Laboratory Administration & Management of Pathology Practices
Personnel Management
Who does what?


Topic Completed: 1 November 2013

Minor changes: 15 January 2020

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: laboratory management [title] personnel

Richard E. Horowitz, M.D.
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Page views in 2020 to date: 56
Cite this page: Horowitz R. Who does what?. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/managementlabwhodoeswhat.html. Accessed July 7th, 2020.
Definition / general
  • The goal of Personnel Management is to work with people, to motivate them, allow them to contribute, develop and achieve
  • Many in a hospital or healthcare system are responsible for the various aspects of personnel management
Hospital or System Administration
  • Responsible for:
    • Strategic planning
    • Approval of personnel budget
Human Resources Department
  • Responsible for:
    • Developing personnel policies
    • Producing an employee handbook
    • Approving job descriptions
    • Developing job classifications
    • Recruitment and advertising for vacancies
    • Preliminary interviews and reference checks
    • Assistance with disciplinary actions
    • Implementation of labor laws and regulations
Unions
  • Function as employee advocates
  • May be involved in:
    • Organizing
    • Bargaining
    • Working conditions
    • Grievances
Laboratory Section Supervisors
  • Responsible for:
    • Defining the job description(s) with the Lab Manager
    • Developing performance standards for each job
    • Interviewing and selecting candidate best qualified to fill the job
    • Providing new employees orientation
    • Assuring employee retention
    • Assessing competencies
    • Staffing and scheduling
Laboratory Director and Laboratory Manager
  • Responsible for:
    • Approving job descriptions and performance standards
    • Approving employee selection
    • Defining job descriptions and standards for higher level positions
    • Interviewing and selecting higher level positions
    • Developing personnel budget for the department
    • Implementing and enforcing departmental and institutional personnel policies
    • Assuring worker achievement, worker safety and esprit de corps
The job description
  • The job description is critical to personnel management
  • It is essential for recruiting and advertising because it defines specific prerequisites, requirements and expectations
  • It is indispensable during job interviews to determine whether a candidate is suitable for a specific position
  • The job description also tells new employees what is expected of them
  • Is also used to evaluate employees' performance and determine whether merit pay, promotion, or other action is warranted
  • The essential components of the job description are indicated below
    • The Heading
      • Includes basic employment information such as:
        • Job title
        • Job classification
          • Level and step
        • Exempt status
        • Salary/benefits
        • Job location
        • Schedule
          • i.e. Shift/PT/FT
    • Position Description
      • Job summary
      • Major (general) duties
      • Reporting/supervisorial relationships
    • Basic Requirements
      • Citizenship
      • Education
      • Licensure, certification and re-certification
      • Experience
      • Organizational requirements
        • English language proficiency
        • Interpersonal skill
        • Time, attendance and dress code standards
        • Compliance with organizational rules and regulations
      • Compliance with CLIA personnel standards
    • Specific Requirements and Competencies / Duties
      • General or core tasks
      • Specific knowledge and skills required
      • Specific detailed duties and tasks
      • Specific performance expectations
      • Physical requirements/working conditions
      • Other requirements for specific jobs
      • Research and teaching responsibilities
      • Administrative or management responsibilities
    • Final comments
      • Writing the job description cannot be delegated to the personnel department
      • Only the lab supervisors, lab managers and pathologists know both the general and the specific knowledge, skills and experience any particular job requires
      • In order to recruit, advertise and interview successfully, those specifics must be included
      • In addition, employees deserve to know precisely what is expected of them and on what basis they will be evaluated
      • The thorough job description provides that essential information
Recruitment and selection
  • Efficient laboratory operation depends on a stable workforce and a low turnover rate
  • The more effective the recruitment and selection process, the greater degree of job satisfaction and the lower the turnover rate
  • A new employee needs three to six months to become fully productive, so the lower the turnover rate, the more effective the laboratory
  • The job description is the main document in this process
    • It determines the content of advertisements, forms the basis of the interview and informs the applicant of the employer's expectations
  • Attracting applicants
    • Newspaper and professional Journal advertisement
    • Internet (e.g., PathologyOutlines) job sites
    • Professional Society (e.g., ASCP) job sites
    • Employment agencies
    • In-house posting, especially for higher level positions
      • Hiring from within establishes and maintains a “Promotional Ladder”
    • Search committees
  • Screening applicants
    • Preliminary by Personnel Department - does applicant meet the requirements
      • Review of application and resume
      • Screening interview
      • Review of letters of reference
    • By laboratory supervisorial personnel
      • Interview - questions should be based on job requirements
      • Skill or competency assessment (New CMS/CLIA Guidelines)
      • Avoid “illegal” questions regarding age, religion, sexual orientation, etc.
      • Psychological and drug testing
    • The job offer
      • Reiterates the job description and its expectations
      • Specifies criteria and timing of performance evaluations
      • Specifies terms of employment
      • Compensation, benefits and working conditions
      • Retain documentation of all conversation and of any offers
Compensation
  • Compensation is regulated by both Federal and State laws which address issues such as:
    • Minimum wage
    • Overtime
    • Required meal and rest periods
    • Permissible vacation
    • Holidays
    • Parental leave
    • Assorted benefits including worker's compensation and other insurance
  • An institution may have additional policies governing such things as shift differential and on-call pay
  • The Human Resources department should assist the laboratory in assuring compliance with the Federal Fair Labor Standards Act and other pertinent laws
  • Laboratory management must also be knowledgeable about compensation of the laboratory staff
  • Salaries
    • Determined by Administration
    • May utilize community standards for rate setting
    • Should maintain internal equity with comparable salaries for comparable jobs
  • Benefits
    • Often more important than salary to employees
    • Insurance
      • Health, Life, Disability
    • Continuing Education
      • Tuition reimbursement
    • Uniforms
    • Hiring bonus
    • Child care
    • Free parking
    • Retirement and pension plans
  • Changing compensation
    • Employees often feel they are not compensated adequately, but institutional salary structures are usually quite rigid
    • When there is justification to increase an employee's salary the following are available:
      • Annual cost of living increase
      • Merit increases
      • Promotion to a higher grade or step
      • Reclassification to a new position
      • Inequity adjustments
        • e.g. is MT paid less than a RN?
      • Incentive and profit sharing systems
      • Spot bonuses
Orientation and training
  • New employees need to be oriented to the laboratory and to the institution
  • The immediate supervisor should first review the job description and the performance expectations with the new employee and inform them of any competency assessments which will be expected
  • Supervisor responsibility
    • Must provide and arrange for:
      • Personal Items
        • Badge
        • Keys
        • Locker
        • Uniform
        • Parking space
      • Computer access
      • Another seasoned employee to serve as “buddy” to introduce the new employee to the department and to the rest of the institution
      • Institutional training, such as HIPAA, fire, safety, sexual harassment, etc.
      • An Employee Handbook with institutional rules and regulations
Employee retention and engagement strategies
  • An important measure of laboratory administration's competence is employee turnover
  • Every time an employee is replaced, there is a 3 to 6 month period of decreased productivity while the new employee "gets up to speed"
  • More than 20% annual turnover in technologists and more than 30% annual turnover in lower job categories is excessive
  • The laboratory needs a formal program to assure employee retention and this should include:
    • Emphasizing worker relevance and achievement
    • Recognizing productive work
    • Establishing a recognition and reward mechanism
    • Maintaining a career ladder - promotional opportunities
    • Providing continuing education, in house and external
    • Providing adequate compensation
    • Providing unique benefits, e.g., Child Care
    • Providing a pleasant work environment
Performance evaluation
  • An annual performance evaluation or appraisal and/or competency assessment is a standard procedure which evaluates:
    • An employee's achievements or deficiencies
    • Determines whether the job expectations have been met
    • How performance can be rewarded or improved
  • Evaluation basis
    • The job description, with its performance standards and specific competencies, is the basis of the evaluation
    • The immediate supervisor must gather performance data and conduct the evaluation based on the job description
    • Specific examples of an employee’s meeting, exceeding, or failing to meet expectations should be documented
    • Success should be recognized with compensation and/or promotion
    • When there are deficiencies, they should be analyzed:
      • Were performance standards known?
      • Is it a training issue?
      • Is it a motivation issue?
      • Is it a competency issue?
      • Obstacles to successful performance?
      • Is it just a bad fit between person and job?
    • The evaluation should include a plan for improvement when necessary
    • Documentation of the evaluation must be thorough and acknowledged, in writing, by the employee
Counseling, discipline and termination
  • In addition to the formal annual performance evaluation there may be ongoing evaluations acknowledging exceptional effort or achievement and these should be recognized in public
  • There may also be ad hoc evaluations because of failure to meet standards - these should be timely, specific, held in private and include counseling with a plan for improvement
  • When counseling fails to correct unsatisfactory performance, disciplinary actions need to be implemented
  • Progressive disciplinary actions
    • They include:
      • First a verbal warning
      • Next, verbal warning with consequences
      • Next, written counseling memo
      • Next, written memo with penalties, e.g., fine or demotion
      • Finally, dismissal / termination
  • Components of a disciplinary warning / report
    • Essential components are:
      • Description of the problem
      • Record and/or copies of previous warnings
      • Employee’s response
      • Penalties or remediation being instituted
      • Description of future performance expectation with time line
      • Signature of rater, employee and witness
  • Unsuccessful disciplinary actions
    • When disciplinary actions are unsuccessful, involuntary termination “for cause” is the consequence and the specific causes must be documented, such as:
      • Incompetence
      • Insubordination
      • Excess absence or late arrival
      • Repeated violation of employee rules
      • Verbal or physical abuse of patients, co-workers
      • Breach of HIPAA confidentiality regulation
      • Falsification of records or tests
      • Criminal activity
  • Other terminations
    • Voluntary retirement
    • Voluntary resignation
    • Involuntary due to downsizing
  • Other actions
    • When termination is other than “for cause”, the employee's contribution to the institution should be formally recognized
    • An exit interview should be conducted any time an employee is terminated, whether voluntarily or “for cause”
    • Vital information about a department, the staff and procedures often surfaces during exit interviews
      • However, exit interviews must be evaluated judiciously and in context
Labor laws
  • Federal and State laws and regulations govern many aspects of personnel management
  • Although most are implemented by the hospital Personnel or Human Resources department, whenever there is an alleged violation, the laboratory directors, managers and supervisors are frequently held responsible
  • It is important to be conversant with the most important laws and regulations
  • National Labor Relations Act (1935)
    • Established the National Labor Relations Board (NLRB) which:
      • Guarantees the right of employees to organize into unions and to bargain collectively
      • Protects employers from certain unlawful union activities
      • Provides bargaining equality between employers and employees
  • Fair Labor Standards Act (1938)
    • Defines minimum wage, overtime and other salary items
    • Differentiates between exempt and non-exempt employees
  • U.S. Equal Employment Opportunity Commission (EEOC)
    • Enforces the following laws and provides oversight and coordination of all federal equal employment regulations, practices, and policies:
      • Title VII of the Civil Rights Act of 1964 prohibits employment discrimination based on race, color, religion, sex, or national origin
      • The Equal Pay Act of 1963 (EPA), protects men and women who perform substantially equal work in the same establishment from sex-based wage discrimination
      • The Age Discrimination in Employment Act of 1967 (ADEA), which protects individuals who are 40 years of age or older
      • Title I and Title V of the Americans with Disabilities Act of 1990 (ADA), prohibits employment discrimination against qualified individuals with disabilities
      • The Civil Rights Act of 1991, provides monetary damages in cases of intentional employment discrimination
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