Management Q&A

Addressing management issues

Edited by C. Anne Pontius, MBA, CMPE, MT(ASCP)

Lab workers concerned for safety

Q We work in a small community, and our doctors’ office laboratory sits alone in a new construction area in a rather desolate part of town. Two of us who work after hours — sometimes until after dark — have asked for additional security measures for the building since we have had a couple of concerning incidents. Once, because some of the windows are only partially covered, we had someone peering through the glass at us. The person disappeared before we could ascertain who he was, but we were frightened. We are convinced the second incident was likely the same person. We asked for total window coverage and some added outdoor lighting, but we were told the aesthetics of the building and its décor were at issue. That was several weeks ago, and nothing has been done yet. How do we persuade management to do something to make us at least feel more secure at night since they have, thus far, ignored our requests? Should we ask our local law-enforcement department for help?

A Alton B. Sturtevant explains, "It is not unusual for laboratory employees to face concerns with physical safety due to the unusual hours that laboratories operate. Being in lab management for many years has allowed me to observe this situation in our various lab locations. Each one has its own unique challenges, but with common sense approaches, they can be addressed and solved.

"Take the extra step of putting your concerns into writing to ensure management understands that you are seriously concerned for your safety. Document the dates and specifics relating to the incidents, and clearly express your concerns without being dramatic. Additionally, ask for solutions that you consider important (to include more lighting and window coverings that can be used after dark). Schedule a face-to-face meeting with the manager, at which time you should present the written document, and explain your issues and proposed solutions.

Take the extra step of putting your concerns into writing to ensure management understands that you are seriously concerned for your safety.

"Ask the manager to speak with the local police department on your behalf to explain the work hours, and request that police representatives come by to speak to your group. The local police appreciate businesses letting them know about work hours and concerns. The police may stop by to speak with you periodically during patrols to ensure everything is okay and that you know that they are checking up on you. If the manager balks at calling the police, ask if you can call on behalf of the practice.

"The practice has the responsibility of providing you with safe working conditions, but you must take an active role in making that happen as well. Do not feel that you are making a pest of yourself when explaining the situation. If nothing is done by management to alleviate the situation after continued discussions, then you must decide if you want to continue to work in an unsafe environment."

Larry Crolla says, "In this situation I would call local law enforcement and make the police aware of the situation and the incidents that have occurred. Simply ask if they can patrol the area on a more frequent basis at night. You may also be able to have officers visit with ‘the powers that be’ to recommend some measures that may be needed to help ensure your safety on their premises. Document all correspondence about this to management If they know you have created a paper trail, they are more likely to believe your concern is serious."

Marti Bailey states, "You have experienced two incidents, so your requests for additional security measures should not be ignored. ‘Building aesthetics and décor’ is not a reasonable justification for failing to implement needed security.

"Document any and all incidents in writing to your employer and the police. This will serve as notice to everyone that there is a problem. If you know the dates and times of the incidents that have already occurred, report these to the police, as well. When leaving the building, arrange with other staff members to leave together, if possible.

"Your employer is responsible for providing you with a safe work environment. The facts are that you have experienced incidents that make it clear there is a safety threat, and requests for additional safety measures have been ignored. Economics might prevent you from resigning and taking another job, but if there is an opportunity to do so, you may want to look into it."

Bottom line: Employees’ safety should be of paramount concern to employers. If you or your co-workers were violated in any manner, it would be terrible for you both, but if you need to get your employer’s attention, remind him that the negative publicity could destroy patients’ confidence to come to your facility. Our experts have offered good advice: Document suspicious events and call the police to escort you out at night if you feel unsafe. Better safe than sorry!

Fear of job loss

Q During this "season" of economic turmoil, we have had layoffs, reassignments, resignations, and negotiations for part time or take-home work. All of this is to be expected. However, the administration — human resources (HR), managers, and supervisors — do not make announcements or hold informative meetings to discuss with employees the plan of action they evidently have developed to cope with the situation. This has created an environment of rumors, speculation, gossip, ill will, and fear. When some of us have attempted to suggest to some of these authorities that these reactions have placed a negative synergy on the lab, their response is, "just keep your nose to the grindstone." Those of us who are left must carry the entire workload. In some cases, this is truly burdensome schedule-wise, but moreover, it is beginning to get wearisome. Not only are some of us afraid we will lose our jobs at some point, we are more afraid that we might be responsible for making errors due to overwork and physical stress. What can we do to set the record straight with our leadership?

A Larry Crolla says, "Have a discussion with the chairman of the department, who bears the legal responsibility for lab quality. Explain your concerns about lab quality. The chairman should then present these issues to the administration; ask the chairman if he would please notify you of administration’s response. If you feel your concerns are not addressed after taking these steps, you can contact the CEO of the hospital in writing. If you are certain patient care is at risk, you should contact your regulatory agency."

Alton Sturtevant explains, "Both parties involved in this issue have a responsibility to ensure that the institution is able to survive this economic downturn. The situation you describe is one that is being played out in many facilities today. Management is tasked with the fiscal responsibility while you are tasked with quality laboratory results.

"Having been on both sides of this issue, I can say that management is walking a fine line between good open communication and saying something that can be misconstrued as a promise to employees when it is really a best guess of the current situation. I do, however, feel that management owes it to the employees to provide factual information to them. Employees must understand that honest communication of the current situation is what management is attempting to provide — not a guarantee.

Employees in many facilities are being stretched beyond their limits due to staffing reductions.

"Calm requests from employees to supervisors, and supervisors to management, requesting a current update on the situation to employees should help to encourage communication among the team. A good place to solicit information is from HR, as that department is tasked with relaying employee concerns to management. If there are suggestion boxes or other anonymous methods of communication with management, take advantage of them.

"Ensure that quality issues found in the lab are diligently reported into the quality-assurance process, so if problems arise due to staffing issues, they will be reported through the normal channels to management. Focus on quality laboratory testing, not on the uncertainties of the economy."

Marti Bailey says, "Two different strategies are used in my area for handling stressed hospital economics. Our hospital developed a survival plan to protect jobs and communicated that plan clearly to all employees. It was made known that a certain number of positions had to be eliminated to maintain financial stability, and the method of reduction was to be attrition. The positions of employees who retired or left for other reasons would not be filled, and a selective hiring freeze was to be implemented.

"Another local hospital also reduced positions but did so by eliminating existing employees. The communication was via pink slips on a Friday afternoon to the employees who were to be laid off — with no advance notice or warning.

"In our hospital, employees sensed that the employer was honestly acknowledging that the business was suffering from the economic downturn, but everything possible was being done to avoid employee layoffs. This, of course, was not the case at the other hospital. Those employees go to work each day wondering who might be going next and feel terrible for the employees who were let go.

"These difficult decisions, as well as the plan for communicating them, are made at a high level and are a good indication of the character and values of the people who make them. Employees’ commitment to their jobs and loyalty to their employer are strongly influenced by their leaders’ performance during difficult times.

"Employees in many facilities are being stretched beyond their limits due to staffing reductions, and the laboratory has been particularly hard hit. It is not good enough to threaten that you might make errors or complain that you are being overworked. It is helpful for co-workers to lend one another support, and keep the supervisor informed of workload impacts, including complaints from lab users regarding test-turnaround times. We are tasked with patient care, and failures in this arena are not acceptable, so it is important that the administration knows when it needs to improve staffing."

Bottom line: As our final commentary points out, it is not good enough to threaten that you might make errors or complain that you are being overworked. Document the bed census and outpatient visits, and correlate that information to the laboratory’s workload, staffing shortage, overtime pay, turnaround times, and quality issues to prove your point. Without such documentation, you do not have much of a case. The laboratory managers may be as disadvantaged by poor communication as are the testing personnel. Communication from administration, whether it presents good or bad news, is better than no communication at all. Do not be part of a rumor mill, as it only deteriorates your personal integrity.

MLO’s "Management Q & A" provides practical, up-to-date solutions to readers’ management issues from a panel of laboratory management experts. Readers may send questions to Anne Pontius at manqa@mlo-online.com . Unless otherwise noted as "confidential" by readers, all queries will be considered for publication without further notice to them. Names, institution, city, and state will be removed before publication. The following panel of laboratory directors, managers, and supervisory technologists have provided their input in the answers given in this column: Marti K. Bailey, MT(ASCP), work unit leader, Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA; Lawrence J. Crolla, PhD, consulting clinical chemist, Departments of Pathology and Respiratory Care, Alexian Brothers Hospital, Elk Grove Village, IL, West Suburban Medical Center, Oak Park, IL, and Northwest Community Hospital, Arlington Heights, IL; and Alton Sturtevant, PhD, laboratory director, LabCorp, Birmingham, AL.

Anne Pontius is a senior medical practice consultant with State Volunteer Mutual Insurance Company in Brentwood, TN, and president-elect of CLMA 2007-2009. Send questions to Ms. Pontius at manqa@mlo-online.com .