Personnel

1. Personnel

2. The Quality System

3. The Problem One of your senior techs has been temporarily re-assigned by the MOH to another province to assist with the back log of reading malarial smears. Another tech has not been able to report to work due to an illness. That leaves 2 techs who must now read malarial smears, even though they have not done so since their initial training several years ago. What must you do to ensure that the techs are competent to process and read malarial smears?

4. The Laboratory Staff YOU ARE: The most critical part of the quality system The laboratory�s greatest asset An important partner in patient care YOU ALSO: Bring your integrity and professionalism to the healthcare community

5. Success or failure of quality system is dependent on the laboratory staff Knowledge and skills Motivation Commitment

6. Personnel Management Job qualifications Job descriptions Orientation and training Competence assessment Continuing education Performance appraisal Documentation Each of the personnel elements must be addressed as part of the quality systemEach of the personnel elements must be addressed as part of the quality system

7. Job Qualifications Often established by the Ministry of Health Levels of education and training Advanced degree Degree Non-degree, formal technical training Bench training Qualifications influences salary, levels of responsibilityQualifications influences salary, levels of responsibility

8. General Skills and Abilities: Problem solving Communication Written and oral Mathematical Manual dexterity Color vision

9. Job Descriptions Specify responsibilities and duties Reflect education, training and experience Incorporate activities or tasks to be performed Competency based General skills Specify QA responsibilities

10. Laboratory Personnel �  QA Responsibility Implement the QA program Generate data and provide day-to-day documentation Should receive training in QA procedures Attitude toward QA should be part of annual performance appraisal

11. Orientation and Training General orientation Organizational information Facilities Safety information Personnel Issues Ethics / confidentiality Benefits Emergency contacts Scheduling Introduction to the laboratory�s operations Safety Information Personnel Issues / Employee Handbook Facilities Restrictive access Policies for rest areas Locks and keysIntroduction to the laboratory�s operations Safety Information Personnel Issues / Employee Handbook Facilities Restrictive access Policies for rest areas Locks and keys

12. Orientation and Training Introduction to the laboratory�s operations Overview of the Quality System Responsibilities Technical procedures Initial competency assessment

13. Competency Having the essential abilities to perform specific tasks. Tasks involve procedures throughout the specimen process Competency Assessment Any system in place for measuring, documenting, or otherwise determining whether employees are able to do their job.

14. Competency Assessment Two approaches New Staff Current Staff New Staff should not report patient results until successfully assessment Testing for new staff may need to be more comprehensive Same methods could be used for assessmentsNew Staff should not report patient results until successfully assessment Testing for new staff may need to be more comprehensive Same methods could be used for assessments

15. Competency Assessment Methods Directly observe test performance Periodically review completed work Give previously analyzed specimens for testing Provide written exercises to assess: Problem solving skills Knowledge Interpretation Directly observe of test performance Whoever observing must be familiar with the test Developing and using checklist would be helpful including specimen handling, processing, and testing Periodic review of completed work - blind specimens, proficiency testing specimens, preventive maintenance and QC records Monitoring the recording and reporting of test results Many skills could be observed during an assessment Testing process including customer service Assessment of test performance through testing previously analyzed specimens, internal blind specimens Written assessments problem solving skills Directly observe of test performance Whoever observing must be familiar with the test Developing and using checklist would be helpful including specimen handling, processing, and testing Periodic review of completed work - blind specimens, proficiency testing specimens, preventive maintenance and QC records Monitoring the recording and reporting of test results Many skills could be observed during an assessment Testing process including customer service Assessment of test performance through testing previously analyzed specimens, internal blind specimens Written assessments problem solving skills

16. Establishing a Competency Assessment Program Establish an assessment plan for each employee 1. Prepare schedule � frequency and what tests or processes 2. Determine assessment method (s) 3. Assign staff responsibility for conducting assessment 4. Document and evaluate results 5. Take remedial or corrective action Prepare schedule Initial competency for new hires Subsequent frequency will need to be determined Ex: CLIA requires biannual Test chosen - May not be practical to assess everything they do. Different test, e.g., test performed less frequent, but still must remain competent to perform. More than on assessment method may be chosen depending on the capability of the lab and the complexity of the test If you are doing direct observation, be sure the assessor is competent on the specific test Document and evaluate results Assessment records become part of employee permanent file Other factors related to the test may influence poor performance Reagents, supplies, equipment, poorly documented procedurePrepare schedule Initial competency for new hires Subsequent frequency will need to be determined Ex: CLIA requires biannual Test chosen - May not be practical to assess everything they do. Different test, e.g., test performed less frequent, but still must remain competent to perform. More than on assessment method may be chosen depending on the capability of the lab and the complexity of the test If you are doing direct observation, be sure the assessor is competent on the specific test Document and evaluate results Assessment records become part of employee permanent file Other factors related to the test may influence poor performance Reagents, supplies, equipment, poorly documented procedure

17. Establishing a Competency Assessment Program Document your competency assessment program Written plan Included in laboratory�s quality documents Periodically reviewed Used for continual improvements Communicate the plans to the staff Document results using standard forms that should be developed ahead of time Communication Important to staff because of sensitivities of self confidence and abilities Not used to intimidate staff Used to improve lab operations Fully understand the plan before its implementedDocument results using standard forms that should be developed ahead of time Communication Important to staff because of sensitivities of self confidence and abilities Not used to intimidate staff Used to improve lab operations Fully understand the plan before its implemented

18. Sample Assessment Checklist

19. Corrective Action Plan Written plan understood by employees Outlines specific steps to be taken Training, reassessment Details resources needed Includes timeframe Consequence for failure Details resources needed Consider results of evaluating poor performance May be problem with the method, QC,Details resources needed Consider results of evaluating poor performance May be problem with the method, QC,

20. Poor initial orientation or training Problem with the specimen Problem with the equipment Poorly written procedure No documented procedure Difficulty in dealing with change � �We�ve always done it this way� When performance fails, consider:

21. Continuing Education �An educational program that brings participants up-to-date in a particular area of knowledge or skills�

22. Why Continuing Education? Important in achieving good laboratory quality Individual personal goals Nothing stays the same! New tests New instruments New clinical programs and drugs

23. Innovative ways to obtain / deliver Continuing Education Make it someone�s responsibility ! On-site seminars Journal clubs Case of the month Videos CD�s Internet opportunities

24. Ex: of where weekly lab conferences were conducted You don�t need fancy facilities to do a good job of CE Ex: of where weekly lab conferences were conducted You don�t need fancy facilities to do a good job of CE

25. Local Resources for Continuing Education QA Committee Clinicians Nurses Pathologists Infection Control Epidemiologists Remote locations should encourage others from major cities to participate locallyRemote locations should encourage others from major cities to participate locally

26. Performance Appraisal Assessing overall job performance Factors to evaluate: Technical competencies Efficiency of accomplishing work tasks Observance of safety rules Timeliness Communication skills Customer service Timeliness Take personal responsibility for work - dependable Show up on time Take appropriate time breaks/lunch periods Communication skills Attitude Interpersonal relationship skills Timeliness Take personal responsibility for work - dependable Show up on time Take appropriate time breaks/lunch periods Communication skills Attitude Interpersonal relationship skills

27. Communicating with Employees Points to remember: Emphasize positive traits Consider personal issues People are motivated differently Be direct in discussing deficiencies Communicating results of CA and PA can be challenging Consider personal issues Chronic vs. temporary problems People are motivated differently Reaction to Incentives vary - Consider different approaches Communicating results of CA and PA can be challenging Consider personal issues Chronic vs. temporary problems People are motivated differently Reaction to Incentives vary - Consider different approaches

28. Documentation: Personnel Personal details Employment details Resume Post held and dates Authorized areas of testing Terms and conditions of employment Job description Continuing education records Competency assessments Personnel actions Work injury records Personnel actions Promotions, awards, special recognitions, and disciplinary actionsPersonnel actions Promotions, awards, special recognitions, and disciplinary actions