The most challenging mission of the clinical
pathology management team is to develop maximum
utilization of existing resources. To accomplish this,
we must sharpen our managerial tools and in
selected cases become more innovative. Management must assume responsibility for:
Proper Utilization of
Evening and Night
Administrative Data
by John Bernard Henry, M.D., and Bettina C. Martin,
M.S., HT(ASCP)
1.
2.
3.
4.
5.
6.
7.
8.
Policy Development (and re-Development)
Planning
Organizing
Budgeting
Staffing
Operation
Reporting
Follow-up.
In essence t h e n , we must begin to lead, and more
specifically, direct and control the organization in a
meaningful manner.
In this vein, we have been concerned in our
laboratory with the lack of systematic, top-flight
leadership and planning for our evening (3:00-11:00
pm) and night (11:00-7:00 am) shift services. Likewise, staff on these t w o shifts often feel neglected
and " o u t of t o u c h " with the day thinkers. W i t h the
limited (reduced) number of staff on this shift, it is
even more important that we keep abreast of their
needs and problems as w e l l . Their workload in
comparison to day staff is not similar. Most all of
the w o r k is STAT and the remainder, expedite! The
pressure, and need for the ability to respond under
pressure, is great.
During the day when someone calls in sick, there
is generally an adequate number of other staff to
share and absorb the absence easily. Not true at
night! The absenteeism and tardiness of this staff is
therefore minimal as they develop a true team spirit.
We perceived a need to secure a better handle on
the actual day-to-day performance and productivity
of this second- and third-shift staff that works
66%% of the total w o r k force time. The staff is
dedicated, hard w o r k i n g , and responsible and we in
management must respond to them accordingly.
W i t h this objective in m i n d , we developed (with
input f r o m our day and evening shift) a worksheet
which we have titled Evening and Night
Administrative Data (Fig. 1).
John Bernard Henry, M.D., is Professor of Pathology
and Director of Clinical Pathology, and Bettina C.
Martin, M.S., HT(ASCP), is Associate Professor of
Medical Technology and Administrative
Technologist, State University Hospital, Syracuse, New York.
12
LABORATORY MEDICINE • VOL 8, NO 4, APRIL 1977
This worksheet was designed to accomplish
several major objectives during the evening and
night shift. W e wished it to provide management
with:
1. A daily report of workload volume (in a
meaningful format, expressed as instrumentation and people)
2. A daily systematic review of preventive
maintenance
3. A daily written report of equipment and instrumentation problems
4. A daily evening safety check
5. Information about the volume of phone calls
into the clinical pathology suite d u r i n g evening
and night shifts
6. A daily review of evening personnel assignments
7. Useful data for administrative planning
8. Useful data that w o u l d serve as a teaching t o o l
for residents in clinical pathology.
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Let's look at these more closely:
Daily Report of Workload
Volume
It is important for every manager to know the
answer to such questions as: What is workload
volume? What trends are developing? Are Mondays
and Wednesdays heavier than Fridays or Saturdays?
Do we need the same number of staff on each of the
seven nights? Could we add other measurements
on selected nights? Should we delete some measurements on selected nights?
Preventive
Maintenance
From the data-volume, we can choose or predict
best nights for " d o w n t i m e " and do preventive
maintenance (PM) tasks. Likewise, w e can better
assist day crew in their PM programs given this
knowledge, and perhaps lighten the day PM service.
Equipment
Problems and Safety Check
It helps the director and the supervisor to have
written records of equipment failures. What time the
instrument went " d o w n " — w h e n was the service
representative called, and w h e n it was " u p " and
functional again. This system keeps service contract
vendors honest as well (especially when you have
written records indicating it took 21/j days for a repairman to show up). Also, it gives a day-to-day account
of where major instrumentation problems are, how
they were solved, and the cost of solving t h e m . Likewise, we should ask: Are the instruments in use
optimal for these hours as well as days?
W i t h the advent of OSHA safety standards, we
need to become more safety-minded, and safety
checks on both evening and night shifts will keep the
staff tuned to their safety obligations and responsibilities at night. These are the same as for the day
crew.
Phone Calls
It is helpful to know how much technical staff time
is allocated to telephone reports. It might even be an
indicator that there is a breakdown in the daily
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DATE:
1 people on
FIRE SAFETY CHECK
Code
CHEMISTRY
Test
# done
SMA
ELEC
GLUC
BUN
AMY
CR/S
ACE
ALB
TP
ALK
BITD
SGO
CIP
HEP
LDH
CPK
SGP
ALC
ACA
BARL
ABG
CSF
\DMINISTRATIVE DATA SHEET
SHIFT: (3-11 p.m.)
(11 p.m. - 7:30 a.m.)
Ace. #
Comments:
Sloped - 513
FB'd - ACA I
SMA CC & E
Check Req
MICROBIOLOGY
Blood
Urine
Sput
Wnd
T/C
Stool
CSF
Misc.
Anaer.
G stain
BLOOD BANK
Probl ems:
313
C
ACA II_
Problems:
Pr<sblems:
SEROLOGY
Monospot
VIROLOGY
Spec Rec
uoae j
rest
f aone
Crossmatch (pt)
T & H
Units released
Trans reaction
Cross (unit)
HEMATOLOGY
Test
# done Problems:
S run
Diffs
Left dif
PT
MICROSCOPY
PTT
TT
Code
rest
f aone
Frooiems:
Urin
Plat M
CSF
Plat A
Hcg
ESR
Na,K
Re tic
Osmo
FSP
1. mic.
LE
Fid
Sickle
Mark S
MWBC
Fib
COMPUTER
G6PD
Change date
Other
problems:
Mark S
TE cards
Print worksheets
Print ward reports
Reviewed by resident
Director, Clinical Pathology
Fire Hazards: matches in wastebaskets, gas jets not turned off, extinguishers
not filled or in place, equipment not turned off or left on for other than
stability reasons. Make at least three fire checks as time permits.
Phone calls:
few
moderate
many
Code
Fig. 1.
(continued
14
LABORATORY MEDICINE • VOL. 8, NO. 4, APRIL 1977
on page 18)