Chapter IV

DIRECTING AND SUPERVISING THE LABORATORY

Similar to any typical workplace, a clinical laboratory’s functional capacity is

substantially dependent on the personnel performance on-the-job. As a core unit in
diagnostics, clinical laboratory should be optimized to perform in carrying out the
purpose of patient-care. Thus it is essential to put into perspectives of directing and
supervising as tools of implementing laboratory services effectively.

Definitions of Directing and Supervising

Directing involves bringing about purposeful action toward some desired outcome; either
self-initiated or aiming the organization’s course and objectives. Duties should not be
limited in meeting patient healthcare solutions, but also to consider patient and staff
safety. Managers must be able to manage well the human resources, contemporary
workplace issues, career progression, and rules and regulations.

Supervising requires people management and coordinating skills. Managers are expected
to lead their employees to meet organizational goals through motivation. Under
supervising, Specific instructions are given to employees in areas which their skills are
best fit. Be it on a specific area of the laboratory or in a more specialized task. The use of
positive motivation instead of negative appraisal improves personnel performance better.

Characteristics of a good leader

There are five major characteristics according to Stogdell (1978) that a leader should
have, these are: Intelligence, Self-confidence, Determination, Integrity, and Sociability.

Intelligence. Is the capacity to think firmly grounded in effective leadership. Verbal

skills, ability to perceive and be logical at all times contributes more in becoming a better
leader.
Self-confidence. Is the knack of a leader to assert himself about skills and competence.
This is necessary to implement policies and somehow ‘make a difference’. Self-
confidence makes a leader to effective in motivating employees in doing things in an
acceptable level.

Determination. The initiative to work, persistence in finishing a job, and the ability to
control. A leader must be at all times proactive and be stable enough to surpass
hindrances on-the-job and withstand stress related to work. Determination simply
speaking is exerting your own will and resilience towards a goal.

Integrity. The manager must be the embodiment of the work ethics he wishes to be
practiced inside the laboratory. His principles, and of the organization must not contradict
each other but rather juxtaposed. If the manager is untrustworthy, chances are, staff will
only follow him because of authority only.

Sociability. A manager’s Emotional intelligence (EQ) is crucial in leadership. Leaders

must know how to understand the emotions of a staff most especially if it already affects
their performance. Likewise, emotional intelligence must be used to understand personnel
behavior.

Leadership styles

Leadership is all about establishing authority to staff personnel without delineating

oneself to the group. Coordination is obtained if the manager constantly communicates
with his staff.
Centralized and Decentralized authority

In the field of medical technology one emerging perspective is the dimension of decision
making in management. Centralized and Decentralized authorities are styles of knowing
how decision-making is made and how it will be transferred across the organization.

Centralized authority
Under Centralized authority, decision making is made by the top levels of the
organizational hierarchy. Therefore, information is disseminated towards the lower levels
of the organization starting from the top management and having the staff line to be the
last group to be informed.

Decentralized authority
For Decentralized authority, the knowledge is transferred starting from the low levels of
the organization towards the top management. The manner how decision is made
explains that lower levels of the organization resolves issues by themselves, giving
managers low control over decision making.

Figure 1. Centralized and Decentralized authority. The central sphere represents the top management
and the small spheres represent the branches and other parts of an organization.
Table 1.Comparative outlines of Centralized and Decentralized Authority.

Centralized Authority Decentralized Authority

Decision making Top management only Middle management and

the supervisors
Repetition or overlapping
Yes No
decisions
Decision making flexibility No Yes
Towards the top Towards the middle
Direction of management
management management
Identifying staff skills and
No Yes
capacities
Dissemination of
Slow Fast
information
Coordination Weak Strong

As a manager, one of the main objectives is to carefully determination of areas where

decentralization could be use or if centralization should rather be used. For both ways, a
manager must always bear in mind that the increased of information is the primary
objective towards total quality management.

Absenteeism and Inattention

Absenteeism
Attendance of employees must be strictly monitored as its significance pose on the
productivity and efficiency of the laboratory. Absenteeism the non-attendance of a staff
that contributes to productivity loss and possible disorder the in the workflow.
Causes of absenteeism in workplace are described in here ways which are determined by
(1) individual, (2) the workplace and (3) societal factors.

(1) Individual
• Past absence history- if an employees has a frequent tendency of being
absent from work.
• Personality- a person’s character play an important in work attendance as
they tend to see work as a priority or not.
• Distance from work- appears to influence sickness due to difficulty in
transportation.

(2) The workplace

• Nature of work.
• Fitness of the person on the job- if an employee’s skills are relative to
his/her job designation.
• Work organization.
• Organizational climate- camaraderie among co-workers, supervisory
support and fairness in all factors.
• Work stress.
• Absence culture- if absenteeism is a common practice at work.
• Work hours- Shift work has an inconsistent relationship with attendance30
even though good evidence exists for an increased association with
adverse health effects.
• Existing policies- organizational policies can discourage absenteeism and
can control in an individual and organizational absence behavior.

(3) Societal factors

• “Quality of Working Life”- the relationship between the working
environment and of a personal health.
Solutions
A quick way of addressing absenteeism is the reward system or a consistent discipline
system. This is in respect that, solving absenteeism without any concern to any
underlying reasons of a problem. Fitzpatrick and Huczynski identified assessments and
analysis to counteract absenteeism.

(1) Attendance policy. Re-inform staffs about the existing policies on absenteeism.
(2) Absence monitoring systems. Managers must constantly keep track of the
attendance of his staff.
(3) Rewards and penalties- The cashing in of sick leave, that is the redemption of sick
leave for full or part full pay, is often promoted as a solution to absenteeism.

Inattention
The inability to focus of an employee that would eventually leads to productivity loss.

Solutions to inattention (Blau, 1999).

1. Provide examples for distracted behavior. Relate to the employee if he has
some likely experience in the past.
2. Allow some leeway on the schedule or ‘unfocused time’. Allow employees to
get out of the track to discard unrelated issues to work or duties. Taking some
time off will clear out an employees’ mind.
3. Identify employees that are inquisitive. Choose duties and tasks that would fit
his expertise and skills.
4. Pair competitive employees to those who are less competitive.
5. Conversation. Question whether there is an underlying reason for the employee’s
lack of focus, if there are any grievances or other related reasons.
6. Mentoring and close monitoring. Provide time to demonstrate techniques and
current trends in the field to some employees who seems to be having difficulties.

Establishing the interest of employees to work is by understanding. Giving efforts to

understand supports the overall productivity and the interest of the staff to work.
 Leadership responsibilities
1. Leadership development. Each manager has the duty to maintain the chain
of command in the managerial rank.
2. Planning and implementation. Carrying out plans should not end, too at the
behalf of the manager but he must see to it everybody abides to it.
3. Employee and process assessment. Systems, like processing of data are still
under the supervision of the manager.
4. Decision making. Leaders may solicit the point of view of his staff as he sees
it fit before taking a critical decision. However, he has the ‘last call’ on every
issues pertaining to the laboratory.
5. Employee motivation. The goal of motivating employees is to encourage
them to use their stumbling blocks into building blocks. Encouragement may
come in the form of a personal letter, incentives, giving of awards and other
methods.
6. Conflict resolution. Complaints by employees against co-employees are
handled by the manager and must be objective at all times.
7. Problem solving. Technical skills and the theoretical are good aides for a
manager to solve problems in the workplace.
8. Coaching. It includes liaison between the top management and among his
staff and mentoring.

Leadership methods

Understanding and conducting leadership requires knowledge. As a process, leadership is

a complex concept but is always understandable in a logical way on which it can be
tested.

Decision making is a vital process for almost all institutions on a daily basis. Health
organizations particularly hospitals are challenged to make decisions to solve problems
be it for patient care or administrative. As any decision making process starts with a
solution to be addressed, issues, questions and operational modifications involves person
from the inside and outside the organization.

Thus, methods are utilized on substantial (analytical-quantitative) methods to provide

choices for giving findings and results for any scenarios where decisions are highly
needed.
• Willful choice of rational models-evidence and analytical approach
• Reality-based or garbage can model- application of contemporary issues to
generate decisions.
• Combination of willful and reality-based model

Figure 2. Three types of decision-making methods

Three types of decision-making methods

• Quantitative method: use of probability-based decision making simulation, use
of mathematical models and programming software and tools
 • Qualitative- person/personnel evaluation such as interviews (formal and
informal) and questionnaire filling up.
• Triangulation- is a cross-application of qualitative and quantitative methods
where, ‘conception’ is conserved to qualitative or the ‘theory planning’ and the
challenging of the result is reserved to quantitative method where the validity
is/are confirmed

The managerial grid

Theory

“The Managerial Grid provides a key for unraveling and solving managerial problems. It
is a tested system which has been applied in industry, and which in each ease has
contributed significantly to increased profits”.

The Grid

The Managerial Grid model is a behavioral leadership model created by Robert Blake
and Jane Mouton to demonstrate the different (five) leadership styles, having two
dimensions of concern for the people and the concern for production. The aim of the
model is to have a practical useful framework to help leaders to go-about their leadership
styles as it plots the degree on task relatedness (concern for production) and person
relatedness (concern for people).
Concern for people

Relates to the degree which a leader considers the needs of his staff line-up and the
employees self decision making on how to perform his work well. Elements of personal
goal achievement, maintenance of self-esteem of workers and the establishment of basic
trust rather than pure pressure of authority provides good working conditions and
maintenance of satisfying interpersonal relations.

Concern for production

Is the degree to which a leader prioritizes the concrete objectives, organizational

efficiency and objectivity over people management. It includes the attitudes of the
supervisor to varied concerns such as policy decisions, the procedures and processes,
quality of staff services, efficiency of work, and the volume of output are prioritized.

To further explain the grid it is presented in a model where two axes with a one to nine
scale is shown. Whereas the x-axis represents the concern for production and the y-axis
indicates the concern for people. The concept here is the leadership style of every line
manager can be allocated within the gird and therefore is line to different leadership
styles. In the managerial grid, training consists of a simple diagnostic framework to aid
participants to describe the behavior in real-time or simulated scenarios.

Four extremes of basic styles

1. The impoverished or the indifferent style: “Low production/Low people (1.)

 • Is a management style which is a delegate-and-disappear management
style or a basic lazy approach. The managers employ low control or
apprehension for people. The only time they act is when there is a need to
communicate information from superiors to subordinates. The leader
evades the potential of risk of responsibility related conflicts, complex
situations wherein staff and production must be prioritized separately or
just simply for the sake of preservation of job and seniority. Negative
effects of this style are escalated dissatisfaction among the staff,
disorganization of his jurisdiction and disharmony of production.

2. Country Club Style (Low production/high people)

• Usually single-sided, and a strong inclination to resolve issues pertaining
to the staff. The orientation of the manager here is usually towards a high
concern for his subordinated which unconsciously compromising the
efficiency of the production. Giving too much attention to the needs and
demands of his staff makes him incompatible to execute punitive, coercive
and legitimate authority. This situation endangers the authority of the
manager to secure command over cases where imposing of such is crucial.
Though the workplace will become friendly but does not result in a high
productivity.

3. Autocratic Task Management

• This is the full prioritization of directly productive work activities,
irrespective of the consequence to the workforce who carries out the tasks.
Concern for employees or their welfare will be seen by management as a
hindrance to the target production/performance and is unnecessary.

4. Team management
• Is a representation of high operational performance and quality because of
a stimulated or motivated workforce. This is a pre-requisite in attaining the
‘ideal workplace/force’ as ranked as the ‘excellent’ conducive condition.
This method relies heavily to the receptiveness of the employes to feel
constructive to the needs/welfare of the company.