Laboratory Management University · PDF file · 2013-08-29For her peer review contributions. 8/13/2013 2 ... • Leaders combine managementLeaders combine management with a vision

8/13/2013

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Laboratory Management UniversityLaboratory Management University™™Laboratory Management UniversityLaboratory Management University™™

Preparing Laboratory Preparing Laboratory Leaders for Today Leaders for Today

and Tomorrow and Tomorrow

The American Pathology FoundationThe Management Association for Pathology

The American Pathology FoundationThe Management Association for Pathology

Management Theory: Applying Emotional Intelligence in the Healthcare EnvironmentEnvironment

Your Faculty

Professor and ChairUniversity of Texas MD Anderson Cancer Center

Department of Laboratory Medicine

Elizabeth A. Wagar, MD

Click NEXT to continue

AcknowledgementsTricia Hughey

Vice President of OperationsWestern Region at American Pathology Partners

For her peer review contributions

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ObjectivesObjectives Introduction

• Identify opportunities to apply leadership skillsleadership skills

• Identify the history of management

• Identify the modern elements of management theory


• Determine your Emotional Intelligence and how it applies to managing a laboratory and healthcare environment

What isWhat is EQ?EQ?What isWhat is EQ?EQ? Emotional Intelligence

Introduced by Peter Salovey and John D. Mayer in 1990

The Emotional Quotient (Emotional Intelligence) is one’s ability toIntelligence) is one s ability to perceive, control and evaluate emotions.

“People high in Emotional Intelligence are expected to progress more quickly through the abilities designated and to master more of them ”1


Take an Emotional Intelligence quiz

designated and to master more of them.”1

“People in good moods are better at inductive reasoning and creative problem solving.”2

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Variables that Explain SuccessVariables that Explain SuccessVariables that Explain SuccessVariables that Explain Success

Bradberry and Greaves study

Success is not totally tied to intellectual measures.

How EQ Affects Success

Emotional Intelligence

3

30%40%50%60%70%80%

How EQ Affects Success


0%10%20%

Performance

High IQ Average IQ Other

Laboratory LeadersLaboratory LeadersLaboratory LeadersLaboratory Leaders

• Many leaders are promoted for their experience or expertiseexpertise

• May not reflect their ability to work emotionally in the workplace

• How do we avoid the scenario of leadership itho t


of leadership without Emotional Intelligence?

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Laboratory EnvironmentLaboratory EnvironmentLaboratory EnvironmentLaboratory Environment

• Practically speaking, most pathologists are both leaders and managers

Laboratory Leaders

• Pathologists are leaders to the laboratory

• The best leaders have some middle-management skills

• Leaders combine managementLeaders combine management with a vision for their laboratory


Why We Need Lab Leaders?Why We Need Lab Leaders?Why We Need Lab Leaders?Why We Need Lab Leaders?

CLIA Requirements

• Provide quality services for pre-analytic, analytic and post-analytic phases

Laboratory Leaders

• Physical and environmental conditions of the lab workplace must be appropriate

• Supervision is required, especially for high complexity testing

• Safety and biohazard requirements are followed


• Sufficient qualified personnel are available for all lab functions

• Review of new test requests and procedures

• Specification of all employees responsibilities and duties

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New OpportunitiesNew OpportunitiesNew OpportunitiesNew Opportunities

• Accountable Care Organizations (ACOs)

Laboratory Leaders

(ACOs)

• Clinical Comparative Effectiveness Research (CCER)

• Electronic Health Records (HER)

New initiatives are on the horizon requiringNew initiatives are on the horizon requiring laboratory leaders at all levels (ARRA)


ACOs: The ConceptACOs: The ConceptACOs: The ConceptACOs: The Concept

•• Bridging a change from fee for service for individual patients Bridging a change from fee for service for individual patients to competitive financially independent entities with riskto competitive financially independent entities with risk--based based health management of populationshealth management of populations

C ll b ti li i ll i t t dC ll b ti li i ll i t t d

Laboratory Leaders

•• Collaborative, clinically integratedCollaborative, clinically integrated

•• ACOs will ACOs will coordinate costscoordinate costs through joint responsibility for through joint responsibility for qualityquality and and costscosts..

•• A problematic assumption: bundling Quality with dollarsA problematic assumption: bundling Quality with dollars


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ACOs: The ConceptACOs: The ConceptACOs: The ConceptACOs: The Concept Laboratory Leaders

• Thus, we will be asked information regarding our laboratory utilization. For example, how do lab tests contribute to good clinical care?

• Become partners with a number of groups in the ACOs to determine these measurements and collect data.


Comparative Clinical Effectiveness Comparative Clinical Effectiveness Research (CCER)Research (CCER)Comparative Clinical Effectiveness Comparative Clinical Effectiveness Research (CCER)Research (CCER) Laboratory Leaders

AHRQ DefinitionAHRQ Definition

A type of health care research that compares the results of one A type of health care research that compares the results of one approach for managing a disease to the results of other approach for managing a disease to the results of other approaches. Comparative effectiveness usually compares two or approaches. Comparative effectiveness usually compares two or more types of treatment, such as different drugs, for the same more types of treatment, such as different drugs, for the same disease. Comparative effectiveness also compares types of disease. Comparative effectiveness also compares types of surgery or other kinds of medical procedures and tests Thesurgery or other kinds of medical procedures and tests The


surgery or other kinds of medical procedures and tests. The surgery or other kinds of medical procedures and tests. The results often are summarized in a systematic review.results often are summarized in a systematic review.

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Comparative Clinical Effectiveness Comparative Clinical Effectiveness Research (CCER)Research (CCER)Comparative Clinical Effectiveness Comparative Clinical Effectiveness Research (CCER)Research (CCER)

Systematic Systematic ReviewsReviewsCCERCCERCCERCCER

Laboratory Leaders

ReviewsReviews

Clinical trialsClinical trials

Studies observing patientsStudies observing patients

CCERCCERCCERCCER


Basic research, theories, animal testsBasic research, theories, animal tests

EHRs: How Can Pathology Can EHRs: How Can Pathology Can Contribute?Contribute?EHRs: How Can Pathology Can EHRs: How Can Pathology Can Contribute?Contribute?

For the purposes of the Medicare and Medicaid Incentive Programs, eligible professionals, eligible hospitals and critical access hospitals (CAHs) must use certified EHR technology.

Laboratory Leaders

Gives assurance to purchasers and other users that an EHR system or module offers:

• technological capability• functionality• and security

Helps providers and patients be confident:

• electronic health IT products and systems they use are secure• electronic health IT products and systems they use are secure• can maintain data confidentially• can work with other systems to share information

Visit this web site to learn more: http://healthit.hhs.gov/


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Pathologists Role in EHRPathologists Role in EHRPathologists Role in EHRPathologists Role in EHR

• Engage in the institutional efforts to implement EHR certification

V lid t ll l t i i t f ith

Laboratory Leaders

• Validate all electronic interfaces with EHR and laboratory IT systems

• Ascertain that reporting IT requirements meet CLIA requirements

• Provide support from laboratory expertise for development andexpertise for development and implementation


Pathologists Role in EHRPathologists Role in EHRPathologists Role in EHRPathologists Role in EHR Laboratory Leaders

• Pathologists understand the importance of validation of IT interfacesinterfaces

• Pathologists regularly review electronic reporting formats

• Pathologists can translate terminology for others involved in the EHR meaningful use initiative


the EHR meaningful use initiative

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History of ManagementHistory of ManagementHistory of ManagementHistory of Management

Explore the History of Management via some of the theories and people who influence approaches used today:

Industrial Revolution 1750-1850

Bureaucratic Management

1864-1920

Scientific Management

1856-1919

Administrative Management

1841-1908

Click on each of the buttons in the timeline to review the information. Select next when you are finished to continue on to the next section.

Henry Ford 1863-1947

Peter Drucker1909-2005

Management Today


Industrial Revolution Industrial Revolution 17501750--18501850Industrial Revolution Industrial Revolution 17501750--18501850 History of Management

The Industrial Revolution gave rise to new industrial technologies and changed the United States from a largely agricultural society to a manufacturing society.

Robert Owen (1771-1858)

• Developed work descriptions in the early Industrial Revolution (early 1800’s, textile mills)

• Productivity and motivation are important

Click Return to History to continue

to the workplace

• Child labor rules created (although he believed children could work in factories age 10 or older)

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Bureaucratic ManagementBureaucratic ManagementBureaucratic ManagementBureaucratic Management History of Management

These classical management approaches were developed to emphasize efficiency:• Bureaucratic• Scientific

Max Weber (1864-1920)

"Father of Modern Sociology", introduced "bureaucratic management" as the most rational structure for large organizations

• Administrative

organizations.

Advocated a bureaucratic structure to organizations, based on rules, procedures, hierarchy, and a clear division of labor.

(Click the image above for more information about bureaucratic management

characteristics.)


Max Weber (1864-1920)

Bureaucratic management characteristics influenced by Max Weber include:

Bureaucratic ManagementBureaucratic ManagementBureaucratic ManagementBureaucratic Management History of Management

1. Clearly defined and specialized functions (giving rise to "working in silos"!)

2. Use of legal authority

3 Superior/subordinate

5. Technically trained bureaucrats

6. Appointment to positions based on technical expertise

7 Promotions based on


3. Superior/subordinate hierarchy

4. Written rules and procedures

7. Promotions based on competence

8. Clearly defined career paths

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Scientific ManagementScientific ManagementScientific ManagementScientific Management History of Management

Increased productivity by making work processes more efficient. Each worker had a specified, well-controlled task that could be performed according to procedures without exceptions.

Frederick Taylor (1856-1915) (Father of Scientific Management)

• During his study of factory jobs in 1911, Taylor learned to design efficient jobs that required less time and fewer motions.motions.

• Introduced rest periods of specific interval and duration, differential pay scales, and offered a piece rate that increased as workers produced more


H i F l (1841 1925)

Administrative ManagementAdministrative ManagementAdministrative ManagementAdministrative Management History of Management

Advocates of "administrative management" emphasized the flow of information in the operation of the organization.

Henri Fayol (1841-1925)“Father of Modern Management”

Defined the manager's job in terms of the now familiar management functions:

• planningp g• organizing• commanding• coordinating• controlling

(Click image above to learn more about the other management principles influenced by Fayol.)


Slide 21

k10 change to bullet spacingkarisam, 10/2/2012

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Henri Fayol (1841-1925)“Father of Modern Management”He also developed principles of management, which included:

Administrative ManagementAdministrative ManagementAdministrative ManagementAdministrative Management History of Management

• division of work • centralization• division of work

• authority and responsibility

• discipline

• unity of command

• unity of direction

• centralization

• scalar chain

• order

• equity

• stability of tenure of personnel

• subordination of individual interests to general interests

• renumeration of personnel

• initiative

• and esprit de corps (union is strength)

Henry Ford 1863Henry Ford 1863--19471947Henry Ford 1863Henry Ford 1863--19471947 History of Management

• Founded Ford Motor Company

• Incorporated the assembly line approach to work to produced low-cost cars efficiently

• Instituted the $5 workday

• Instituted the 40 hr/5 day workweek (1926)

Thought Exercise

What kind of management style do you think Ford used?


Image Editorial Credit: Nataliya Hora/ Shutterstock.com

<a href="http://www.shutterstock.com/gallery-105424p1.html?pl=edit-00&cr=00">Nataliya Hora</a> / <a href="http://www.shutterstock.com/?pl=edit-00&cr=00">Shutterstock.com</a>

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Peter Peter DruckerDrucker 19091909--20052005Peter Peter DruckerDrucker 19091909--20052005

• Introduced the term “knowledge worker”

• Concept of the “Corporation”

History of Management

• Viewed management as a liberal art (“social ecology”)

• Changed the views of corporate leaders

• Primary goal of a company is to serve its customers (profit is an “essential goal” but not a primary goal)

Thought Exercise

What kind of management style do you think Ducker was more closely aligned with?

(Click the image above to learn more about other management approaches

introduced by Peter Ducker).


Peter Peter DruckerDrucker 19091909--20052005Peter Peter DruckerDrucker 19091909--20052005 History of Management

• Decentralization and simplification (vs. command and control)

• Use of workers with high education

I t d “ t i ”• Invented “outsourcing”

• Described the “third sector” as nonprofit, legitimizing much healthcare as a business

• Concept of “planned abandonment”

• Popularized the social concepts of k th “ l t it ”


work, the “plant community”

• “Management by objectives”

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Management TodayManagement TodayManagement TodayManagement Today

• Rapid emergence of information technology

• Continuing radical changes in our social, economic, legal and political environments

• Do MORE with less

• Work in new and flexible ways within fluctuating environments


Management Today Management Today Management Today Management Today

Modern forms of management and leadership emphasize:

• guidanceguidance• empowerment• implementation• coaching• teamwork• coordination• balance work and life demands

Emerging Management Approaches

• Human Relations• Integrated and Emerging Management


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What is Work?What is Work?What is Work?What is Work?

• Physical or mental effort to produce or accomplish something

• Ties into personal accomplishments• Tiers of supervision created

Management Today

• Tiers of supervision created• Formal definitions of employee relationships

explicitly defined by the

Supervisor: “Any individual having authority from an employer to hire transfer lay off recall promote discharge assign reward orhire, transfer, lay-off, recall, promote, discharge, assign, reward or discipline other employees, or responsibly to direct them, or to adjust their grievances, or effectively to recommend such actions, if in connection with the foregoing the exercise of such authority is not of a merely routine or clerical nature, but requires the use of independent judgment.” (NLRA)


Maslow’s Needs CategoriesMaslow’s Needs CategoriesMaslow’s Needs CategoriesMaslow’s Needs Categories

Self Self ActualizationActualization

Esteem Needs Esteem Needs ( i i( i i

Management Today

(status, recogniti(status, recognition)on)

Social Needs (belonging)Social Needs (belonging)

Safety Needs (security, protection)Safety Needs (security, protection)

Physiological Needs (hunger, thirst)Physiological Needs (hunger, thirst)

Click NEXT to continueMaslows Needs 4

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Herzberg’s Satisfiers and DissatisfiersHerzberg’s Satisfiers and Dissatisfiers

Competent Management

Competent TechnicalStatus

Management Today

Technical Supervision

Good Interpersonal Relations with

Supervisors, Peers, Subordinates

Working Conditions

Status

Dissatisfiers(important only when absent)


SalaryJob Security

Herzberg’s Satisfiers and Dissatisfiers5

Herzberg’s Satisfiers and DissatisfiersHerzberg’s Satisfiers and Dissatisfiers Management Today

Achievement

RecognitionResponsibility

Satisfiers(the real

“motivators”)


AdvancementGrowth Potential

Herzberg’s Satisfiers and Dissatisfiers5

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Emotional IntelligenceEmotional Intelligence

• Work is much more than sustaining one’s existence through the act of employment

• Sense of self worth, a profession, and success are components of the work experience

• Involves Emotional Intelligence to personally sustain work


How Emotional Intelligence Enables the How Emotional Intelligence Enables the Successful Pathologist in the WorkplaceSuccessful Pathologist in the WorkplaceHow Emotional Intelligence Enables the How Emotional Intelligence Enables the Successful Pathologist in the WorkplaceSuccessful Pathologist in the Workplace Emotional Intelligence

Competencies What We See What We Do

Personal Competence

Self-Awareness

Self-Management

Click NEXT to continueParameters for Emotional Intelligence3

Social Competence

Social Awareness

Relationship Management

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Select each of the buttons below to learn more about how the four areas of Emotional Intelligence can influence the success of a pathologist leader in the workplace.

How Emotional Intelligence Enables the How Emotional Intelligence Enables the Successful Pathologist in the WorkplaceSuccessful Pathologist in the WorkplaceHow Emotional Intelligence Enables the How Emotional Intelligence Enables the Successful Pathologist in the WorkplaceSuccessful Pathologist in the Workplace Emotional Intelligence

Self-Awareness

Social Awareness

Self-Management

Relationship Management


Personal CompetenceSelf-AwarenessPersonal CompetenceSelf-Awareness Emotional Intelligence

Ability to accurately perceive your emotions and understand your tendencies across their range

Questions for Yourself

1. How do you react to a conflict in opinion?

2 What kind of emotion do you have when

g


2. What kind of emotion do you have when someone challenges your self-worth?

3. How would people describe your problem-solving skills in meetings?

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Case ScenarioCase ScenarioCase ScenarioCase Scenario

A member of Dr. Mack’s group has a tendency to irritate him with small talk when his is busy signing out cases. Usually he is patient, but one day he became frustrated and lost his temper and exclaiming that he had too much to do than to talk about little


How else might Dr. Mack have handled this situation? (Choose one best answer)

Dr. Mack was justified in his response and the situation needed to change

Examine his emotions on multiple occasions

gleague.

when he has been interrupted by small talk and determine in advance a way to divert conversation when this emotion appears

Insist that the head of the group intercede to make for a more productive workplace

Return to Emotional Intelligence Menu

Personal CompetencePersonal CompetenceSelf ManagementSelf ManagementPersonal CompetencePersonal CompetenceSelf ManagementSelf Management

Tolstoy: “The two greatest warriors are time and patience.” (War and Peace)


Ability to determine in advance when your emotions will interfere with self-management

Questions to Ask Yourself

1. How would you approach a problem which has t b l l l i d t ?


not been clearly explained to you?

2. What tools do you use when you are uncertain of a decision?

3. How do you respond to a personal style you have difficulties with?

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Dr. Gilmore is in a medical staff committee meeting and a clinician proposes putting more point-of-care testing in his clinic in a demanding manner. She knows that her point-of-care coordinator has had problems in the past with his clinic.


What should Dr. Gilmore do? (Choose one best answer)

Ask questions regarding the clinic needs, talk to her coordinator and wait 24 hours to cool off

Indicate that point-of-care testing should only occur in it ith ibl lsites with responsible personnel

Provide feedback regarding the number of point-of-care tests the lab supports and the ways they support them


Social CompetenceSocial AwarenessSocial CompetenceSocial Awareness

Ability to discern small behavior changes in others and interpret their meaning

Q ti t A k Y lf



1. Can you evaluate the body language of your superiors?

2. How would you use timing in a confrontational situation?

3. Give an example of how a question may solve a problem better than a statement


problem better than a statement

Hint: Plan ahead for work social events and committee meetings.

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Case ScenarioCase ScenarioCase ScenarioCase Scenario Emotional Intelligence

Dr. Edwards has been asked to implement new software for a quality management system. At his first meeting with managers he notices that a Core Lab manager has his arms crossed and seems disengaged.

What would Dr. Edwards do? (Choose the best answer)

Ask him how he is going to participate in the project

Speak louder and more firmly

seems disengaged.

After the meeting, Dr. Edwards should ask if there is anything he can do for him.


Social CompetenceRelationship ManagementSocial CompetenceRelationship Management

The ongoing effort of maintaining relationships in the workplace, skills that enhance this


p ,maintenance


1. If you realized someone did not understand your statement in a meeting, what would you do?g, y

2. Can you control when you get mad?

3. What is your reaction when you encounter something new?


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A faculty member of Chinese background sits quietly through a faculty meeting when Dr. Timm is discussing change in administration within her department. It seems as if the meeting went well. Later, she heard through the grapevine that he is quite upset regarding his move from one service to another


another.

What should Dr. Timm do? (Choose one best answer)

Recognize that she may have to manage her relationship differently with this faculty member given his less demonstrative cultural background


Immediately seek him out and apologize

Allow the administrative changes to proceed since they have already been announced and no one else appears upset

EQ Score

100

7677

Emotional Quotient (EQ)Emotional Quotient (EQ)Emotional Quotient (EQ)Emotional Quotient (EQ) Leadership

50

7471

Individual Supervisor Manager CEO

0

Click NEXT to continueBradberry T, Greaves J. Emotional Intelligence 2.0. San Diego, CA: TalentSmart Inc.; 2009, p. 235.

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Competencies of LeadershipCompetencies of LeadershipCompetencies of LeadershipCompetencies of Leadership Leadership

• Leading is based on communication and understanding

• It is concerned with aligning an organization with the stated objective

• It requires motivating and challenging staff to achieve their goals

• When effective, leadership ensures the continued effectiveness of a well-placed


continued effectiveness of a well-placed and well-timed strategic plan

Let’s review three common leadership styles that you may be familiar with

Click each folder to learn more. Select “next” when you are ready to go onto the next section.

Leadership StylesLeadership StylesLeadership StylesLeadership Styles Leadership

66


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What Leadership Style is This? What Leadership Style is This? What Leadership Style is This? What Leadership Style is This? Leadership

Dr. Zee is a new member of the pathology group. He has been asked to devise a test utilization plan for the clinical laboratory. Not knowing much about test utilization, he researches the topic and then invites the Lab Manager and Supervisors to a meeting.

What leadership style is Dr. Zee exhibiting?Authoritative

Democratic

g p gHe begins by explaining the project and then assigning projects to each area of the laboratory. He gets questioning looks from around the table and ends the meeting with a deadline.

Laissez-faire


Thought Exercise

Did Dr. Zee hold a successful meeting?

Click here to find out.

Leadership ApproachesLeadership ApproachesLeadership ApproachesLeadership Approaches Leadership

There are number of leadership approaches described in management literature. These are just a few to take note of

Click on each folder to learn more. Select “next”, when you are ready to continue to the next screen.

Click Click NEXTNEXT to continueto continue

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What Leadership Approach is This? What Leadership Approach is This? What Leadership Approach is This? What Leadership Approach is This? Leadership

Dr. Miller is considering using a new process in his lab, but, prior to making any changes, he has decided to get some input from some key members of his team. He believes their ideas will not only encourage innovation, but, also ensure adaptation of the new

What leadership approach is Dr. Miller using?Task-oriented

Change Management

Theory X and Theory Y

process throughout the rest of the organization.

Theory X and Theory Y

Theory Z


Empathy in LeadershipEmpathy in LeadershipEmpathy in LeadershipEmpathy in Leadership Leadership

• Thoughtfully considering the feelings of one’s associates and employees along with other factors in making

4

along with other factors in making intelligent decisions

• Requires understanding and caring about the emotional make-up of others

Treat people ith consideration of


• Treat people with consideration of their emotional needs

• In other words, use your “Emotional Intelligence”

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References

1. Mayer P, Salovey D. “What is Emotional Intelligence?” in Emotional Development and Emotional Intelligence: Educational Implications. New York, NY: Basic Books; 1997.

2. Salovey, Mayer, Goldman, Turvey, and Palfai. Emotion, Disclosure, and Health. Washington, D. C: American Psychological Association; 1995.

3. Bradberry T, Greaves J. Emotional Intelligence 2.0. San Diego, CA: TalentSmart Inc.; 2009.

4. Maslow, AH. A theory of human motivation. Psychology Review. 1943;50: 370-396. doi: 10.1037/h0054346

5. Herberg F, Mausner B, Snyderman B. The Motivation to Work, 2nd ed. New York, NY: Transaction Publishers;1959.

6. Wagar, EA, Horowitz, RE, Siegal, GP. Laboratory Administration for Pathologists. Northfield, IL; Collage of American Pathologists Press; 2011: Chapter 1.

CongratulationsCongratulations Completion Requirements

You have successful completed the online learning course:Management Theory: Applying Emotional Intelligence in the

Healthcare Environment

Credit is awarded upon successful completion of the postCredit is awarded upon successful completion of the post-test.

Access the post-test by exiting the course and returning to the course content page.

Click the link Post-Test to take the exam. You must score 80% in three attempts for credit to be awarded.

Interested in applying Lab Leadership best practices on the job?

Please download from your Lab Management Tool Kit the performance support tools provided to help apply the skills learned in this course.

Please join the lab leadership best practices discussion at the Lab Management University online Leadership Communities of Practice.


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Move to downloadable reference sectionMove to downloadable reference sectionIf you still want to be an LMD…If you still want to be an LMD…Move to downloadable reference sectionMove to downloadable reference sectionIf you still want to be an LMD…If you still want to be an LMD…

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Laboratory Management University · PDF file · 2013-08-29For her peer review contributions. 8/13/2013 2 ... • Leaders combine managementLeaders combine management with a vision