Unit 4: Organizing and Staffing the Laboratory

(hours)

Introduction:
After the objectives of an organization are determined and plans are prepared,
the next step in the management process is to organize the activities to execute
the plans and attain the objectives. Organizing is the process of identifying and
grouping the work to be performed, defining and delegating responsibility and
authority and establishing relationship for the purpose of enabling the people to
work most effectively together in accomplishing objectives. It is the backbone
of management. Organizing creates and maintains rational relationships
between human, material, financial and information resources by indicating
which resources are to be used for the specified activities and also when, where
and how they are to be used.
Organization is the backbone of management. Sound organization contributes
greatly to the continuity and success of the enterprise. Good organization
structure does not by itself produce good performance – just as good
constitution does not guarantee great presidents or good laws a moral society.
But a poor organization structure makes good performance impossible, no
matter how good the individuals may be. The right organizational structure is
the necessary foundation; without it the best performance in all other areas of
management will be ineffectual and frustrated.

Unit Learning Outcomes

Upon completion of this module, you will be able to:
1. Describe the characteristics of organizational system
2. Differentiate the types of organizational charts
3. Explain the process of work analysis and job design
4. Learn the standard protocol in pooling of qualified staff and laboratory
personnel
5. Create s strategy in proper scheduling of work load to appropriate
personnel

Laboratory Management
 Chapter 4: Organizing and Staffing the Laboratory

Activating Prior Knowledge

Have you ever watched the movie Inside Out? Who is your favorite character,
is it joy, anger, disgust, sadness? What lessons related to management can be
learned from the movie?

When I have watched that movie, I realized that as a leader you need to
cultivate the potentials you see in your subordinates and you have to accept the
fact that you are not the only key to solve all the problems in the organization;
hence, you have to allow your members to take over in the situation you think
their potentials suit best. This is what makes a great leader great- bringing out
the best in others without the fear of not being recognized and be just one of the
people behind the scenes just as how Joy allowed Sadness to step in.

This is the importance of organizing and staffing in the laboratory, putting right
people in the organization.

Presentation of Contents

The organizing function takes the tasks identified during planning and assigns
them to individuals and groups within the organization so that objectives set by
planning can be achieved. Organizing, then, can be thought of turning plans
into actions. Organizing function can be viewed as a bridge connecting the
conceptual idea developed in creating and planning to the specific means for
accomplishing these ideas. The organizing function also provides on
organizational structure that enables the organization to function effectively.
Managers must match an organization’s structure to its goals and resources, a
process called organizational design. Organizing thus involves the following
sub-functions:

1. Identification of activities required for the achievement of objectives and

implementation of plans.
2. Grouping the activities so as to create self-contained jobs.
3. Assignment of jobs to employees.
4. Delegation of authority so as to enable them to perform their jobs and to
command the resources needed for their performance.
5. Establishment of a network of coordinating relationships.
6. Organizing process results in a structure of the organization. It comprises
organizational positions, accompanying tasks and responsibilities, and a
network of roles and authority-responsibility relationships.

GENERAL PRINCIPLES OF
ORGANIZING AND STAFFING THE
HOSPITAL LABORATORY

Hospital laboratory services have little less in common. They are distinct
laboratory fields requiring considerably different education and training of
personnel. Each is a unique discipline embodying large volumes of technical
data and employing considerably different analytical techniques and
instrumentation.

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 With regard to hospital laboratory staffing, the sheer growth and diversity of
laboratory services clearly demonstrate the need for specialization of personnel.
Efficient and effective selection, grouping and utilization of personnel
constitute a major responsibility.

OVERVIEW OF ORGANIZATIONAL
SYSTEM

The term “organization” means a collection of people working together under

a defined structure for the purpose of achieving a predetermined outcome. It
serves to provide society with products and services, offer employment and
economic exchange, and give a framework for a social system.
A system is self-contained collection of interacting and interdependent
components working together toward a common purpose. For example, in a
stand-alone laboratory, at least there are two interlocking components of
organization. These are the head of the laboratory and other staff having their
own duties and responsibilities.

CHARACTERISTICS OF
ORGANIZATIONAL SYSTEM

1. Primary task: defined duties that are necessary because of the nature of
system’s products or services. To fulfill the established goal of the
laboratory which is to release accurate and reliable results in a timely
manner, each staff has its designated work. Every staff can enjoy privacy at
work because they are aware of the jurisdiction of their work and power.

2. Hierarchy of system: the process of whereby self-contained subsystems

develops within a parent organization such as a laboratory within a hospital.
As the clinical laboratory expands, the hierarchy of staff and the nature of
work being performed increases in complexity.

3. Open systems: systems that interact with their environment by both

receiving and delivering product services. A clinical laboratory must have
transparent procedures for streamlining diagnosis for the benefit of the
patient.

4. Equilibrium: a state of stability within and between the system and its
environment. In the laboratory, it involves staff knowing their jobs, what
other staff do and the importance of their individual functions to overall
performance.

5. Self-regulation: the feedback process by which the system monitors

performance and provides information to its members. The laboratory
should have plans and strategies to improve performance based on the
feedback.

FUNCTIONS OF ORGANIZATIONAL
SYSTEM

Organizational system has three (3) distinct functions, namely:

1. Input mechanism which is the process through which needed resources are
acquired and replaced.

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 2. Transformation which is the internal process whereby resources received
through the input channels are converted into the products and services
produced by the organization.

3. Output mechanism which is the process of delivering the goods and

services produced to the external environment.

TRANSFORMATION
INPUT
PROCESS
Specimen OUTPUT
Staff
Test requests Test results
Instruments
Supplies
Processes

Figure 4-1 Laboratory Organization

In the Clinical Laboratory, Figure 4-1 shows how the input such as the
specimen, test requests and available supplies undergoes processing by the
laboratory staff using the required processes and instruments to produce
accurate results.

The Clinical laboratory is an open system with a congruency model (Figure 4-

2) that has four important aspects or elements:

1. Formal organization. The officially sanctioned lines of authority assigned

by the owners of the organization, with the authority and responsibility to
carry out the organizations designed duties. Members of the organization
know whom they work for, whom they supervise and how their departments
relate to other group.
2. Informal organization. Alliances that form outside the boundaries of the
formal organization from the interaction and allegiance of people with
common interests. Table 4.1 shows the characteristics of formal and
informal organization

ORG. FORMAL INFORMA

TRAITS L
Leaders Appointed Charisma
Followers Recruitment Personal
incentives attraction
Purpose Profit or social Peer motives
goals
Shared Organizationall Social norms
opinion of y driven and more
how things
should be
done
Performanc Job & tasks Issue –
e and standards focused
commitmen
t
expectation
s
Sanctions Organizational Peer
rewards and pressure
punishment
policies
Table 4-1 A comparison between the characteristics of formal and informal
organization

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 3. People. The workforce or staff who performs their duties and
responsibilities.
4. Work. The division of tasks so that everyone is indispensable. (Figure 4-3)

Figure 4-2 The Congruence Model

Figure 4-3 Medical Technologists at work

Organizational Systems Shaping the Manager’s Job:

1. The Life Cycle of the Organization:
Phases: starting point, stabilizing period, terminate or begin anew

2. The External Environment of the Organization: Outside the influence of

the manager, shapes the character and capabilities of the institution.

3. The Internal Culture of the Organization: History, lifestyle, images of

both people and organization itself

CONCEPTS OF ORGANIZATIONAL
SYSTEM

1. The Herd concept: The subordinates follow the leader who yields
exclusive power to decide and enforce unquestionable obedience in his
subordinates. The rule is: “Obey now, question later”.
2. Man to Man Concept: The organization sees the individual working, in
terms of direct personal relation with his superior.

3. The Social Concept: The superior and the subordinates are members of the
team.
ORGANIZATIONAL DESIGN

An organizational design consists of four structural components. Each

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 component is specially functioned to fulfil the mission and vision of the entire
organization.
1. Functional component. It is the hierarchal organizational levels (Figure 4-
4). Specialized units report in an upward chain of command. There is clear
understanding of responsibilities and authority. It functions best when the
departments are engaged in repetitive, efficient and routine tasks.

A Table of Organization or Organizational Chart is the diagram or chart

that identifies the major operational units of an organization and their
attending job position. It is the formal written map of the structural plan and
authority delegation. Lines have been inserted to clearly indicate the
channels of communication. They run vertically and horizontally and
beginning and terminate in precise position. They complete a graphic
demonstration of the total organization including the rank and relationship
of all its part.

Alternative Charts Formats

-Team structure design
Traditional Organizational Chart format:

a. Tall structure – many management layers

b. Flat structure – few management layers

Hospital Admistrator

Pathologist

Chief Medical Technologists

Individual Disciplines
Figure 4-4 Laboratory Organization Structure

2. Self-contained component. A self-contained organization is arranged along

a common platform. There is subdivision of work areas according to
specialization. As shown in Figure 4-5, the laboratory services are divided
into 4 areas such as specialty testing, clinical services, anatomical services
and transfusion services. Specialty testing is focused on examining special
specimens. The clinical services are concerned with routine or special
laboratory examinations. Anatomical services cover biopsy, histopathology,
autopsy, etc. Transfusion service is an extension of the blood banking
section.
STp
m
ato
n gfu
ti
rvicsA
e lyC

Manage
ment

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 Figure 4-5 Laboratory as a self-contained organization

3. Matrix component. (Table 4-2) It shows the different areas of work and
person assigned as section head. Each staff member can have an
independent function irrespective of whether they are assigned to any of the
sections in the laboratory, or performing routine or special tests.

Administrative Director
Technical Operations Manager
Director Routine Special STAT
Test Tests

Hematology
Clinical
Chemistry

Clinical
Microscopy

Microbiology
Blood Bank
Immuno-
serology

Histopatholog
y
Table 4-2 Applying Matrix Component in the Laboratory

4. Network Component. It reflects an information technology model. It also

consists of units or realignment of work to reduce duplication and expand
revenue generating services. Some laboratories may have an affiliated or
satellite laboratory, which are part of networking services.
Factors that Influence the Design and Structure of the Organization
1. Organizational goals and strategic direction. In any organization, it is
imperative to set goals and objectives in order to give direction for the
organization’s journey towards the achievement of its mission and vision.
2. Technological Capabilities refers to the kind of services it can offer.
3. Size. This factor is the basis for determining the classification of the
laboratory.
4. Environment. It refers to the specific location of the laboratory. The
profitability of the laboratory is dependent on its location and targeted
clientele.
5. Leadership style, Member Behavior and Organizational culture. The
success of a laboratory is the responsibility of the management.
ELEMENTS OF LABORATORY
ORGANIZATION

The elements of laboratory organization include:

1. Level of authority. Authority is the legal right to command actions by
others and to enforce compliance. It empowers one to do a job and is
essential for the leader to accomplish the task. It goes with responsibility.
Authority can be divided into position authority (derived from holding the

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 position) and personal authority (derived from characteristics of a
leader).Table 4-3 shows some example of tasks in a clinical laboratory set
up with its corresponding authority level.
Rank 1 – Part of regular duties
Rank 2 – Take any action necessary, but let the supervisor know as soon as
possible during normal work schedule
Rank 3 – Must attempt to check with supervisor before intervening, but
take emergency action if needed before a supervisor can be contacted
Rank 4 – must clear any decision before proceeding

TASK AUTHORITY
LEVEL
Perform testing services 1
according to procedure
manuals
Change testing protocols 3
and policies in special
cases
Reject unacceptable 1
specimen
Discipline staff 3
Request service 2
assistance from outside
vendors
Table 4-3 tasks and the corresponding authority level

Work assignments and job descriptions should be accompanied with the

right amount of authority and responsibility. Every staff is accountable in
the task assigned to him/her.

Delegation of authority can and should be done in some cases, but for the
right reasons. It is the temporary assignment of authority and responsibility
to perform a duty normally performed as a supervisor. Some tasks cannot be
delegated. Delegation should be used as an opportunity for learning, but
never as a punishment. When a task is delegated, the authority transfers to
the one whom the task was delegated. However, the responsibility for
delegating the task remains with the manager.

Several factors affecting delegation include delegation route, fear of

delegation, and when, how and whom to delegate.

Types and Roles of Authority:

a. Line and Staff Authority: is a concept that most organizations
employ in designing organizational structure.
b. Line Authority (Figure 4-4): is the relationship in which superior
exercises direct supervision over a subordinate.
c. Staff Authority: is advisory service that comes from outside the
chain of command. It helps line people work efficiently.

In a clinical laboratory, the chief Pathologist is the head who has the
authority to give orders and enforce policies and regulations. Under him/her

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 is the Chief Medical Technologist who in turn supervises the different
section heads. The section head is in-charge of the section assigned to
him/her. Other staff such as Senior or Junior Medical Technologists,
Medical Technicians and Laboratory Aides or assistants are under the
supervision of the section head.
2. Level of communication. This is discussed in detail in Unit 7 - Information
Management.
3. Division of work. It is the designated function of a department head to
divide and delegate tasks or workload to avoid confusion and
complications.

PRINCIPLES OF ORGANIZATIONAL
STRUCTURE AND AUTHORITY

1. Departmentalization. Related activities are grouped together to expedite

the production process, that is specialization.
2. Decentralization. The decision-making process is brought as close to those
who are actually performing the work as possible.
3. Unity of command. Each individual must have only one boss.
4. Scalar Principle. Supervision should be a linear system providing a direct
vertical link from the board of directors to the lowest level worker. (Figure
4-4)
5. Span of Control. There is a definable limit to the number of people one
person can effectively supervise, within the limits of specific work
condition. In general, one position should have span of control (direct
supervision) of 4 to 12 positions - 12 if functions are similar; 4 if functions
are dissimilar.
6. Exception Principle. The manager and stall are able to do their jobs
without having to check with the supervisor about every detail.

Views in Organizing:
1. Specialization is the process of identifying tasks and assigning them to
individuals or groups who have been trained specifically to do them.
2. Formalization is the specification of function/methods used to perform a
job to increase efficiency and reduce variability in the outputs of work.
3. Industrial Engineering breaks each job and task into smaller components,
with particular emphasis on the motions involved in the work.

Other Issues in Organizing:

1. Re-Organization is the process which an existing organization undergoes
that brings about changes in size and shape of the organization structure.
The reasons for re-organization are growth and adaptation.
2. Reengineering is the re-organizing work processes in an organization. Flow
diagram the specific work processes to determine if more effective process
could be implemented. Examples: use of robotics to automate,
computerization, pneumatic tube system to transport specimens.
3. Benchmarking is a process whereby the best process in one organization is
modified to fit similar processes in another organization. Examples: cost per
test, number of test performed per full time.

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 STAFFING AND SCHEDULING THE
LABORATORY

The laboratory requires considerably different education and training of

personnel. Each is unique discipline embodying large volume of technical data
and employing different analytical techniques and instrumentation. With regard
to laboratory staffing, the sheer growth and diversity of laboratory services
clearly demonstrate the need for specialization of personnel. Efficient and
effective selection, grouping and utilization of personnel constitute a major
responsibility.

JOB DESIGN

A job is a collection of tasks, duties and responsibilities assigned to an

individual worker.
Major factors influencing the make-up of a job
1. Organizational factors – includes management styles, bureaucratic
structure, products or services produced, technology requirements and
general economic health of the enterprise
2. People issues – people’s skills and limitations, personal motivational needs,
behavior characteristics, expectations, social mores, work force availability,
and the ability to function in the conditions of the work environment.

Job design is the process of organizing work into jobs.

Application of job design information:
1. Staffing – the process of matching the number and types of people with
jobs that meet the goals and structure of the organization. It is done by:
a. Identification of workforce requirement
b. Inventory of people available
c. Recruitment and selection
d. Promotion of staff
e. Appraisal
f. Planning career of employees
g. Training and development

2. Job description and Performance appraisals – are written declarations of

given job positions.
Job Description supplements the table of organization by providing
definition to all position. It not only defines and provides a baseline for the
performance tasks of the employee, but it defines the employee’s
interactions with people and how the position is integrated into the entire
organization. Job descriptions should change as the needs of the organization
change. It is the basis for preparing an advertisement for the position and the
basis for employee evaluation. It is used in the interview process and
reviewed with the employee prior to filling the position. Because it is a legal
document, the employee should sign it, acknowledging receipt of the
document.

Job descriptions also hold managers and employees in a position of

accountability. It serves as a toll to remind employees of the many
responsibilities they have within the position for which they’ve been hired.
The sections of a job description should include the following (Figure 4-5):
a. Title of the organization. It includes Name of the facility, location,
department, sections

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 b. Job Title
c. Job specifications. This is the position summary. Represents the
requirement for employment of a given job. The format consists of a set
of factors or parameters that bear significantly on all or most positions
and a corresponding set of pre-requisites developed specifically for the
job(s) under consideration. It provides the organization with the
personnel requirements considered to match most efficiently with the
demands of each job.
d. Summary of duties for the position. It is the heart of the document.
e. Reporting relationships or authority level. The person or position to
whom the employee reports is specified in the supervisor), along with
the supervisory responsibilities of the job (the supervisees)
f. Preparer
g. Date of preparation and activation
h. Approval signatures

Job advertisement should be prepared after studying the job description.

Key elements of a job advertisement include the following points:
a. Title of job
b. Location of job
c. Brief description of job
d. Brief description of the company/organization
e. The minimum requirement regarding education, experience, training
and knowledge
f. Additional comments or information related to job advancement, travel
requirements, or level of responsibility
g. How to apply
h. Deadline for application
i. Equal opportunity statement

Figure 4-5 Sample Job Description

3. Scheduling – builds on staffing information and focuses on matching

people on a day-to-day basis with the fluctuating workload of the
laboratory. In making work schedule, you need to remember that the
staffing of shifts depends upon the demand and the availability of personnel

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 to meet the demand.

Basic Rules in Scheduling:

a. No more than 5 consecutive working days for each individual.
b. Provide 2 consecutive day offs, except in the rare case where the individual
prefers split of day offs.
c. Within the possibilities. Give the individual the shift he wants.
d. Rotate weekend and holiday off with as much fairness as possible.
e. Post schedule at least 3 weeks in advance, even more if possible.
f. Stick to the schedule as closely as possible, and make changes only when
essential and only after discussion with others concerned.
g. Provide the opportunity to ask for a specific day off on occasion.

Job analysis is the process of collecting and analyzing information about tasks,
work flow and jobs being done in an organization so that job descriptions, work
standards and performance appraisal systems can be developed. The three-step
process of job analysis, job and assignment culminates in a formal written
document called job description.

Factors to be considered in job analysis:

1. working condition
2. technology
3. job specification
4. availability of labor
5. personnel interaction
6. legal aspects
7. work flow
8. work itself
9. work process

Application

SCHEDULING MADE EASY: Advanced Healthcare Scheduling

Softwares
Working in healthcare is one of the most stressful jobs. Healthcare staff
scheduling is incredibly complex, with shifts at all hours of the day and night.
Nowadays, there are several advanced healthcare scheduling softwares
available in the internet. As compared with the traditional way of scheduling,
these softwares provide a streamlined way to schedule and organize staff in the
cloud, saving not only time, but money as well.
Whether the healthcare organization is a large hospital with multiple locations
or a small clinic, these tools give you configurable, unified system to accurately
track the diverse workforce. Traditional scheduling schemes have numerous
issues in the field of healthcare and when it comes to scheduling processes,
some of the most common grievances healthcare employees have about their
schedules are:
 Unpredictability in scheduled time that constantly changes from
week to week
 Minimal control over schedules and a lack of ability to make
changes
 An uneven distribution of overtime, extra shifts and time off
 Disparity in shift managers accepting schedule change requests
 Difficulty balancing work and personal life responsibility due to
schedule constraints

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 These advanced healthcare scheduling softwares helped some of today’s
leading healthcare organizations implement advanced healthcare scheduling
solutions to simplify processes for employees and departments. More effective
scheduling and time management ultimately leads to improved patient care.
Advanced healthcare scheduling solutions help organizations improve their
workforces (and patient care) in several important ways:
 Schedule Generation – Optimize schedules based on the
organization’s work demands and employee needs.
 Scheduling Efficiency – Avoid scheduling too many employees
when there isn’t enough work or avoid being shorthanded during
high workload periods.
 Mobile Scheduling – Send a text message to alert employees about
a shift opening for a faster and more convenient way to fill empty
shifts.
 Workload Insights – Leverage forecasting insights to schedule your
employees, minimizing the risk of over or understaffing
 Simplified Employee Processes – Reduce the amount of time
employees spend on logging their time and finding someone to fill
their shift.
Hospital and other types of healthcare staff scheduling softwares translate to
better patient care, stress free staffing, better contact between management and
staff, more accurate schedules and less overtime, while assuring that all staff
needs are met and ultimately.

Summary of the Unit

Organizing is the backbone of management which comes after the planning. It
entails developing an organizational structure and assigning and allocating human
resources in order to accomplish the planned objectives. The structure of the
organization is usually represented by an organization chart. Organizational
system has various characteristics and has three distinct functions which are input
mechanism, transformation and output mechanism. Clinical laboratories have four
aspects or elements namely: formal organization, informal organization, people
and work. On the other hand, organizational design has four structural
components namely: functional component, self-contained component, matrix
component and the network component. The design and structure of an
organization are influenced by its organizational goals and strategic direction,
technological capabilities, size, environment, leadership style, member behavior
and organizational structure. In a clinical laboratory organization, there are three
elements namely: level of authority, levels of communication and division of
work. Organizing also involves the design of individual jobs within the
organization. Decisions must be made about the duties and responsibilities of
individual jobs, as well as the manner in which the duties should be carried out.
Decisions made about the nature of jobs within the organization are generally
called “job design” decisions. Organizing at the level of a particular job involves
how best to design individual jobs to most effectively use human resources. Job

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design information can be applied in staffing, job description and performance
appraisals and on scheduling.

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