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Laboratory Administration & Management of Pathology Practices

Human resources

Who does what?

Author: Richard E. Horowitz, M.D.

Last author update: 1 November 2013

Last staff update: 3 March 2021

Copyright: 2002-2024, PathologyOutlines.com, Inc.

PubMed Search: laboratory management [title] personnel

Page views in 2023: 81

Page views in 2024 to date: 18

Table of Contents

Cite this page: Horowitz R. Who does what?. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/managementlabwhodoeswhat.html. Accessed April 24th, 2024.

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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