Volume 79 - Fall 2001	Download

Incorporating Management Skills Into the CLS/MT Curriculum by Vicki S. Freeman, PhD, MT(ASCP)SC Program Director, University of Texas Medical Branch, Galveston, Texas

The new NAACLS Essentials/Standards include the same technical skills that we have taught for many years. However, there is an increased emphasis on the principles and application of laboratory management skills. While I believe that many of us see the need for increased exposure of students to these skills, finding a way to incorporate them into an already full curriculum presents a challenge. Many programs have capstone projects that they require their students to complete for graduation. Using these projects as a method to accomplish the application of management skills could be very appropriate. Below is a project that I have had my students carry out for the last four years. Each year, I see the students blossom while working on this assignment. What is interesting, when I look over the new proposed NAACLS Essentials/Standards, is that just about every topic is covered some place in this project. Upon completion of the project, students are expected to critically evaluate their part of the health fair and to evaluate the performance of their fellow peers as well.

Major Management Project: Health Fair Project

Situation: The laboratory is to provide testing at the local Galveston Health Fair. Officials of the Health Fair have requested that the laboratory perform: hematocrit (or hemoglobin), total and HDL cholesterol, ABO grouping, and glucose. The laboratory will be in charge of collecting the samples for the blood work. It must provide all equipment, supplies, and personnel. Your task will be to develop an efficient and cost-effective laboratory using the following tools: workflow analysis, turn-around time, workload (staffing), cost analysis, and instrument evaluation. You will need to organize the laboratory to its maximum efficiency and cost-effectiveness. The anticipated number of people expected to participate in the Primary Care Day is 500.

Laboratory Personnel: The CLS Management Class is in charge of this laboratory.

• The class must select a laboratory manager and laboratory technical supervisors for each of the test areas to be performed. Testing teams will be comprised of management class members. All class members must be available and attend the Health Fair on the scheduled day.
• Each of the tasks below must be completed. Some tasks will need to be done by individuals assigned the responsibility; other tasks will be the responsibility of the testing teams. The management team can delegate responsibility to other members of the class.
• The junior class can (and should) be called upon to attend and help with the testing (but they will need training on the procedure(s) they will be performing). Please remember that you will need a phlebotomy team, and training in each area is essential.
• Enlist the help of other allied health professionals, such as physician assistants, in taking patient histories, determining appropriate laboratory testing, reviewing results with patients, etc.

Determine what tests will actually be performed at the Primary Care Day

• List those tests that will be performed within the laboratory setting. (You can make suggestions to the Primary Care Day officials on changes in the test menu based on a cost analysis of the procedures.)
• Construct laboratory request, log, and report forms for the unit and describe their use. (Remember to follow CLIA rules, obtain patient permission, etc.)

Develop a procedure manual

• Write a complete procedure following NCCLS guidelines for each of the tests to be performed in the laboratory to include:
  1. Name of procedure
  2. Principle
  3. Equipment
  4. Reagents
  5. Methodology
  6. Calculations
  7. Normal values
  8. Interpretations
  9. Special considerations
  10. References
• Establish written protocols for quality control procedures and for monitoring and evaluating the quality of the testing process of each test to be performed. (Include standards for maintaining acceptable test methods, equipment, reagents and materials, establishment and verification of test performance specifications, calibration and control procedures, corrective actions to be taken when procedures arise, and QC records.)

Develop a Budget

• List the capital equipment that will be required, perform a cost analysis, and instrument evaluation, selection, and productivity.
• Determine the cost per test for each procedure to be performed and the total cost of performing laboratory tests on 500 participants.

Develop a flow diagram of the laboratory setting

• Draw a floor plan for the laboratory including bench area, equipment positioning, and power outlets.
• Perform a workflow analysis describing the flow of the specimens and analysis, and estimate the turn-around time for completion of all tests.
• Upon completion of the Health Fair, analyze the actual turnaround times for ways to increase the efficiency for the next fair.

Analyze personnel issues

• Meet safety and CLIA regulations for the level of testing to be performed.
• Describe the staffing pattern for the laboratory to assure complete coverage of all areas. Identify the number of employees this laboratory will require, and briefly describe the anticipated division of responsibilities for each employee. (Use CLIA guidelines to determine the employee mix.)
• Develop a staff orientation and training program, competency testing and education.
• Develop a proficiency testing plan and show how to use the result of the PT interpretation.
• Upon completion of the Health Fair, analyze how the personnel performed, and identify any problems encountered (i.e., individuals not showing up, personality conflicts, etc.)

Develop an inventory of equipment and supplies needed, including storage needs

• Formulate a plan for inventory control and maintenance of supplies.
• Upon completion of the Health Fair, provide an updated inventory analyzing actual supply usage.

Market the Health Fair Laboratory

• Determine the clientele population that is at high risk for diabetes, nutrition deficiencies, etc.
• Formulate a plan on how to market the Health Fair laboratory to the high-risk individuals.

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