling; specimen rejection; specimen referral.
• sample preparation for analysis, to include centrifugation, separation, numbering, aliquoting
Billing and Reporting
• Online by accessing our site• Via mail• Massage on mobile • Letter • Via Telephone • Customer care
LABORATORY MANAGER??
• A laboratory manager is a uniquely skilled employee with a very high level of daily responsibility that spans all areas of the organization
They are “extenders” of the physician directors.
PLANNING-Selecting a planning group- Environmental analysis- SWOT analysis- Vision and Mission statements- Goals, Objectives & strategies-Prioritization- Accountability-Measuring success
ORGANIZING- Time management- Organization chart-Policies- Procedures- Staffing and scheduling
DIRECTING- Communicating- Delegating- Motivating- Coaching
CONTROLLING- Evaluating Performance- Decision making
LABORATORY MANAGER
The objective of planning is to set an achievable course of action by
establishing an environment where day-to-day activi-ties are well-controlled,
measurable, and thoroughly understood by employees at every level of the
organization.
A knowledgeable and motivated group from within the laboratory should be assembled to create and administer a
strategic plan. This group must include key people from all functional areas.
An environmental analysis is a systematic review of the internal and
external factors that influence the operation of the laboratory. A vision statement sets an articulate visualization of
what the organization seeks to become at some point. A mission statement answers certain fundamental questions about the organization, such as “What is our purpose?” “In what activities will we be engaged in order to ac-
complish that purpose?”
A practical implementation timeline should be developed. For most modern medical laboratories, a planning horizon
of 18 months to 2 years is practical.
It is necessary to assign priorities by weighing the importance of the tasks at hand to determine which have
the highest level of immediate precedence. Therefore, planning is often a struggle between “must do” and “want
to do” decisions.
A plan must have built-in accountability. This amounts to assigning a specific individual to be
responsible for each action item to ensure follow-through.
A regular reporting mechanism must be established to review progress on action items and to monitor changes in environment. Monthly, or perhaps even weekly, meetings should be scheduled to discuss
progress toward stated goals and objectives.
PLANNING-Selecting a planning group- Environmental analysis- SWOT analysis- Vision and Mission statements- Goals, Objectives & strategies-Prioritization- Accountability-Measuring success
ORGANIZING- Time management- Organization chart-Policies- Procedures- Staffing and scheduling
DIRECTING- Communicating- Delegating- Motivating- Coaching
CONTROLLING- Evaluating Performance- Decision making
LABORATORY MANAGER
A key management task is to organize the activities of the
laboratory in such a way that effort and expenditures are mini- mized
and output is maximized.
In all circumstances, a manager should set and adhere to a reasonable schedule, building enough
time into the day for essential meetings, interaction, and completion of necessary paper work. Some examples include a personal digital
assistant (PDA), a day planner, or an online calendar.
An organizational chart helps to clarify workflow, reporting lines, and areas of
responsibility by explicitly listing delineated work areas, be it by division, laboratory, or medical
specialty.
Policies are “Laws” of laboratories. understand set of policies. These policies must be
made known to each employee.
A laboratory manager must maintain current, concise procedure manuals for all
processes that are performed in the laboratory. As with policies, the book of
laboratory procedures should becontinuously updated by a team of experts. The standard operating procedures (SOP)
manual is a very important tool in the laboratory. An up-to-date SOP ensures that
procedures performed by the technical staff are consistent and of the highest
quality.
Each laboratory has an ideal number of employees based upon the number of
specimens that it handles and the level of automation in the laboratory. A manager
must ensure that efficient staffing is maintained.
PLANNING-Selecting a planning group- Environmental analysis- SWOT analysis- Vision and Mission statements- Goals, Objectives & strategies-Prioritization- Accountability-Measuring success
ORGANIZING- Time management- Organization chart-Policies- Procedures- Staffing and scheduling
DIRECTING- Communicating- Delegating- Motivating- Coaching
CONTROLLING- Evaluating Performance- Decision making
LABORATORY MANAGER
Directing is the process of influencing people to attain pre- determined objectives.Some basic attributes of
quality communication include attention, ac-
ceptance, and empathy.
Delegation is the process of selecting people from a very limited pool (current job incumbents) to perform a task. It is
important to give the employees a feeling of empowerment.
Employees require motivation in order to consistently give their best effort. Motivation
is both internally and externally derived. Every individual has professional strengths
and limitations, activities that they find exciting and tasks that are drudgery.
The best managers are teachers and coaches, always engaging their employees in a
productive and ongoing process of continuing education. Many employees require active,
hands-on development to realize the best of their abilities.
PLANNING-Selecting a planning group- Environmental analysis- SWOT analysis- Vision and Mission statements- Goals, Objectives & strategies-Prioritization- Accountability-Measuring success
ORGANIZING- Time management- Organization chart-Policies- Procedures- Staffing and scheduling
DIRECTING- Communicating- Delegating- Motivating- Coaching
CONTROLLING- Evaluating Performance- Decision making
LABORATORY MANAGER
Controlling is the process of determining that everything is going according to plan. A manager must constantly and con- sistently review
the current situation in the laboratory to ensure that there are
no unattended details.
A probationary period, usually 6 months or 1 year in duration from the time of hire, is the time when the manager should be critically observant of performance. The purpose of a performance appraisal is to
provide the employee with written feedback about how he or she is pro- gressing toward specific employment
objectives.
When presented with a big decision making opportunity, it is often
helpful to write down the problem and make a list of possible
solutions, intended outcomes, and potential problems. Most importantly, never panic
• The technical aspects of running a laboratory are codified and tightly regulated. When technical problems arise, there is very often a manual to help guide the solution.
• When it comes to managing the human side of the laboratory, there are daily challenges for which there are no obvious solutions.
• There does exist, however, a set of time-tested management tools for use by laboratory managers in addressing these daily challenges.
• A laboratory manager must become familiar with these tools and use them on a daily basis to gain confidence and experience in managing the human side of the laboratory.
• http://labmed.ascpjournals.org/content/37/7/397.short
SOURCE