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Chapter 30 : Human Resources at the Local Level: an Important Component of Financial Management

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Abstract:

This chapter concentrates on personnel costs because they are the ones over which a manager can exert the greatest influence. It addresses some practical issues that face the manager on the front lines. When a recurrent problem is moving towards a final confrontation, it is absolutely essential that both superiors and institutional contacts in human resources be involved. In very simple and straightforward terms, following the biblical golden rule by all concerned is the surest way to motivate employees. A manager must ask whether subordinates are being treated the same way he/she wants to be treated by superiors. Communication naturally should proceed in multiple directions. It is just as essential that the lines of communication upward be free and clear as that lateral and descending channels be protected. The chapter discusses classic personnel situations that may interfere with optimal performance. Personnel problems can occur at any level in the organization. The higher up the problem is, the more difficult it is to pinpoint the issue. It may take considerable effort and persistence to determine that the problem is with a supervisor or assistant supervisor, rather than with the lower level employees. The chapter focuses on practical issues in utilization of personnel resources. Unit managers can make important contributions to the success of an organization by exerting careful control over manageable components.

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30

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References

/content/book/10.1128/9781555817695.chap30
1. Baron, R. A. 1986. Behavior in Organizations. Understanding and Managing the Human Side of Work, 2nd ed. Allyn and Bacon, Inc., Boston,Mass.
2. Kanter, R. M., 1992. Power failure in management circuits, p. 449461. In J. M. Shafritz, and J. S. Ott (ed.), Classics of Organization Theory. Brooks/Cole Publishing Company, Pacific Grove, Calif.
3. Kotter, J. P. 1990. What leaders really do. Harvard Business Rev. May-June:103111.
4. Martin, B. G. 1985. Cost containment: strategies and responsibilities of the laboratory manager. Clin. Lab .Med. 5:697707.
5. Mechanic, D., 1992. Sources of power of lower participants in complex organizations, p. 424431. In J. M. Shafritz,, J. S. Ott, (ed.), Classics of Organization Theory. Brooks/Cole Publishing Company, Pacific Grove, Calif.
6. Rodgers, T. J. 1990. No excuses management. Harvard Business Rev. July-August:8498.
7. Schaffer, R. H. 1991. Demand better results-and get them. Harvard Business Rev. March-April:142149.
8. Schuler, R. S.,, and S. E. Jackson. 1996. Human Resource Management. Positioning for the 21st Century, 6th ed. West Publishing Company, Minneapolis/St. Paul, Minn.
9. Snyder, J. R. 1992. Technician or technologist? sorting out overlapping roles in the lab. Med. Lab. Observ. June:3641.
10. Snyder, J. R.,, and D. A. Senhauser. 1989. Administration and Supervision in Laboratory Medicine, 2nd ed. J.B. Lippincott Company, Philadelphia, Pa.
11. Szilagyi, A. D., Jr.,, and M. J. Wallace, Jr. 1990. Organizational Behavior and Performance, 5th ed. Scott, Foresman/Little Brown Higher Education, Glenview, Ill.
12. Umiker, W.O. 1991. Turning around the behavior of uncooperative employees. Med. Lab. Observ. October:5966.
13. Umiker, W.O. 1992.How to qualify as a praise master. Med. Lab. Observ. July:4146.

Tables

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Table 30.1

Manageable and unmanageable cost components

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
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Table 30.2

Constraints on unit managers

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
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Table 30.3

The cardinal rules and possible consequences

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
Generic image for table
Table 30.4

Classic personnel situations

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
Generic image for table
Table 30.5

Practical approaches to optimization

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
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APPENDIX 30.1a Operational Costs for a Hypothetical Hospital Laboratory

Spreadsheet detailing operational costs for a hypothetical hospital laboratory. Indirect costs assessed by the institution for support of other departments (housekeeping, cafeteria, security, etc.) are not included. Some items are composed of both manageable and unmanageable components. For instance, fringe benefits and, to a large extent, unproductive time, are determined by the institution as a matter of policy but are also affected by the levels of staffing achieved by the manager (row 14). Supply costs (row 67) are determined by the volume of testing, which is beyond the control of a unit manager, but are also affected by the acumen that the manager brings to the selection of brands and negotiation of contracts. Note the wide variation by department in the proportion of the total operating costs that are represented by salary and fringe benefits (row 69).Much of this variation is easily understood. The very low percentage (16%) in the blood bank is a reflection of the very high (and ever-increasing) cost of purchased blood components. Some seemingly anomalous values, such as the relatively low value for administrative support (58%), are artifacts of the assignment of a large maintenance contract to that division. The low percentage in the highly automated chemistry laboratory (46%) is a reflection of the high cost of reagents and instruments and the relatively few technologists required to operate that equipment. Divisions that do little actual testing or use few supplies have high personnel costs, e.g., the outpatient laboratory, specimen accession, customer service, and the autopsy service. Similarly, divisions in which the testing is more frequently manual have relatively high personnel costs, e.g., microbiology, cytology, and cytogenetics. The percentage of operation budget represented by personnel costs in the microbiology division is 65%.

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
Generic image for table
APPENDIX 30.1b Operational Costs for a Hypothetical Hospital Laboratory

Spreadsheet detailing operational costs for a hypothetical hospital laboratory. Indirect costs assessed by the institution for support of other departments (housekeeping, cafeteria, security, etc.) are not included. Some items are composed of both manageable and unmanageable components. For instance, fringe benefits and, to a large extent, unproductive time, are determined by the institution as a matter of policy but are also affected by the levels of staffing achieved by the manager (row 14). Supply costs (row 67) are determined by the volume of testing, which is beyond the control of a unit manager, but are also affected by the acumen that the manager brings to the selection of brands and negotiation of contracts. Note the wide variation by department in the proportion of the total operating costs that are represented by salary and fringe benefits (row 69).Much of this variation is easily understood. The very low percentage (16%) in the blood bank is a reflection of the very high (and ever-increasing) cost of purchased blood components. Some seemingly anomalous values, such as the relatively low value for administrative support (58%), are artifacts of the assignment of a large maintenance contract to that division. The low percentage in the highly automated chemistry laboratory (46%) is a reflection of the high cost of reagents and instruments and the relatively few technologists required to operate that equipment. Divisions that do little actual testing or use few supplies have high personnel costs, e.g., the outpatient laboratory, specimen accession, customer service, and the autopsy service. Similarly, divisions in which the testing is more frequently manual have relatively high personnel costs, e.g., microbiology, cytology, and cytogenetics. The percentage of operation budget represented by personnel costs in the microbiology division is 65%.

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
Generic image for table
APPENDIX 30.1c Operational Costs for a Hypothetical Hospital Laboratory

Spreadsheet detailing operational costs for a hypothetical hospital laboratory. Indirect costs assessed by the institution for support of other departments (housekeeping, cafeteria, security, etc.) are not included. Some items are composed of both manageable and unmanageable components. For instance, fringe benefits and, to a large extent, unproductive time, are determined by the institution as a matter of policy but are also affected by the levels of staffing achieved by the manager (row 14). Supply costs (row 67) are determined by the volume of testing, which is beyond the control of a unit manager, but are also affected by the acumen that the manager brings to the selection of brands and negotiation of contracts. Note the wide variation by department in the proportion of the total operating costs that are represented by salary and fringe benefits (row 69).Much of this variation is easily understood. The very low percentage (16%) in the blood bank is a reflection of the very high (and ever-increasing) cost of purchased blood components. Some seemingly anomalous values, such as the relatively low value for administrative support (58%), are artifacts of the assignment of a large maintenance contract to that division. The low percentage in the highly automated chemistry laboratory (46%) is a reflection of the high cost of reagents and instruments and the relatively few technologists required to operate that equipment. Divisions that do little actual testing or use few supplies have high personnel costs, e.g., the outpatient laboratory, specimen accession, customer service, and the autopsy service. Similarly, divisions in which the testing is more frequently manual have relatively high personnel costs, e.g., microbiology, cytology, and cytogenetics. The percentage of operation budget represented by personnel costs in the microbiology division is 65%.

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
Generic image for table
APPENDIX 30.1d Operational Costs for a Hypothetical Hospital Laboratory

Spreadsheet detailing operational costs for a hypothetical hospital laboratory. Indirect costs assessed by the institution for support of other departments (housekeeping, cafeteria, security, etc.) are not included. Some items are composed of both manageable and unmanageable components. For instance, fringe benefits and, to a large extent, unproductive time, are determined by the institution as a matter of policy but are also affected by the levels of staffing achieved by the manager (row 14). Supply costs (row 67) are determined by the volume of testing, which is beyond the control of a unit manager, but are also affected by the acumen that the manager brings to the selection of brands and negotiation of contracts. Note the wide variation by department in the proportion of the total operating costs that are represented by salary and fringe benefits (row 69).Much of this variation is easily understood. The very low percentage (16%) in the blood bank is a reflection of the very high (and ever-increasing) cost of purchased blood components. Some seemingly anomalous values, such as the relatively low value for administrative support (58%), are artifacts of the assignment of a large maintenance contract to that division. The low percentage in the highly automated chemistry laboratory (46%) is a reflection of the high cost of reagents and instruments and the relatively few technologists required to operate that equipment. Divisions that do little actual testing or use few supplies have high personnel costs, e.g., the outpatient laboratory, specimen accession, customer service, and the autopsy service. Similarly, divisions in which the testing is more frequently manual have relatively high personnel costs, e.g., microbiology, cytology, and cytogenetics. The percentage of operation budget represented by personnel costs in the microbiology division is 65%.

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30
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APPENDIX 30.2 Budgetary Effects of Use of Overtime in Three Hypothetical Laboratories with Different Mixes of Staff

Budgetary effects of the need to use overtime in three hypothetical laboratories with differing mixes of full-time and part-time personnel. Lab A is staffed entirely by full-time workers. Lab B has two halftime workers. The full-time equivalents in Lab C are a mix of 75% full-time workers and 25% half-time workers. For normal operation, the salary costs of all three laboratories are the same. When unexpected factors (e.g., additional workload, unexpected illness, pregnancy, disability, etc.) require additional work, the expenses are highest in Lab A and least in Lab C, which has the greatest number of part-time workers available to work at regular pay. When catastrophic conditions prevail, the differences are even more pronounced. This hypothetical example assumes, of course, that some or all of the part-time workers are willing and/or able to work additional hours. Other factors that must be considered when selecting full- and part-time staff include possible detrimental effects of having too many individuals whose expertise is diminished by part-time employment.

Citation: Winn W, Westenfeld F. 2004. Human Resources at the Local Level: an Important Component of Financial Management, p 513-524. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch30

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