LEADERSHIP BASICS FOR CLINICAL LABORATORY
LEADERSHIPBASICS FORCLINICALLABORATORYPROFESSIONALSCOMMITTEE ON CLINICALLABORATORY MANAGEMENT
2018LEADERSHIP BASICSFOR CLINICALLABORATORYPROFESSIONALSSEDEF YENICEEDWARD RANDELLEDITORSCOMMITTEE ON CLINICAL LABORATORY MANAGEMENTLEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS1
EDITORSSedef YeniceDepartment of Core Clinical Laboratory ServicesGayrettepe Florence Nightingale HospitalGayrettepe mah. Cemil Aslan Güder sok.,Beşiktaş 34349, Istanbul, TurkeyEdward RandellClinical Laboratory Services,The government of Newfoundland LabradorEastern Health Authority & Faculty of Medicine,Memorial University, St. John's NL, CanadaLEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS2
CONTRIBUTORSMATTHIAS ORTH Institute for Laboratory Medicine, Vinzenz von PaulKliniken gGmbH, Marienhospital Stuttgart, Postfach 103163, D-70027Stuttgart and Medical Faculty Mannheim of Heidelberg University,GermanyEDWARD RANDELL Clinical Laboratory Services, Government ofNewfoundland Labrador, Eastern Health Authority & Faculty of Medicine,Memorial University, St. John's NL, CanadaAYE AYE KHINE WAMONO Department of Chemical Pathology, NationalHealth Laboratory Services, Dr. George Mukhari Academic Hospital,School of Medicine, Sefako Makgatho Health Sciences University, POBox 227, Medunsa 0204, Pretoria, South AfricaSEDEF YENICE Department of Core Clinical Laboratory Services,Gayrettepe Florence Nightingale Hospital, Gayrettepe mah. Cemil AslanGüder sok. Beşiktaş 34349, Istanbul, TurkeyLEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS3
PREFACECommittee on Clinical Laboratory Management (C-CLM) aims through this manual tosupport clinical laboratory professionals to discover their leadership strengths andsee how developing and applying these principles can help them reach the highestsummits in work. This manual also complements the C-CLM Clinical LaboratoryLeadership Certificate Program and is part of the required reading list. We promotesix leadership strengths towards business and personal success includingdemonstrating social intelligence; adopting a flexible leadership style; empoweringothers; development of trust; managing risk in an environment of uncertainty, andseeing the big picture. Those strengths provide a valuable model in the clinicallaboratory workplace, whether one is already in a leadership position or aspiring toget there.Each chapter presents the most important facts and concepts in that subject area.The chapters address topics such as defining the laboratory medicine leaders,effective leadership styles, skills/qualities of a good leader, the leader as visionaryand motivator, work culture, and ethics in leadership. In addition, the assessmenttools provided in the Appendices section are designed to provide the reader's insighttowards the selection of the best leadership model, when starting to manage newpeople and selecting which leadership style to be used and discover the motivationlevel of persons under his/her authority.All contributing authors have reflected on their own professional excellence in theircontributed chapters, being educators and outstanding professionals in thelaboratory medicine field.We wish to thank the authors for their willingness to contribute to this monographand hope that the information contained in the chapters is both educational and ofpractical use to those who lead and engage in management roles.Please send your feedback to this manual at the following email address:sedefyenice@gmail.com.Sedef YENICEEdward RANDELLLEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS4
TABLE OF CONTENTSLEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS . 0List of Acronyms . 8CHAPTER 1 . 9Overview . 9Introduction . 9Objectives . 12REFERENCES . 13CHAPTER 2 . 14Effective Leadership Styles . 14LEARNING OBJECTIVES . 14KEY QUESTIONS . 14Introduction . 14Roles and Responsibilities in the Laboratory . 16Leadership and Management . 20Leadership Traits and Skills . 20Leadership Styles . 24Challenges in the Laboratory Services . 27Conclusion . 27REFERENCES . 28CASE STUDY AND EXAMPLEs. 28CHAPTER 3 . 34Skills and Qualities of a Good Leader . 34LEARNING OBJECTIVES . 34KEY QUESTIONS . 34Introduction . 34Skills and Qualities needed as a Laboratory Manager. 35Perception of Necessary Skills Dependent on the Profession of the LaboratoryManager . 36The Medical Act, The Medical Laboratory and Necessary Skills . 36Skills Needed for Medical Interpretation . 38DIrect Access of Patients to Bioanalytical Specialists (Non-Medical LaboratoryLEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS5
Specialists) . 39Conclusions . 39REFERENCES . 40CHAPTER 4 . 41Are Standards Helpful for Good Leadership in the Medical Laboratory? . 41LEARNING OBJECTIVES . 41KEY QUESTIONS . 41Challenge of Standards in Laboratory Medicine . 41Definition of Standard . 42Definition of Medicine/Healthcare . 42Drawbacks of Standards in Healthcare. 42Standardization in Laboratory Medicine . 43Standards versus Medical Guidelines. 44Total Quality. 46REFERENCES . 46CASE STUDY & EXAMPLEs . 46Case Study References . 47CHAPTER 5 . 48The Leader as Visionary and Motivator . 48LEARNING OBJECTIVES . 48KEY QUESTIONS . 48What is Motivation? . 48What Leaders and Individuals Need to Understand About Motivation—Why ItMatters? . 49Theories of Motivation . 49Extrinsic and Intrinsic Motivation. 54Motivational Drivers . 58The Appraisal Process . 66Work Climate and Work Culture . 68How to Measure Total Motivation . 72Summary . 72REFERENCES . 73CHAPTER 6 . 76Workplace Culture, Ethics and Laboratory Leadership . 76LEARNING OBJECTIVES . 76KEY QUESTIONS . 76LEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS6
Introductıon . 76Ethics and Laboratory Medicine. 77Defining Ethical Leadership . 77The Foundations of Ethical Leadership in the Clinical Laboratory . 79Workplace Culture and the Clinical Laboratory . 81The Ethical Challenges of Laboratory Culture . 81The Ethical Laboratory Leader. 81Culture of Quality and Ethical Laboratory Leadership. 82Addressing Medical Errors and Utilization Management . 85Pursuit of Service Excellence and Continuous Improvement . 86Summary . 87REFERENCES . 87CASE STUDY & EXAMPLEs . 88APPENDICES . 90Appendix A. 90Appendix B. 95Appendix C . 100Appendix D . 101Appendix E. 103Appendix F . 105Appendix G . 108LEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS7
LIST OF ACRONYMSAACCAmerican Association for Clinical ChemistryC-CLMCommittee on Clinical Laboratory ManagementCEConformité Européene or European ConformityCENComité Européen de NormalisationCEOChief Executive OfficerCLSIClinical Laboratory Standards InstituteCPDContinuing Professional DevelopmentCMEContinuing Medical EducationDINDeutsches Institut für NormungEFQMEuropean Foundation for Quality ManagementFT4Free thyroxineIFBLSInternational Federation of Biomedical Laboratory ScienceIFCCInternational Federation of Clinical Chemistry and LaboratoryMedicineISOInternational Organization for StandardizationIQCInternal Quality ControlIVDIn vitro diagnosticsPDCAPlan-Do-Check-ActQAQuality AssuranceQCQuality ControlQMQuality ManagementQMSQuality Management System(s)SOPStandard Operating ProcedureTSHThyroid Stimulating HormoneWHOWorld Health OrganizationLEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS8
CHAPTER 1OverviewEDWARD RANDELLINTRODUCTION"Leadership is an action, not a position."Donald McGannon (A broadcasting executive during the early years of Television)One of the greatest challenges to growth and improvement and operationalexcellence in any organization is the availability of good leadership. Leaders play theprimary role in establishing workplace culture and impact the quality and rate atwhich the laboratory progresses over time. Good leaders inspire others to find selfmotivation, greater creativity, and productivity and create team spirit. In spite of theimportance of good leadership to the success of any organization, relatively few inleadership roles have received training and exposure on how to become an effectiveand good leader. For many laboratory professionals leadership skills and styledevelop out of mentoring by senior scientists, managers, and directors within theworkplace. While there are clear benefits from sound mentoring, bad habits andineffective behaviors and strategies can also be adopted. Moreover, good mentoringalone is insufficient to produce good leadership skills, thus, calling on the need forstructured training, and guidance. This monograph addresses this gap by providinginstructional materials to help the leaders in laboratory medicine toward moreeffective leadership strategies and practices.While the qualities of good leadership transcend many different disciplines ofbusiness and human interaction, the environment and problems encountered in theclinical laboratory setting are unique, making good leadership skills, fine-tuned to thespecific challenges of laboratory medicine, even more important. Unique to healthcare, and in contrast to other areas of business is the primary focus on the wellbeing,the expectations and the safety of the patient, and then secondarily the funder, thehealth organization, or government. A particular challenge to the leadership is the invitro situation of Clinical Pathology which carries medical consequences for thepatient without having the direct personal patient contact such as in most other areasin medicine. But just as in other areas of health care, there is a need for a carefulbalancing of productivity, cost control, and adherence to the ethical requirementssurrounding the provision of quality service. Often it is even more challenging for aleader in inspiring other laboratory staff toward a common vision and purpose, toavoid the pitfalls of one’s lack of self-awareness. This monograph addresses suchchallenges as it describes the components of leadership in laboratory medicine.LEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS9
Good leadership in laboratory medicine is comprised of many factors. Figure 1.1characterizes the clinical laboratory leader by five roles. Good leadership ischaracterized by competency in practice, involvement in quality management (QM),being an effective problem solver and strategist, one who pursues improvement andexcellence in service, and promotes the development and sustainability of thisservice. Such leaders are competent in working with other experts in laboratoryscience, patient safety, technology, epidemiology, informatics, communications, andthe public and other areas of healthcare. Leadership in laboratory medicine is alsoconcerned with competency in a specialty area and being able to recognize new andbeneficial developments that can be translated into the local environment towardoverall improvement in patient care. As a scientist, the laboratory leader ismeticulous in drawing attention to detail and finds himself/herself on the cutting edgeof new development and reorganization and is also expert in the operations of theorganization and apt to perform investigations towards improving service quality andefficiency, but also to conduct applied laboratory research to address healthproblems. The laboratory leader is a lifetime learner, always learning through regularattendance and participation in seminars, journal reading, attending annualprofessional conferences, and presenting the findings of their own investigations tothe scrutiny of and towards growth and development of the field. The leader isactively engaged in the laboratory quality management system (QMS). As achampion of quality of care and patient safety, the laboratory leader organizescomprehensive laboratory safety and risk assessments and ensures such activitiesare familiar and ingrained in the local workplace culture. The laboratory leader is alsoa promoter of the monitoring and evaluation of laboratory services by regularlyattending meetings and events influencing and impacting laboratory service delivery,promoting more effective integration and application of the laboratory services topatient care in medical decision making and outcomes. Chapter 2 defines for us ingreater detail the components of Leadership.ScientistPromotorof hampionfor QualityVisionaryManagerFigure 1.1 Roles of theClinical Laboratory LeaderCompetentPractionerLEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS10
Not all leaders are the same. An important step towards excellence in leadership isrecognizing your leadership style compared to the kind of leader you wish to be(Figure 1.2). Chapter 2 describes the styles of effective leadership. Several keyattributes accompany effective leadership. These include being effective atmanaging people, having a clear vision, and having a keen self-awareness andsound ethics, being masters of self (1) (Figure 1.3). According to Grace MurrayHooper, a famous American computer scientist and Admiral in the US Navy, "Youmanage things; you lead people." Although leadership and management are oftenused
LEADERSHIP BASICS FOR CLINICAL LABORATORY PROFESSIONALS 10 Clinical Laboratory Leadership Scientist Visionary Manager Competent Practioner Champion for Quality Promotor of the Clinical Laboratory Good leadership in laboratory medicine is comprised of many factors. Figure 1.1 characterizes the
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