CHAPTER SIX

MANAGEMENT OF LABORATORY
RESOURCES
Learning Objectives

Upon completion of this chapter, students are expected to:

 Know how to manage time and space
 Prepare a laboratory time table, schedule, and duty rosters
 Know how to arrange work space and work flow
 Manage equipment and laboratory supplies
 Explain how to order, issue, store and control laboratory chemicals and equipment
 6.1 Management of Time and Space

 Many health care units (health centers and health stations/posts) in Ethiopia have been built without a
laboratory room.
 In some health centers, laboratory rooms have been built but they are too small to enable the laboratory
staff to work safely and efficiently.
 Moreover, it is not uncommon to observe in many laboratories problems in using the available time and
space which are believed to be among the many factors that affect the quality of laboratory service.
 6.1.1 Management of Time
 Time is different from all other resources in that it is too precious, non recurrent and it cannot be stored,
purchased and maintained.
 It is something invisible which can be highly wasted and corrupted resource. Especially in a country like
Ethiopia this resource is highly corrupted and not wisely managed and much has to be done in this regard.
 Time can be managed through planning for future utilization.
 Time can be managed by forming a schedule, timetable, rosters, programs, etc.
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 Schedules
Schedule is an easy way of dividing and managing time and is used for routine, repetitive
activities which takes place daily, weekly, monthly, etc.
For the laboratory of an average general hospital, an amazing number of schedules are
planned to provide personnel and service for regular workdays, weekends, evenings, and
holidays. Additional plans are required to make provisions for annual leaves, for special
procedures, and for a disaster plan. The approach varies with individual hospitals, each
having a plan designed to meet its requirements.
 Timetable
This is different from schedule for the following reasons:
 It is used for non-repetitive activities,
 Irregular activities at different times and place
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 Programme
This includes a variety of wide range of activities done over a long period of time at
different place by different people. A program gives answer for the questions what, who,
when, and where.
 Roster
In this, activities are repetitive and take place at the same time, by different people at
different times. An example is a duty roster.
 Various plans for nights and weekends Callback System
Labor laws and union agreements may define the rates of standby pay, minimum pay
per call back, rate of pay per hour for each call, port-to-port and return time,
transportation, or allowance for it. A breakeven point may be reached for which regular
shift work may be more economical.
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 Regular Shifts
These shifts require a definite number of personnel who work stated hours and by
some system of five days on with two days off.
Teams for Shift Work and Weekends
D.F. Moore of Saskatoon used the following system: Six technicians made up a team to
cover evening and night shifts. The technicians on duty covered a short evening shift
and then assumed stand-by duty callbacks. The team consisted of registered
technicians who had recently joined the laboratory staff. As each technician joined the
staff, this person was assigned to the evening/night team and replaced the technician
with the greatest seniority on it who, having served in the team, was never required to
do night duty again
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 Permanent Non Rotating Staff

 Occasionally, a laboratory technician may request evening and night duty as a permanent
arrangement.
 Superficially, the arrangement is attractive, but there are problems.
 For example, it is difficult to control the situation where there is little or no contact with the
technician.
 The technician has no contact with the day staff and eventually becomes out of touch. New
methods are difficult to introduce. Short cuts and modifications are often introduced
without prior consultation.
 Technicians who are involved in evening and weekend work are often rotated through
certain sections of the laboratory in order to provide them with necessary experience.
 6.1.2 Arranging Work Space and Work Flow

 Intra-laboratory Relationships
 The relationship of various laboratories to each other and to supporting areas such as phlebotomy,
specimen receipt, data processing, glass washing, media and/or reagent preparation & sterilization,
storage should be taken into account.
 A workable arrangement is to have a specimen receiving, data processing, and reporting center serve
as the hub of the laboratory. Radiating from this could be the various laboratories.
 The critical care laboratories and large volume laboratories (such as hematology and chemistry) might
be most closely related to these central areas.
 Those laboratories with greater turn around time and/or less volume, as well as those requiring special
safety features might be more removed from the central area.
 Traffic flow: It is very important to plan the traffic flow so that intra-laboratory traffic is separate from
outside traffic. Provisions should be made for ambulatory patients and blood bank donors coming into
the laboratory.

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 Specimen and data flow: A diagram of specimen and data flow through the proposed laboratory
will be helpful in arranging a schematic layout. Questions, which should be considered, include:
(1) Do all specimens come to a central processing area or to the individual laboratory section?
(2) Are pre-analytical processing and storage of specimens to be done centrally or by each laboratory?
(3) Are routine and stat (emergency) specimens to be treated in the same manner?
 Organizing patient flow
 Outpatients: These are usually sent to the lab with their own requisition form. In health centers
that do not use lab requisition forms, lab requests should be written on a separate piece of paper
to avoid the clinical notes becoming contaminated in the lab.
Specimens are collected in the laboratory or patients are given instructions to bring specimens
directly to the laboratory.
Patients either wait for the results or are told when to return to collect them. Patients take their own
results back to the clinician.
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 Inpatients: In health centers that do not use lab requisition forms, lab requests
should be written on a separate piece of paper. The patient's notes should not
leave the ward as they may be needed in an emergency.
 Stool and urine samples are collected by the nursing staff and taken to the lab.
Blood samples are collected on the ward unless the patient is well enough to walk
to the laboratory. Clinical staff must assist the laboratory staff to collect venous
blood from infants and small children, and also samples like CSF or other invasive
fluids and send them immediately to the laboratory
 Emergencies: In emergency all health staff must be prepared to attend to
patients. If the patient is unable to come to the lab, the lab staff must go and
attend to the patient.
6.2 Management of Equipment and Supplies

In any laboratory there are two main types of items. These are:
 Expendable (also called consumable)
Materials that are used until exhausted are expendable items and may include matches,
cotton, wool, laboratory stains, disposable syringes, glass wares, etc.
 Non-Expendable (also called capital)
These are instruments/equipment that are used for several years and need care and
maintenance and include microscopes, autoclaves, centrifuges, water baths, incubators,
spectrophotometers, balances, etc.
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Procedures in the Management of Laboratory Items

I. Ordering: obtaining lab items from stores or procuring items from suppliers or manufacturers.
II. Storing: Recording, labeling and holding items in a stock or storeroom.
III. Issuing: Dispensing items to users.
IV. Controlling and Maintaining: This includes controlling expendable items and maintaining and
repairing equipment/instruments.

6.2.1 Ordering Lab Items

 Ordering lab items only senior staffs are authorized to order lab items. Laboratory supplies are
ordered regularly before stocks are depleted.
 Check the prices of items before ordering to ensure that laboratory expenditures do not exceed
the budget. One has to follow government guidelines carefully when ordering supplies.
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 The following skills are needed to order equipment:

 To list requirements with relevant and clear specifications.
 To balance requirements with available resources and make cost estimates.
 To use a catalogue to make correct lists of items
 To complete an order form or requisition form.
Note: It is important that in procurement of items there should be certificate of
origin of each required item and expiry date clearly labeled to have more than 80%
laps of time before this date
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Making Lists
 Make a list of laboratory items with appropriate place of purchase, for example, paper
is bought from the government stationary, spectrophotometer is brought from
EPHARMICOR etc.
 For each item write down the exact type required (specification of items is very
essential). For example, microscope, binocular 220v.
 Estimate the quantity of each item. For example, 5 packs of applicator stick for a year.
 The Quantity of an item used depends on the number of people using it and can be
estimated from experience or by asking experienced persons. Since resources are
always limited it is important that consumable items be used immediately.
THANKS