Bueller?…Bueller?

Attendance in the workplace can be a tedious process that most supervisor/managers loathe because it forces us into an almost parental role that can be downright annoying. However you penalize call-offs or late clock-ins/outs, keeping track of attendance can be compared to balancing a checkbook. Even though it may be tedious it is a necessary evil to make sure all employees are being treated equally and not one individual is taking advantage of arriving early or in some cases clocking out late to rack up small amounts of overtime. All of these examples can affect your productivity numbers and also the workflow of the laboratory.

So the question becomes how do you avoid the attendance issue without having to balance the checkbook every other day? First, address each and every attendance issue swiftly and equally with each employee. This will get the attention of all the employees so they know that you take attendance seriously and expect punctuality. If you want to be lenient and let the first one or two instances slide make sure you record this and treat each employee equally. The first hint of favoritism may cause your employees to lose respect which may lead to a much bigger problem other than attendance. Second, if you have monthly employee meetings (which I recommend), be sure to remind everyone your attendance policy and have each employee sign the meeting minutes so you have documentation that each employee understands the policy. Lastly, the best time to properly introduce an employee to the attendance policy is when they’re going through the hiring process. For some of our young hires, this may be their first job after college and clocking in for a full-time position may be a large change from walking in the door half-asleep for an 8am class.

The last attendance issue that should be discussed is call-offs (unexcused absences) that seem to follow a pattern. Employees may feel they shouldn’t work a Friday before they work the weekend. The generally accepted definition of a pattern is three or more examples of the call-off. So if the previous employee example called-off three Fridays before they had to work that following weekend we would contact HR and see if we could address the situation. Some may feel this is obvious but when employees work every third weekend this pattern may take a couple months to present itself. These are especially difficult as a supervisor/manager because you most likely do not have any direct evidence that the employee is calling-off without actually being under the weather. This becomes especially difficult when an employee has an approved medial leave issue and appears to be using it to their advantage.

In each of the examples above the most important item for you as a supervisor/manager is documentation. You must have a detailed record so when the time comes to use corrective action or even address it with HR you have everything you need to address it with the employee. You don’t want to be walking into your laboratory, see an empty bench, and say, “Bueller?”

 

Herasuta

Matthew Herasuta, MBA, MLS(ASCP)CM is a medical laboratory scientist who works as a generalist and serves as the Blood Bank and General Supervisor for the regional Euclid Hospital in Cleveland, OH.

How Do We Monitor the New Anticoagulants-Podcast

As may or may not be aware, Lab Medicine has a podcast series geared toward laboratory professionals and pathologists. In a recent installment, Dr. Geoffrey Wool discusses the laboratory’s role in monitoring the new anticoagulants. Click this link to listen.

 

 

Find Your Passion and Become Engaged

What does it mean to be engaged? Since I’ve been involved in grassroots organizing and health advocacy for most of my adult life, I believe its means to find your passion and become a proactive participant and not just a spectator – for me that has always meant educating those in minority and immigrant communities and those who affect these communities on health equity issues as well as fighting for the rights of those who are marginalized within these communities. I spent much of my time in medical school working as the head of our mobile migrant farm worker clinic, as a Schweitzer Fellow helping to promote free hepatitis B screenings and free vaccinations at two free health clinics, and co-organizing multiple health fairs that served the Philadelphia Asian community. I also worked as the national grassroots leadership coordinator and subsequently, national chair of AMSA’s Race, Ethnicity, Culture in Health (REACH) action committee.

Even though I’m back in Chicago where much of my grassroots experiences began, I’ve had to put these types of efforts on hold. Unfortunately, residency doesn’t always afford enough time for a consistent commitment in terms of my health advocacy. I do have at least enough time to still remain engaged to drive systems change within our profession. If this is something you’re passionate about, what do you need to do first?

Educate yourself on the opportunities out there. Organizations that focus on AP/CP issues like ASCP (the CP here means clinical medicine as opposed to research, not just clinical pathology) and CAP are good places to start. Check out their webpages (www.ascp.org and www.cap.org) to see how residents can become involved. Both organizations have junior positions for residents on their committees and councils and both also have resident councils that you might be able to become a part of. Often, there are also reserved resident positions on committees within specialty organizations (eg – Association of Molecular Pathology aka AMP) as well. Google is your friend. So check their websites often and get on their email lists as most of these position applications or elections (for CAP resident forum aka RF) have deadlines in the early spring. ASCP and CAP also have resident representative and delegate to the RF positions available and each residency program handles the appointment or election of residents to these positions differently so ask your PD.

Many of these committee positions are fairly competitive so you might not succeed at first; simply try again. Build your CV and network at conferences as there are often opportunities built-in for physician leaders of these organizations and residents to meet. You’d be surprised how an innocent encounter with one of these organizational leaders results in an unexpected opportunity. Last weekend, I was in Tampa as the only resident representing our interests with the educational planning committee for the 2014 ASCP Annual Meeting. I had no idea that sitting at lunch with an ASCP leader last spring when I was chosen to be the resident representative at their Future of the Pathology Workforce Roundtable and Leadership Forum would result in her recommending me for this position. I had a great time (and away from the snow and cold in Chicago although I did get stranded in Birmingham for a day on my way back), my opinions were appreciated, and I think the conference is going to be awesome (btw, there is a resident boards mini-course built into this conference every year). But don’t be Machiavellian when you network – just be yourself and you may be surprised at the doors that open for you. If you’re sincerely passionate about something, trust that it will show and that good things will happen.

So, I gave an example of chance encounters that granted me unexpected opportunities and it happened because I was at a conference where I was presenting a poster. So, I highly encourage submitting abstracts and presenting posters at conferences. You never know whom you may meet or how they may touch your life. Plus presenting a poster or platform is a good experience to develop skills you need and to build your CV for subsequent fellowship and job applications. As I mentioned before, residency is not the same as medical school but more like the training ground for your first job. We all must be more pro-active at taking ownership of our education and we must no longer expect that our education will be spoon-fed or organized around our needs specifically. Be aware of and engaged in obtaining what you need because there isn’t necessarily a syllabus for how you should learn during residency.

Becoming engaged and involved with these organizations as a resident gives you a glimpse as to issues that affect our profession, now and in the future. It also gives you an outlet to be a part of that change because our opinions are truly valued – most of the ASCP and CAP committee and council positions support your travel and expenses to these meetings, so they really are making an investment in you and the resident opinion you represent.

And lastly, give your 110%. If you are chosen for a leadership role, take it seriously, work hard, and be humble – being entitled and saying that you were “too busy” if you miss a deadline won’t reflect well on you…after all, we all are busy and that’s where time management skills come into play. So find what you are passionate about and go after it!

 

Chung

Betty Chung, DO, MPH, MA is a second year resident physician at the University of Illinois Hospital and Health Sciences System in Chicago, IL.

Customer Service—The Buck Stops Everywhere!

Laboratories are notoriously hidden in basements, outbuildings, storefronts, and historically have been hard to find, difficult to get to, and in many cases, an afterthought in facility planning. It couldn’t be farther from the truth that “labs should be seen and not heard.” Those of us who live in the lab don’t give it much thought…until we have to get OUR blood drawn, that is!

We all know the scene where someone has a “lab complaint.” It typically centers on having their blood drawn, getting stuck multiple times, having a result not ready, or heaven forbid, having to suffer a “re-draw.” If you think about it, the service we provide that has the customer-facing moment is the specimen collection phase. Our pre-analytical capabilities are where our patients/customers/clients judge the quality and strength of our laboratories. I have often described it to students in this way; if you want to buy a house and its gate is broken, the paint is peeling, the door hinges rusted, and the yard is full of weeds, you automatically assume the house is also “broken down” on the inside. It may have upgraded electricity, brand new appliances and plumbing, and the structure is solid and weather proofed. But you decline to delve further based on the appearance. The second house you see has fresh paint, new hinges on the doors, a little grass and flowers in front, and a nice walkway to the front door with a shiny new mailbox. You are charmed…and, sadly, it has a leak in the main drain, the paint inside is lead-based, the electrical system must be rewired and the structural walls are rotting and soon the stairwell will cave in. Nothing you can really see from the outside, but not something you can judge from the street.

I find that the elements of customer service and the way we present and appeal to our patients/customers is the “face of the laboratory.” Professional presentation and treating each patient and each specimen as if it were your mother’s or your child’s specimen gives our clients the confidence and trust they need to feel good about their test results. Communicating, making eye contact, soothing and reassuring those with “difficult veins” makes any situation go more smoothly. And, since most people are unable to judge the quality of our laboratory work—they have no training or understanding of what goes on in that “black box”—remember the house example. We all tend to judge by our first impressions.

Customer Service is a universal concept, and one that is a challenge in every laboratory, everywhere. One of the most popular international training programs ASCP Global Outreach provides is for pre-analytical phase quality improvement, and it always includes a heavy dose of customer service. Not only with patient engagement, but also with other departments, physicians, hospital staff, and even in community outreach. It is universal all around the world, that customer service makes the difference in how people evaluate the laboratory profession. You may be the best clinical scientist or clinician on the planet and your lab may have won awards for superior performance; but no one will know or care about that if they have a bad pre-analytical experience! The buck really does stop EVERYWHERE!

Next time YOU have to have your blood drawn, take a close look around and notice what your patients and customers see. I guarantee you will always be surprised by something, and will leave the drawing room with at least one idea of how your lab can do it better. Next time, we’ll talk about some ideas I’ve learned about customer service in other countries.  And, if you have a great example of stellar customer service practices, let me know at bsumwalt@pacbell.net I’m always in the market for new ideas to share.

 

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Beverly Sumwalt, MA, DLM, CLS, MT(ASCP) is an ASCP Global Outreach Volunteer Consultant.

 

New Rule Gives Patients More Access

Yesterday the Obama Administration and the Department of Health and Human Services implemented a regulation that amends the Clinical Laboratory Improvement Amendments of 1988 and the Health Insurance Portability and Accountability Act of 1996 in regards to reporting of patient results. Basically, the new regulations state that patients (or their personal representatives) can receive lab results directly from the laboratory. In most cases the laboratory has 30 days to comply with the request. This regulation goes into effect 3/31/14 and laboratories must comply by 9/27/14.

So what does this mean for laboratory professionals? The language of the final rule gives laboratories a lot of flexibility in terms of dealing with a request for information. In a nutshell:

  • Individual laboratories can set up systems to receive, process, and respond to requests for results however they choose to do so.
  • If a state law is different than the federal regulation, laboratories must comply with the “more stringent” law, with “more stringent” meaning “greater rights of access.” For example, the federal regulation requires results to be given within 30 days of the request; if state law requires those results be given with 15 days, then the laboratory should follow the state law.
  • Laboratories need to have “verification of identity” policies in place. There is no mandate that requires specific forms of identification.
  • Laboratories that currently have patient portals in place may continue to use them.
  • Laboratories CANNOT require patients to make requests only through their providers; mechanisms must be in place for a patient to make requests directly to the laboratory. However, laboratories CAN require patients to make these requests directly to the laboratory.
  • Laboratories can recoup the costs of providing results to patients, but the fees must be cost-based and reflect labor, supplies, postage, and preparation of an explanation of PHI. Laboratories CANNOT charge fees that reflect the cost of searching and retrieving information, nor can they charge fees for costs associated with verification, documentation, liability insurance, maintaining systems, etc.  It should be noted that laboratories cannot withhold future lab results if a patient chooses not to pay the fee.
  • Laboratories must provide results in the form (electronic or paper) requested by the individual if readily producible.  This could be a MS Word or Excel document or PDF as well as access to an electronic portal.
  • Laboratories are required to reasonably safeguard information (electronic or paper).
  • Laboratories are not required to include test interpretations but may do so if desired.
  • Providers are encouraged, but not required, to tell patients they have access to their laboratory results directly from the laboratory.

 

Swails

Kelly Swails, MT(ASCP), is a laboratory professional, recovering microbiologist, and web editor for Lab Medicine.