Laws/ regulations

Motivation

Staffing/scheduling

Discipline/Counseling

Competency and CE programs

Motivation

Understanding what motivates people is essential to getting the work done.

It is the manager’s job to get the work done.

Therefore, it is the manager’s job to motivate!

Managers must create an environment that enhances motivation.

3 theories of motivation

Mazlow’s Hierarchical theory of Needs

Herzberg’s Two Factor Theory

Vroom’s Theory of Expectation

1. Theory of Motivation: Maslow’s Hierarchy of Needs

Human beings are motivated by unsatisfied needs, and that certain lower needs (basic needs) need to be satisfied before higher needs can be addressed.

Hudson Chapter 13

3

Maslow’s Hierarchy of Needs

Mazlow (con’t)

Physiological Motivation: Provide ample breaks for lunch and recuperation and pay salaries that allow workers to buy life’s essentials.

Safety Needs: Provide a working environment which is safe, relative job security, and freedom from threats.

Social Needs: Generate a feeling of acceptance, belonging, and community by reinforcing team dynamics.

Esteem Motivators: Recognize achievements, assign important projects, and provide status to make employees feel valued and appreciated.

Self-Actualization: Offer challenging and meaningful work assignments which enable innovation, creativity, and progress according to long-term goals.

See lecture notes for more details

5

2. Theory of Motivation: Herzberg’s Two Factor Theory

Herzerberg’s theory suggests there are certain factors in the workplace that can cause job satisfaction and other factors that cause job dissatisfaction

2 factors are:

Motivators: job satisfaction: achievement, recognition etc and are similar to Mazlow’s growth needs

Hygiene: job dissatisfaction: working conditions, wages ,co-worker relations. rules similar to Mazlow’s physical and social needs

Herzberg theory differs in that only the growth needs motivate. Hygiene only serves to dissatisfy.

Herzberg’s two-factor Theory

3. Theory of motivation: Vroom’s Expectancy Theory

Expect that high effort will result in high performance

Expect that high performance will produce high rewards

Reward preference: do you or do you not want it to work or have the outcome you want?

See page 74 of Hudson

8

Vroom’s Expectancy Theory

Scenario #1

An employee does not perceive that work is important. According to Vroom’s theory what type of problem is this:

Effort expectancy

Performance expectancy

Reward expectancy

Scenario #2

An employee is unhappy because he body fluid precautions are not being implemented correctly. In Mazlow’s and Herzberg’s theories what need or factor is identified?

Hygiene

Motivator factor

Social need

Physical need

Staffing/Scheduling Staff

Staffing Needs

Dictated by:

test menu

test complexity

education and experience of staff members

speed of techs

test volume,

TAT expectations

# of shifts to maintain

weekend/holiday coverage,

complexity of software and instrumentation

flexibility and training knowledge/competency of staff.

Salary $ compose the majority of the departmental budget.

Hudson Chapter 26

13

Worked Hours

A standard unit of work is applied to each billable test

Billable Test: a billable test (also known as “reportable result“) is one for which the laboratory is reimbursed

Unit of work for billable tests X # tests performed = # worked hours needed (specified hours)

# worked hours/80 = (Full time equivalents FTE in 2 week period)

0.25 (standard unit of measure of work) X 12,000= 3000 hours

3000/80=37.5 FTE

We will get into this more in later weeks!

14

Scheduling is dependent on Productivity

Productivity is closely monitored by management

staffing is adjusted if productivity increases or decreases over established

Worked hours needed (specified hours)/actual worked hours (takes out vacation/SL/AL) X 100 = productivity

Should be between 70-110%

3000 earned hours/actual hours worked

Scheduling

Employee schedule, budget, staff mix and intertwined

Example: new technologist with no experience: what shift

Full time staff vs PRN (pro re nata)

Scheduling Staff

Lab work schedule:

impacts morale

employee retention

The goal of the scheduler should be:

adequate staffing to care for patients

work schedule that satisfies the needs of the employee

Family

Religious

Scheduler should try their hardest to work with employees as much as they can

Making the schedule

Publish minimum 3-4 weeks in advance

Less/minimum staffing on off-hours and weekends/holidays

Minimize OT needs (OT is expensive 1.5X)

How weekends and holidays are assigned

How many days off in a row (2 at least)

Make sure there are some experienced techs where needed

Employee Correction/Discipline

Any action that an employee takes that results in danger a patient or to another employee will result in immediate dismissal

Re-hiring is costly so correction should be constructive and not destructive

Employee Correction and Discipline Plan

TALK to employee:

find out why/what happened, LISTEN!

Enhance dignity of employee

If employee corrects then give praise!

Verbal Warning –

Identify problem/issue

State the correct performance that is needed ; what needs to be corrected

documentation of what was said (notes).

Written Warning –

All the same steps (1-3) as above

supervisor and employee signs document (may be put on sick leave certification etc).

Second written warning:

All of the above in #3

Documented and signed by manager and employee

State that dismissal will be the next corrective action if correction does not take place

Dismissal

Employee Correction and Discipline Plan

See Hudson steps 1-5 pg. 41 (talk informally, verbal warning, written warning, 2nd written warning (maybe with suspension), dismissal.

Hudson Chapter 7

21

TALK to employee:

find out why/what happened, LISTEN!

Enhance dignity of employee

If employee corrects then give praise!

Verbal Warning to Employee

Identify problem/issue

State what and how it needs to be corrected; offer assistance

documentation of what was said (notes).

Written Warning to Employee

All the same steps (1-3) as above

supervisor and employee signs document (may be put on sick leave certification etc).

Second written warning:

All of the above in #3

Documented and signed by manager and employee

State that dismissal will be the next corrective action if correction does not take place

Dismissal

Employee Correction and Discipline Plan

See Hudson steps 1-5 pg. 41 (talk informally, verbal warning, written warning, 2nd written warning (maybe with suspension), dismissal.

Hudson Chapter 7

22

Scenarios

You, the lab manager, receive a report from an evening shift technologist that another is dumping urine samples in the sink in order to get to dinner faster. What do you do?

An employee brings a weapon to work and shows it to a coworker and tells him that if that other coworker ever bothers him again he will shoot him. When confronted, he threatens you. What do you do?

You receive a complaint from a nursing unit that the phlebotomist is distributing religious material to patients while doing her blood drawing rounds. What do you do?

Competency and CE programs

Different from conduct issues (late, calling in sick too often, fraud, ethical issues, HIPPA violations).

Performance issues are often failure to follow the critical elements in your Performance Standards (technical, QC/maintenance). For example: failure to follow SOP, failing a PT survey, misidentification of a patient, or resulting a test incorrectly.

EXAMPLE: VA gives person a Performance Improvement Plan (PIP). Performance is closely monitored for the elements that were below standard for a period of time. It’s an opportunity to improve.

Performance Issues

VAMC

25

An employee is evaluated on:

technical competency,

customer service/teamwork,

administrative duties (critical and non-critical)

A pass/fail or tiered system c be used

Performance can be tied to monetary award/bonus

Unacceptable performance or minimally successful may be tied to performance improvement plans and possible termination.

Performance Standards

Competency assessment is done by using the following methods (not all are necessary):

Blind sample

Split sample

PT

Problem solving

Direct Observation (maintenance and testing)

Written examination

Maintenance/QC review

Errors

Review of test records

Evidence of continuing education

Must do semi-annual first year and annually thereafter

Competency (CLIA federal Register 493.1235)

CLIA Federal Register 493.1235

27

Don’t ever stop learning! You are a professional now!

CEU = continuing education units

CH = contact hours

P.A.C.E = Professional Acknowledgment of Continuing Education

CMLE = Continuing Medical Laboratory Education

Know if you have a minimum required for your facility for annual performance evaluation – and to maintain your certification!

Look for the best bang for your buck – might be teleconferences or webinars.

There’s a lot of on-line training

Continuing Education

Scenarios

State some advantages of using PRN personnel

Discus the impact of test menu and staff skills/training on scheduling

A senior, long-term employee approaches you about a family member’s illness and tells you that she needs more time to take care of things. However, she needs to continue to work because her family will need the money and insurance benefits. What are some scheduling options you could suggest?