2.

Have purposeful activity or primary task –

Module 4: ORGANIZING & ORGANIZATION
defined duties that are necessary because of
● Organizing – is a management function but the nature of the system’s products or services.
provides the relationship between the people 3. Develop into Hierarchy of systems – the
and the activities that they will undertake to process whereby self-contained subsystems
fulfill their organizational objectives. develop within a parent organization, such as a
● Organization – is an entity that results from laboratory within a hospital.
people joining together in pursuit of a 4. Organizations operate as open systems -
common cause. This allows interacting with the environment
● Organizational System – defined as a self- by receiving and delivering products and
contained collection of interacting and services.
independent components, working together 5. Seeks a state of stability and equilibrium. -
toward a common purpose. It has an input A state of stability within and between the
(receive instructions and resources from system and its environment. Because the
external sources), transformation (internal mission of the organization defines the nature,
process) and output (finished products, lab. demands and tasks associated with the purpose
Results) mechanisms. will create an inertia to develop around certain
levels and tasks.
Functions of Organizations 6. Self-regulating. - The feedback process by
which the system monitors performance and
1. Input Mechanism – process through which provides information to its members.
needed resources are acquired and replaced.
Supplies, knowledge, machinery and labor are
required by money and replaced by delivery of Organizational Forces Influencing the
service. Manager’s Job
2. Transformation – internal process whereby 1. External Environment of Organization
resources received through the input channels - This factor is outside the control of a
are converted into the products and services manager, shaping the character and
produced by the organization. capabilities of the institution. This includes
3. Output mechanism – process of delivering the general economic conditions, laws and
goods and service produced to the external regulations, national and local customs,
environment. transportation routes, available work force and
even weather conditions.

2. The Internal Culture of the Organization

- The manager exert influence on changing the
organizational goals, objectives but should
consider the background of the organization
(history, lifestyle and images) and people as
well.

Organizational Structure
● A process where a group is formed including
Characteristics of Organizations the lines of communication channeling of
1. Holistic and synergistic with clearly defined authority, span of control and making
boundaries decisions.
Each component acts on, and is acted upon, by ● A formal structure of the organization which
other members of the elements producing a reflects the official arrangement position and
holistic synergisms that makes the system working relationships
greater than its parts. Clearly defined ● Know the specific role and different positions
boundaries refer to landmarks or labels of in the organization
ownership. ● Consider also the type of laboratory according
to ownership (private or public) and according
 to level of service (primary, secondary and
tertiary).

Types of Organizational Structures

1. FLAT
- Decentralized structure
- Span of control and authority is widened
- There is participation in the lower level of
management.
Formal Organizational Structures
2. PYRAMID
- Centralized structure There are four main factors in assembling the
- The manager has full control of members structural design of an organization namely:

3. BUREAUCRATIC / LINE / A. Design Elements and Factors

HIERARCHICAL a). Tasks to be performed – includes type of
- Oldest and simplest form equipment, level of automation, nature of
- Rule centered structure product or service produced.
- Associated with chain of command b). People involved – number of people
- Downward communication needed and availability to perform the work
are very important in an organization.
4. SHARED GOVERNANCE Motivation also plays a very important factor.
- Combination of flat and pyramidal type c). Workplace – includes the total space
available, amount of storage room, the
visibility and accessibility of workers,
Characteristics of Organizational Structure supervisors and proximity of test areas.
● Division of Labor – represents individual or
sub- units responsible for a given task. B. Design Strategies and Models
● Chain of Command – lines indicate who The essence of any structural organizational
reports to whom and by what authority. plan is the relationship between people within
● Span of Control – specific group of people a group. From this premise, bureaucratic and
who are responsible to. situational models fall into groups namely:
● Level of Management position – top, middle,
low level 1. Bureaucratic models – maintain tight
● Organizational relationship reporting ties with each sub-unit and require
Formal – direct relationship, uninterrupted. that all decisions be checked with
Informal – dotted line, coordinated “headquarters” before action can be taken.
relationship. Important features include:
a) Modern job description – each job has
a formally established set of official
FORMS of ORGANIZATIONS duties.
1. Formal Bureaucracy (Formal groups) – b) Hierarchy based chain of command
officially sanctioned lines of authority c) Rules and Regulations are consistently
assigned by the owners of the organization. applied
The members of this group know whom they d) The system works as its own
work with, whom they supervise, how their “formalistic personality” without the
department relates to other groups and even attachment of human emotions.
who supervises their boss.
2. Informal Groups – alliances that form Hiring and firing are based on qualifications
outside the boundaries of the formal and performance and the worker is protected
bureaucracy from the interaction and from arbitrary and unpredictable whims of any
allegiance of people with common interests. one particular manager.
 2. Situational models – attempt to tailor the 5. Span of control – number of individuals one
organizational structure to the specific job person can effectively supervise within the
needs dictated by the work condition. Looking limits of specific work conditions.
at both the type of work to be performed and 6. Exceptions principle – allows the manager
the ability of the staff to work independently and staff to do their job without having to
accomplish this. This could be based on a check with a supervisor about every detail.
technological approach depending upon
production process: small batch production,
CONCEPTS OF AUTHORITY
large batch and long run and continuous
output. This utilizes a matric schemes a ● Power to Act. Empowerment by formal job
featured by: classification of an individual to make
commitments and act on behalf of the
a) Routine Strategy – work consists of repetitive organization to decide how resources, rewards
tasks and needs minimally trained workforce. and penalties are used to ensure that
b) Engineering Strategy – non-repetitive work designated goals and responsibilities are
that requires independent judgment and is achieved.
performed by a professionally prepared staff. ● Authority and responsibility should go
c) Craft Strategy – is applied to produce best, hand-in- hand to ensure harmonious flow of
unique products whereby workers are organizational energy toward completion of its
extremely skilled. tasks and mission.
d) Discovery Strategy – for work that requires
investigation such as the structural TYPES AND ROLES OF AUTHORITY
development
1. Line Authority – authority taking the
straight- line route from administration to
department head, to supervisor to the staff.
This type of authority is assigned through the
formal bureaucratic process. Ex. Supervisors
have line authority over the subordinates.
2. Staff Authority – exercised through such staff
departments as the business and personnel
departments – those that provide supportive
services in a more direct fashion. This is the
type of authority the personnel office exerts.
3. Functional authority – exercise control
PRINCIPLES OF ORGANIZATIONAL within the boundaries or profession’s specialty.
STRUCTURE & AUTHORITY This type of authority is shown when
physicians write prescription orders to
1. Departmentalization – the grouping together patients.
of related activities to expedite the production
process. This involves the concept of
specialization. In the laboratory, specialization DELEGATION OF AUTHORITY
can be based on such factors as the type of ● The need for delegated authority and shared
specimen received (hematology, microbiology, responsibility is related to the concept of span
urinalysis) or the function performed (quality of control; that is how many persons or
assurance, safety). operations can one person effectively direct.
2. Decentralization – process of having the ● Line positions are filled by Section Head,
decision-making process close to those who Supervisors or Technologists who are
are actually performing the work. primarily responsible for the delivery of
3. Unity of Command – states that each clinical laboratory services and are in direct
individual has only one boss. line from the Head or Director of the
4. Scalar Principle – involves the concept of Laboratories. Staff positions are filled by
chain of command and career ladder. Workers persons who provide supportive or
should know to whom they report. administrative service for the organization.
 limitations, personal motivational needs,
Module 5: Staffing and Scheduling
behavior characteristics, expectations, social
1. Staffing – the setting of long term goals and norms, workforce availability and ability to
objectives for the number and types of function in the conditions of the work
personnel needed to meet the labor environment.
requirements of the laboratory.
2. Scheduling – matching the people presently 3. Legal and Union requirements – include
working in the laboratory with current legislative and labor rules and regulations.
workload requirements. Determines the name
of people who will work the slots.
Job Designs
3. Job – collection of tasks, duties and
responsibilities assigned to an individual 1. Organizational Needs – the goal is to match
worker. the right people with the right job to achieve a
4. Job Design – the process of organizing work workforce that is productive in both volume
into jobs. and economics. People who are technically
5. 8/80 hour rule – a special provision to the and legally qualified to perform the tasks of
wage and law hour. the production process.
6. Floater – a person who is able to work in 2. People Needs – a motivated and committed
many sections of the laboratory and is workforce is the most important element in
assigned according to fluctuating daily and meeting the productivity and efficiency needs
hourly workload needs. of an organization.
7. Professional Extenders – technical and a. Job Enrichment – efforts of
clerical assistants who do the task traditionally make-work more meaningful and
performed by a professional. satisfying especially by increasing the
8. Skeleton Schedule – the first working draft of level of autonomy, control and
a schedule that posts only weekends and responsibility for job performance in
requested time-off. areas that allow the worker to grow
9. Absenteeism – failure to meet the standard for professionally.
attendance set by the laboratory. b. Herzberg’s motivators –
10. Absence – occurrence of an unscheduled achievement, recognition, challenging
absence. work, responsibility and chance for
advancement.
JOB DESIGN c. Job Behavior factors – level of
● Jobs are the link between people and autonomy, variety of skills, talents,
organization. They encompass the activities needed to perform job, task
expectations of both the company and identity, task significance and clarity of
individual. feedback on the effectiveness of
● Jobs are the mechanism through which work is employees performance.
done, products and services delivered and all d. Worker selection – matching
duties are rewarded. individual needs with specific jobs is
● Hence, close attention must be given to how an important responsibility of
jobs are constructed , who does the work and management. Many factors guide the
what resources are needed to accomplish the manager in his decision including age,
tasks. career stage, and ambition, educational
● Many factors influence the makeup of a job. background, experience and
personality.
Many factors influence the makeup of a job. Main
determinants are the following:
Staffing and Scheduling Process
1. Organizational factors – include
management styles, bureaucratic structure, Staffing – is the process of determining
products or services produced, technology personnel and job needs, recruiting qualified
requirements and the general economic health. staff, matching them with the appropriate job
2. People Issues – include people’s skills and and training them to perform the work
assigned.
 Staffing – establishes how many and what necessary to perform the duties and the
types of working conditions.
personnel are needed, whereas scheduling
determines the names of the persons who will Job Description – is a written statement that
work at this time. designates the tasks, duties and
Staffing Levels – determines the number of responsibilities, working conditions and
staff on a specific day and shift. reporting relationships for a specific job.
Scheduling – is the posting of the specific Job Description – is a summary of important
names of the individuals assigned to work this or significance about a particular job. It is a
shift. useful tool in classifying positions,
determining pay grades, recruitments,
STAFFING LEVELS orientation of new employees and setting
● Primary determinant in the staffing process is employee performance standards.
the level of service expected from each unit
and the resulting workload. ● It includes: Title/Position, Relationship and
● For example, weekday shift – shift may be Duties and Responsibilities.
expected to perform all services offered by the ● Purpose of Job Description:
section and needs the specialized personnel to 1. For recruitment and placement
accomplish this mission. If however, only 2. For guidance, direction and evaluation of
routine procedures are performed during performance
weekends, evenings or night shifts, then 3. Help reduce conflict, friction and overlapping
medtech staff with general laboratory skills duties.
may be appropriate. 4. Basis for salary.
● Technical skills, matched with workload, 5. To determine a working relationship.
set the types and numbers of personnel
needed during each staffing period. A properly prepared job description answers the
following questions:
PERFORMANCE TRAINING
● The important aspect of staffing is to make 1. WHAT are the duties and responsibilities
certain that employees are properly trained to including the % of time spent at the various
perform their assignments. tasks?
● Training personnel to staff the laboratory 2. HOW, WHERE, WHEN are the duties and
beginnings with their arrival (orientation) responsibilities?
and follow through with the employee 3. What qualifications are required, that is, the
development programs run by the laboratory knowledge, skills and abilities needed to do
to ensure competency, availability of future work?
staff, and the continual growth of both 4. WHY is the job necessary, that is, what Is this
laboratory and its employees. the purpose of the job?
● Management has a distinct responsibility to 5. HOW does the job relate to other jobs in the
properly educate and train the staff for the organization? (each point should be written in
tasks and duties it is expected to perform. a concise, clear way so that anyone can
identify the job from description).
Job Specification – is summary in abridged
form SCHEDULING
of the formal education, skills and experience ● Scheduling builds on staffing information and
required to perform the duties of the job; also focuses on matching people on a day to day
include my unusual physical requirements or basis with the fluctuating workload of the
working conditions. laboratory.
● Scheduling determines where and when
● It includes the formal education and employees work and usually results in a
experience qualifications (legal, union, schedule posted on a periodic basis-daily,
professional requirements) for employment; weekly or monthly. The supervisor must
the technical, people and physical skills balance the needs of the department with those
 of the employees who need time off for 4. Frequent “rush” orders of supplies.
vacations. 5. Low morale in the laboratory.
6. Requests for deserved pay raises by competent
Rotation Plan of the Staff workers.
a. Determine the day-off schedule 7. Excessive cost of operation
b. Be aware of the schedule of leave: Sick, 8. Ignorance of the cost of operation
maternity, vacation, emergency and absence 9. Expenditure of much of the directors time in
without leave. making minor decisions.
c. Note the availability of the reliever 10. Inability to do one or more tests when an
d. Determine the rotation (am, pm, night shift) individual has a day off.
ORGANIZATIONAL & MANAGEMENT OF
CLINICAL LABORATORY Setting Objectives
● Efficient operation of a clinical laboratory The use of such objectives for the purposes of
and the effective delivery of medical management by MBO. In order to achieve
laboratory services to clinicians and their these objectives the clinical laboratory must
patients requires: have:
1. Interdigitations of expertise in medical, 1. Adequate facilities, equipment and supplies.
scientific and technical areas. 2. Adequate number of qualified personnel.
2. Resources in the form of personnel,
equipment, supplies and facilities.
GOALS vs OBJECTIVES
3. Skills in organization, management
and ● GOALS are those general and qualitative
communication. statements of the overall philosophy of the
4. The laboratory head and supervisors organization. Example of a goal is
must also be aware if the accreditation commitment by the laboratorie to be a vital
standards and governmental assurance component of a hospital whose goal is to
quality laboratory heads, supervisors provide a patient care environment of
and medical technologists. excellence to serve the community and to
● The medical, technical and scientific expertise serve as the primary setting for clinical
are prerequisite for the provision of medical teaching and research for the medical school.
laboratory science. Success in applying ● OBJECTIVES are the statements of the more
techniques to benefit patients is vitally specific and quantifiable steps taken to achieve
dependent on the management and the organizational goals. An example of an
communication skills of laboratory heads, objective “to evaluate the available methods
supervisors and medical technologists. and to introduce into regular use of an LDH
● Entire activity of the laboratory will be guided isoenzyme procedure.” The goals should be
and to an extent by the proliferation of consistent with the organization structure, the
accreditation standards, governmental management style of the laboratory head and
regulations and financial constraints. the available resources.
● Persons in the laboratory must be aware of all ● The types of goals set for the laboratory will
the functions and external influences affecting vary greatly. For instance, the goals for the
the practice of laboratory medicine and must operation of an office laboratory with the
assume other roles as well as those of physicians are vastly different from that of a
managers and executives. reference laboratory serving thousands of
physicians and patients in a large geographic
area. Another factor that affects the setting of
Indicators of Lack of Management and
goals is the type of patient served “ the nature
Communication Skills:
of the educational and research commitments.”
1. Inability to maintain an adequate staff.
2. Recurring or persistent misunderstanding with Such written goals may organized as follows:
the hospital administration. 1. A statement of the primary external goals of
3. Frequent or recurrent confusion concerning the laboratory. Most laboratories exist within
requisitions or reports of laboratory work. the framework of some other institutions such
 as hospital, clinic, sanitarium or cooperation. Traditionally, laboratories have been organized
The goals of the laboratory should thus be a in relationships to clinical problems, disease
subset of the overall goals of the organizations orientations, or functional efficiency. It has
or institutions. been pointed out that traditional laboratories
2. A statement of the primary internal goal of the have a mixture of approaches.
laboratory in reference to service, research and
education. For example:
3. A statement as to the secondary and tertiary
goals of the laboratory in reference service, 1. Clinical Chemistry is technique oriented.
research and education. 2. Microbiology is technique oriented and
4. A statement in reference to the management disease oriented.
philosophy and need for cost effectiveness. 3. Urinalysis is specimen and organ system
5. A statement as to what kind of environment is oriented.
desired in the laboratory with respect to 4. Hematology is specimen and organ system
interpersonal relationships, working oriented.
conditions, and attitudes toward teaching and 5. Blood Bank is product oriented.
scholarly activities.
TAT Laboratories
Objectives should be quantifiable statements of aims
that are achievable in a designed time frame. They In an effort to make laboratories more
should be formulated as part of planning for the responsive to the needs of the physicians, the
next year’s budget as part of multiyear long range concept of laboratory organization based on
planning effort turn-around-time (TAT) has been involved. In
this approach, laboratories are organized on
the basis of turn-around time, that is the
LABORATORY FACILITIES &
elapsed time from arrival of the specimen in
ORGANIZATIONS
the laboratory to the availability of the result
● The successful design of a functional clinical in the laboratory. No STAT requests are
laboratory, either new or renovated, requires accepted.
the cooperation of overall groups of
professionals. 1. The one-hour-or-less TAT Laboratory also
operates 24 hours a day, 7 days a week and
1. The laboratory head and the staff need to be manually performs those procedures such as
intimately and continually involved in the process. electrolytes, amylase and blood gasses needed
The laboratory supervisor should have a clear immediately for patient care.
understanding with the appropriate administrative 2. The four-hour-or-less TAT laboratory also
personnel concerning the right to final review of all operates 24 hours a day but uses
plans and any changes. predominantly automated equipment to meet
2. Outside consultants or designers of laboratories bulk of ongoing patient care requirements.
may be utilized, but this is not an essential feature. 3. The 24 hour-or-less TAT laboratory operates
3. An architect or architectural firm is essential to one or more shifts 7 days a week with
prepare the various drawings and specifications. predominantly automated equipment to
4. A contractor is needed to construct the facility. provide the less urgent routine procedure.
4. The greater-than-24 hour TAT laboratory may
operate sift 5-days a week and provides the
FUNCTIONAL CONSIDERATIONS IN
more sophisticated, low volume procedures.
LABORATORY DESIGN
The above approach to the organization of
The laboratory head or supervisor having the laboratories is analogous to recent trends in
opportunity to design a new laboratory or hospitals to organize patient care in progress
make of levels of care, such as critical care, routine,
major renovations in an older laboratory and ambulatory care units.
should
think in functional terms about the laboratory
operation and its facility needed.