STAFFING AND SCHEDULING
o Continuing education
 Preparing a schedule is one of the most prominent duties of
a laboratory manager
 Posted schedule represents the operational plan for the
immediate future  encompasses work on job design and
analysis, labor budget, prediction of current testing volume
 Staffing process  long term effort reflected in job
descriptions and the budgeting process
 release of the schedule  represents the application of
the plan for everyday operations of the laboratory
The staffing process
 Staffing – process of determining:
o Personnel and job needs
o Recruiting qualified staff
o Matching with appropriate job
o Training to perform the work assigned
 It is the realization of the human resource component of
the planning management function conducted to develop
the labor budget and the organizational tasks of job design
 Ensures that the lab has appropriate personnel to deliver a
timely, high quality service that meets the needs of its
patients.
STAFFING SCHEDULING
How many Names of the person
What type of personnel (Who) working at certain
time
 Staffing must address the ff issues: TNTP
1. Set the type of personnel needed by the laboratory
2. Determine the number and placements of each type
needed
3. Ensure that the staff is suitably trained to perform its
duties
o Orientation
o Competency assessment
o Employee development
4. Project long-term variation in personnel needs
 caused by such factors as changes in workload, tests
mix, methodology, and extent of automation
Types of Personnel Needed TATAE
 The type of personnel needed to staff a laboratory depend on
1. Technological and analytical complexity of procedures
2. Amount of supervision and support available
3. Testing volume or workload
4. Analytical throughput or turnaround time expectations
5. Equipment, instrumentation and Computer technology
available
Example:
 For a highly sophisticated reference laboratory offering
specialized procedures  graduate level clinical scientist
need only minimally trained assistants
 High-volume hospital laboratory  technical staff made up
of highly trained professional laboratorians
 The overriding principle remains the interest of the
patients and the quality of care they receive
 Evident guideline  technical expertise of staff and amount
of supervision
Staffing Levels
 Primary determinant for staffing decision:
1. level of service expected from each unit
2. resulting workload
  Technical skills match with workload  set type and
number of personnel needed during staffing period
 To be effective, the staffing fxn should support scheduling
process and help avoid gaps in personnel that cause a
scheduling crisis and disruption of service
Performance Training
 Important aspect of staffing  employees are properly
trained to perform assignments
 Training personnel to staff the laboratory begins with
arrival (orientation) and follows through employee
development programs
 This ensures:
 Competency
 Availability of future staff
 Continual growth of laboratory and employees
Workload Projections AHA
 Accuracy in workload projections is an obvious factor in
establishing a stable labor force and an effective staffing
plan
 Data from which workload projections may come from:
1. Historical records  productivity and financial data
(basis for current staffing req. and preparation of
schedule)
2. Analysis of future trends  based on an examination
of past and current testing volume to detect tests
gaining popularity, becoming obsolete, or giving way to
alternative
3. Analysis of foreseeable changes  resulting from the
introduction of new procedures, discontinuance of old
test, acquisition of new instruments, changes in medical
staff and availability of new service
 Such info help predict current and future needs and
prepare staffing budget, personnel position control records,
and schedule
THE SCHEDULING PROCESS
 Preparing a schedule can be:
 Routine  it is a regular task that follows set of pattern
 Challenging  find someone to fill in gaps
 Scheduling  matching the people now working in the
laboratory with current workload requirements.
 Scheduling  major part of directing and controlling
Issues and Factors Influencing Schedule decisions
 Same issues reviewed in staffing but must be dealt on an
immediate basis WAT
1. Availability of Staff
2. Type and Volume of work
3. Workplace
 Availability of Staff
 Is a major determinant and limitation
 Not only the number of persons available but also types
and skills
 Staff availability issues SPFT
1. Skills of each worker
o Generalist
o Specialist
2. Paper qualifications of employee (licensure &
accreditation)
3. Flexibility in hours available to work
o Issue is usually addressed with shift
assignments for both full and part-time
employees
 o Best solution  Regular staff core
supplemented with fill-in assignments
o Less desirable solution  rotate all
personnel to evening and night shifts
4. Total number of persons available including
employment status
 Type and Volume of Work Performed
 Essence of scheduling is creating a match between
previously listed factors and the workload of
laboratory
 Workload  determined by the patient base
(emergency room, outpatients surgery, and
hospitalized patients)
 Alignment of staff & workload must consider: TT
1. Test and procedures offered and technical
expertise needed
2. Timing elements (e.g. STAT)
o Batching tests  offers the lab a great
advantage in both staffing efficiency and cost
control
 Workplace
 Involves instrumentation, methodology,
organization and facility layout as well as support
resources (extent of automation, computerization,
and the availability of support staff )
Work Schedules
 Three 8-hour shifts have become the custom in all
institutions that require around the clock staffing
 8/80 hour rule  sets overtime pay when exceed 80 hours
in a 2 week calendar period or work more than 8 hrs in a
single day
 40 hour rule  sets overtime when work is more than 40
hours in a 7 day calendar period
 Traditional Work Schedules
 Most easily defined as a standard 8-hour shift
 40-hour work week: 5 days on and 2 days off
 8/80 hour work cycle: 10 days on and 4 days off
during 2 week calendar period
 There are no limits as to days of the week or hours
 many schedules in the lab do not necessarily fit
the customary 9 to 5 Monday to Friday workweek
 Advantage:
o Presents a three-shift package that fit into the
24 hour day
o Aligned with the standard work philosophy
of society: 8 hrs of duty, 5 days work, 2 days
off
o covered with a regular core staff and
supplemented with other personnel  offers
stability and continuity
 Disadvantage:
o Discourages and restricts flexibility and
individualization
o Tend to build a staff whose identity and skills
are tied to a particular work area or group
and discourages interaction and cooperation
between different sections of lab.
 Alternative work schedules
 driven by the needs of the hospital to meet the
changing nature of its patient population and to aid in
the recruitment and retention of its workforce
1. Compressed Work Cycle
 Creative scheduling programs allow employers
to match production goals with reduced facility
cost.
  First developed in medical centers such as Baylor
University Hospital
 Examples:
o 10- to 12- hour shifts spread over 3 to 4
days
o 7 days on, 7 days off
o Five 8-hour days 1 week, four 10 hour days
the next
o Intensive weekend coverage, employee
might work 16-hour days every weekend
and have weekdays off
o Employees work double (16 hour) shifts
during certain weekdays or seasonal
periods in exchange of day offs
 Effective in staffing off-shifts: evening, nights and
weekends
2. Flexible working hours
 Employees are required to be on the job during a
core period but allowed to establish own arrival
and departure depending on personal needs and
demands of the workload
 Deadline or completion goal may be substituted
for a core period.
 Split shift allows employee to work at different
times of the day
 Uncommon in healthcare setting and rare in
laboratory
 Areas wherein flextime can be useful
o test that can be saved and batched together
(thyroid profile), infrequently run tests &
other special chemistry procedure
o preadmission and preoperative work
(common in BB and evening shifts
o end process procedures (cytology screening,
interpretation of electrophoresis patterns)
o Administrative task (policy and procedure
writing, QC records review and preparing
schedules)
3. Job sharing
 Occurs when two or more persons are responsible
for a job that is normally performed by a single
employee
 Each employee take full responsibility for the total
job and all duties
 Shares the benefits due a full-time employee
Others:
4. Exempt and professional status
 Staff can be classified as payroll status employees
which means they can be exempted from the
restraints by the overtime provisions of wage and
salary laws
5. Work at home
 Cytotechnology is setting the pace in the work at
home movement
 Data entry, transcription, and information
analysis examples of work done at home
6. Off-site testing
 Includes not only satellite labs but point of care
testing at the patient’s bedside which may be in
another facility (nursing home or patient home)
7. Freelance employment
 Opportunity of laboratorians to work away from the
traditional laboratory
 Ex. Technical consultants to lab in physician’s
offices
STEPS IN MAKING SCHEDULE
Summary of steps  Monthly schedules are also popular because they follow
the calendar
1. Select type of schedule
 Final schedule should be posted at least 2 weeks prior to
2. Establish staffing levels
end of the current cycle to allow the staff time to plan
3. Develop staffing personnel pool
accordingly
4. Determine format, terminology and schedule keys
5. Set posting time frame Skeleton Stage
6. Prepare skeleton stage
 Skeleton schedule  working draft that includes
7. Complete routine scheduling stage
weekends and requested time off.
8. Fill in gaps
 Started as far in advance as feasible; even 3 months ahead
9. Post schedules
is not to soon
Types of Schedule  Serve as a working document in which the supervisor notes
any changes and requests that will influence the final
1. Attendance – showing who is working and who is off
schedule
2. Work assignments – give the station or section in which
 Steps:
the laboratorian is to work on a day
1. Fill out the form with dates and names of staff
3. Combination – both attendance and work assignment
2. Mark required time off: Vacations, must days
Staffing levels 3. Pencil in preferred time off
4. Record routine weekend work and off-day patterns
 Determine staffing requirements for shifts with specific
5. Post and update skeleton schedule
number and type of personnel needed
Routine Stage
Staffing pool
 This phase follows a set of pattern marking Xs and Os
 Staffing pool must be larger than the number personnel
 Steps:
needed
1. Fill in the off days (O)
Schedule terminology and Keys 2. Fill in the set workday schedule (X)
3. Fill in part-time personnel who can work a variable
 Acronyms, symbols and marks vary according to institution schedule
 Letters may be used to designate work assignments 4. Compare the schedule
Time Frame  Wednesday -Monday , Thursday – Tuesday, Friday –
Wednesday
 Schedules are frequently posted for either 1 month or 4
weeks Filling in the Gaps
 4 week format is easy to read and fill out because the  Unanticipated scheduling slots need to be filled
weekends and the days always follow the same pattern
  These can be caused by unexpected resignations,
dismissals, last minute request for time off and illness
 Possible solutions:
o Check with part-timers
o Adjust schedule of full time employees
o Seek volunteers willing to work an extra day
(1)Letting each member of the staff know on an
individual or collective basis of the time slots
(2)Posting a notice on a bulletin board
o Use overtime
o Call in temporary help
o Force a schedule change
Computer Programs and Posting
 Final step is posting the schedule for the next period
GENERAL COMMENTS ON STAFFING AND SCHEDULING
 Floaters  person who is able to work in many sections
of the lab and is assigned according to fluctuating daily
and hourly workload needs.
 Persons most amendable to floater situations  part-
timers and temporary personnel
 Professional Extenders  technical and clerical
assistants who do tasks traditionally performed by a
professional (e.g. phlebotomists, nurses, clerical staffs)
MANAGEMENT OF WORKFLOW
 Constant vigilance on the management of work is part
of the equation of staffing and scheduling
 THREE W’S
o What test should be done?
o Where should these test be performed?
o When should tests be performed?
MICROMANAGEMENT OF WORKFLOW
 Concerns the actual live, ongoing processing of the work in
laboratory
 Two kinds of prioritization:
1. Ranking of workload by factors such as STATs,
instrument availability and TAT
2. Bulk or bottleneck management
WORKLOAD PRIORITY
 based on factors such as clinical urgency and patient
throughput
 completing tests by priority (STATS, Timed specimen, unit
priority and so on) and postponing more routine tests until
time permits
BULK or BOTTLENECK MANAGEMENT
 all of the work must pass through this narrow point before
reaching the internal production machinery of the
organization
 bottlenecks  individual specimen that require unusually
large amounts of time often holding up completion of other
samples. (ex. Difficult phlebotomy, DIFF with abnormal
cells, blood bank antibody workup)
 leave items that take up a large amount of time to the end of
the work cycle or assigning them to a workstation
MANAGEMENT OF ABSENTEEISM
 Overreaction makes managers appear hard-hearted
inhumane
 Underreaction may arouse resentment toward co-workers
perceived as abusing the system
 Mutual understanding, respect along with fair and
forthright communication are basis of sound policy of
absenteeism management
 Key elements:
 1. Clearly defined policy on when absenteeism becomes a
corporate problem
2. Measureable and objective criteria for monitoring
attendance
3. Correction Plan for following and correcting a problem
at its earliest stage in a mature manner
 Absence  occurs any time a person is not at work when
scheduled
 Seriousness depends on:
(1)Duration
(2)Frequency of occurrence
 It is the frequency not the reason for a single event that
creates concern over the ability of employee to meet their
obligations
 Absenteeism  failure to meet the standard for
attendance set by the laboratory
 Average of one unscheduled absence per month 
excessive and triggers absenteeism management plan
ABSENTEEISM MANAGEMENT PLAN
 Must be handled in the same framework as all behaviour
and performance problems, ff closely to corrective action
policies of the institution
 Before any formal intervention, managers must talk with
employee and inform the concern and offer help in
addressing any job related factors  Appearance of an
absenteeism pattern
 Key is to show concern and willingness to help within the
restraints of staffing needs of the laboratory,