the laboratory manager/supervisor: roles, responsibilities and expectations · pdf...
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The Laboratory Manager/Supervisor: Roles, Responsibilities and Expectations
Professor of PathologyThe University of Utah
Department of Pathology
Ronald L. Weiss, MD, MBA, FASCP
Your Faculty
Administrative Director of Laboratory, Respiratory and Ancillary Services
Mercy Medical Center, NY, NY
John F. Boyle, PhD
AcknowledgementsTricia L. Hughey
Executive Vice PresidentAmerican Pathology Partners
For their peer review contributions
INTRODUCTION
Delivery systems are migrating to focus more
Roles and Responsibilities
The role of the laboratory manager or supervisor is filled with challenge and opportunity.
Delivery systems are migrating to focus more on
• prevention
• maintenance of wellness
• a team-oriented approach to chronic disease management
• compensation based upon providing ti t lpatient value
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INTRODUCTION
L b t M
Roles and Responsibilities
The role of the laboratory manager or supervisor is filled with challenge and opportunity.
Laboratory Managers
• use their skills and interests in implementation of accountable care organizations and patient-centered medical homes
• are responsible for the technical operation of the laboratory
• serve as advocates, influencers and ,leaders
What does it take to successfully bridge the gap from technical expert to leadership?
INTRODUCTIONThe Transition
You are accountable for people and their behavior
In addition to managing the technical aspects of operations, you must now work through others to achieve organizational goals
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INTRODUCTIONDefinitions
What is a Supervisor? What is a Manager?Supervisor
• people, positions, technology and capital goodsp p p gy p g
• lab section/specialty team
• financial and strategic planning
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INTRODUCTIONDefinitions
What is a Supervisor? What is a Manager?Supervisor
• people, positions, technology and capital goodsp p p gy p g
• lab section/specialty team
• financial and strategic planning
Manager• people, positions, technology and capital goods
• multiple supervisors, sections or specialty teams
• operations of a lab unit, department or division
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operations of a lab unit, department or division
• complex programs or projects
• financial and strategic planning
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Your job is to organize your unit and to mobilize
Managing SystematicallyLab supervisors/managers are responsible for the overall quality and quantity of output.
j g yyour staff to work in a systematic way to serve the needs of your “customers” and staff.
Perform these management functions in an effective manner
• Controlling
• Planning
O i i• Organizing
• Staffing
• Directing
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In this course you will learn the roles and responsibilities as a clinical laboratory manager or supervisor.
Course Objectives INTRODUCTION
Upon completion, you will be able to
• Compare and contrast the role of a Lab Manager and a Lab Supervisor
• Identify key supervisor/manager tasks
• Identify 7 problem-solving steps
• Use problem-solving techniques
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• Complete a self-assessment and discuss your results with your supervisor or manager
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Managing Systematically
Click on each function to view an explanation and examples
Planning
OrganizingDirecting
Controlling
Staffing
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Planning
The ongoing process of developing (or providing input into) your department
Managing Systematically
The ongoing process of developing (or providing input into) your department goals and objectives, determining how and when they will be accomplished, and ensuring they are aligned with your department’s mission and broader organizational goals.
Typical laboratory activities for a manager or supervisor include:• Knowing your vision and mission statement• Understanding your teams goals and objectives• Prioritizing resources• Establishing measurements for success• Creating a laboratory budget
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Managing Systematically
Organizing
Creating your department’s internal structure to make progressCreating your department s internal structure to make progress towards its goals. Organizing includes management functions to ensure productivity.
Typical laboratory activities for a manager or supervisor include:• Developing a organizational chart with clearly defined
relationships• Establishing an standard operating procedures (SOPs) for
your team• Defining workflow and interconnected processes• Establishing a staff schedule
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Staffing
Staffing involves hiring and retention of qualified workers in all positions in the
Managing Systematically
Staffing involves hiring and retention of qualified workers in all positions in the business. Activities include: Recruiting, hiring, training, evaluating and compensating.
Typical laboratory activities for a manager or supervisor include:• Hiring the “best” qualified candidates for the job• Training your staff in laboratory best practices• Evaluating your staff periodically • Rewarding your staff for exceptional performanceg y p p
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Managing Systematically
Directing (Leading)
Influencing people's behavior in order to channel their efforts toward theInfluencing people s behavior in order to channel their efforts toward the mission and goals, to adapt to change, to form communities of knowledge, practice, and support, and to reach personal career objectives.
Typical laboratory activities for a manager or supervisor include:• Communicate expectations• Delegate for enhanced productivity• Coaching your staff as needed• Conducting regular staff meetingsg g g• Model ethical values
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Managing Systematically
Controlling
Controlling requires measuring and assessing performance relative to goals makingControlling requires measuring and assessing performance relative to goals, making corrections as needed and reinforcing progress. This will enable you to collaborate with your manager, communicate with staff about progress, anticipate problems, work with them in a systematic ways to create your outcomes, and develop yourself for advancement and success.
Typical laboratory activities for a manager or supervisor include:• Making sure everything is going according to plan• Setting performance goals
C d ti f i l• Conducting performance appraisals
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Drag each question to the corresponding management function in the diagram below
ManagementFunctions
LEARNING ACTIVITYLEARNING ACTIVITY
How you reviewed your units mission and goals?
Have you communicated expectations to your staff?
Have you examined opportunities to enhance productivity?
Are the requirements for each position appropriate for the patient
Planning
OrganizingDirecting
Controlling
Do you conduct regular staff meetings?
position appropriate for the patient needs?
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Staffing
Key competencies areas of laboratory leaders include
EXPECTATIONSKey Competencies
Leadership Personnel Management
Operations
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Financial Management
Informatics ComplianceClick on each of these areas to review some examples of the
skills that are covered
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EXPECTATIONSKey Competencies
Effective leaders are visionary role models who know what the “right things” are to do. They demonstrate integrity and engender trust.
Managers administer, while leaders inspire. As a manager or supervisor, you are expected to make hard decisions aligned with organizational or team mission to achieve results.
Leadership is based on
• integrity and courage
• trust of othersi ti d d t di
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• communication and understanding • motivating and challenging staff to achieve their
goals
Effective leaders have the Emotional Intelligence to
• recognize value and celebrate success
EXPECTATIONSKey Competencies
g
• treat others with compassion
• act responsibility
• create effective teams
• hold themselves and others accountable
• help others to change
• continuously improvecontinuously improve
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EXPECTATIONSKey Competencies
Personnel Management is a continuous process that involves identification and evaluation of performance objectives and competencies These expectations shouldobjectives and competencies. These expectations should be aligned with organizational goals.
Your role
• communicate these expectations
• provide the resources to achieve them
• promote an atmosphere that creates intrinsic motivation for your team members
Understanding one’s role in context of the lab enables effective performance.
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As effective communicators, leaders
• support, guide and direct others
• mentor coach and develop others
EXPECTATIONSKey Competencies
• mentor, coach and develop others
• correct and discipline
• resolve conflict
• explain their vision
• create the necessary urgency
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EXPECTATIONSKey Competencies
Managing operations of a laboratory involves design and development of staff procedures and providing the tools and resources to achieve departmental goalsand resources to achieve departmental goals.
Some responsibilities include:
• establishing standard operating procedures (SOPs) for your staff
• standards for Point of Care, Provider provided and Waived tests
• developing guidelines for process improvement programsprograms
• analyzing and trouble shooting workflow problems
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EXPECTATIONSKey Competencies
Informatics is the practice of information processing centered around pathology tests and patient information. This includes identifying and interpreting clinical dataThis includes identifying and interpreting clinical data including sensitivity calculation, ROC curves, positive/negative predictive value, and likelihood ratio at any given threshold.
You are also responsible for:
• tools for scheduling, analyzing, communicating and presenting
• working with IT to improve efficiency
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• leading lab EMR selection
• conducting evaluation of lab transaction databases and storage
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EXPECTATIONSKey Competencies
You are responsible for preparing a unit and laboratory budge for pathology services and operations. This includes:includes:
• analyzing financial data including cash flow, income statement and the balance sheet
• preparing for financial audits
• conducing cost accounting for common lab procedures
• identifying and analyzing forms for reimbursement of lab services
• assigning CPT codes
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EXPECTATIONSKey Competencies
You are responsible for designing, developing and implementing a basic laboratory safety program including OSHA MSDS radiation safety lab safety bio hazardsOSHA, MSDS, radiation safety, lab safety, bio hazards, universal precautions and electrical safety.
You must also design a comprehensive compliance plan including :
• CLIA certification
• analytical complexity
• CAP, COLA and JCAHO accreditation
• risk management planning
• effectively managing any safety and compliance issues that occur
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Serve Your "Customer"One of the first steps in serving in a supervisory or manager role is to know your customers.
CUSTOMER SERVICE
Process Relationship
Hint:External customers are at the end of your major work processes and usually pay for your service
Internal customers are those who rely on you for guidance and support (your staff and others) and upon whom you rely to do your job (your staff and others)
External Supplier Process External
Customer
Internal Supplier
Internal Customer
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A process is any sequence of interdependent procedures
CUSTOMER SERVICE
Process Relationship
A Process
that are connected at every step through their consumption of resources that converts inputs into outputs.
• A beginning and an end that can be reproduced in the future
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CUSTOMER SERVICE
Process Relationship
Process Step 1
A Process
Step 1
Process Step 2
Goal or Result
ProcessStep 3
ProcessStep 4
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Brainstorming
New Process
Improvement
CUSTOMER SERVICE
Process Relationship
A Process
Failure
Goal
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Brainstorming
New Process
Improvement
CUSTOMER SERVICE
Process Relationship
A Process
Failure
Goal
Brainstorming
New Process
Improvement
CUSTOMER SERVICE
Process Relationship
A Process
Failure
Goal
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Brainstorming
New Process
Improvement
CUSTOMER SERVICE
Process Relationship
A Process
Failure
Goal
Brainstorming
New Process
CUSTOMER SERVICE
Process Relationship
A Process
Failure
Goal Improvement
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External supplier is a party such as a non-profit
External Suppliers
CUSTOMER SERVICE
Process Relationship
organization or lender that influences and is influenced by an organization’s success or failure but is not a member of that organization.
External suppliers may include
• transport service
• investors
• marketing
• accounting
• others
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Internal Suppliers
CUSTOMER SERVICE
Process Relationship
Internal suppliers provide services to their internal customers who in turn serve the external customers.
Examples include:
• Phlebotomy
• Laboratory Testing
• Radiology
• Physical Therapy
• Others
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Internal customers evaluate their internal suppliers
Internal Suppliers
CUSTOMER SERVICE
Process Relationship
laboratory services on both short-term and long-term profit indicators which are a strong indicator of external customer satisfaction.
CUSTOMER SATISFACTION = DEGREE OF SUCCESS!
Reliable ancillary services can be the node for additional growing opportunities for many other servicesservices.
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The team or players who await the delivery of a product
Internal Customers
CUSTOMER SERVICE
Process Relationship
or service that allows them to reach the final step in the process, providing the result to the external customer.
Compensation for an internal supplier is often tied directly or indirectly to evaluation by internal customers.
They include• physicians• nurses• nutritionists• environmental services• ancillary services• administration
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This also includes your staff who rely on you to
Internal Customers
CUSTOMER SERVICE
Process Relationship
• help them know what is expected of them • help them do the correct things well, to make
the best use of their time, effort, and resources • equip them to do the job • help them grow professionally to perform in a
new and different environment • create a workplace that is motivating,
challenging and free from fearchallenging, and free from fear
You are also the "internal customer" of your staff. You rely on them to do their jobs, so that you can do your job.
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External Customers
CUSTOMER SERVICE
Process Relationship
Individuals who ultimately use the products and/or y pservices of an organization. They are the beginning and end of your major work.
This includes• patients• Medicare• Medicaid• insurance companies• Federal government
Review changes made in the Affordable Care Act (ACA) for changes affecting lab performance requirements.
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1. Take a few moments and list your external and internal "customers" and
Off-line Activity
Customer ServiceLEARNING ACTIVITYLEARNING ACTIVITY
y"stakeholders".
• What do they expect and need from you? • What are you currently offering them?
2. List those people and units upon whom you rely as a customer. • What do you expect and need from them? • What are you currently receiving from them? • How might you initiate a dialog to bridge any expectations?
3 H d thi k thi ill h ith th Aff d bl C A t (ACA)?3. How do you think this will change with the Affordable Care Act (ACA)?
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An intrinsic part of a supervisor’s and manager's
Creative Problem-solving
job is to solve problems.
Being outstanding at successfully controlling, planning, organization, staffing and directing will help will help reduce the number and severity of problems in you laboratory unit.
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It's important to view problem-solving NOT as an interruption, but as part of your job.
Creative problem-solving involves
Creative Problem-solving
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• Paying attention and monitoring your unit's activities
• Recognizing problems in their early stages
• Adapting to a variety of supervisory situations
• Thinking out of the box; creatively
• Using deductive logic to figure out the exact source and nature of the problems
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1 2 3
Problem-solving Steps
PROBLEM -SOLVING
A supervisor or manager must think out of the box, creatively and use deductive logic to figure out the exact source and nature of the problems¹.
Define the problem
Determine the cause
Establish new
objectives
Establish alternatives
Make a decision
Implement action plan
456
Click on each step in the process to view its outcome
Monitorresults
7
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This method is widely used and required by most
PROBLEM -SOLVING
Root Cause Analysis
states to determine causes of errors and develop corrective actions.
For many processes, there is a definite progression of actions and consequences leading to completion or failure.
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Root Cause Analysis
PROBLEM -SOLVING
Target your solution to the cause of a problem, not just the symptom. Analyze a situation for its "root cause“.
Administration insists on providing
outreach lab service
Collection
No clear line of responsibility in receiving specimens
Specimen is lost
PLO ‐ Lost Business
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Specimen tracking
system not in place
of specimens occurs
PLO confidence
lost
Lost Business Opportunity:Reference lab account lost
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Root Cause Analysis
PROBLEM -SOLVING
Once the cause tree is completed and checked for logical flow, the team determines what changes to make to prevent the sequence of causes and consequences from occurring again.
Administration insists on providing
outreach lab service
Collection
No clear line of responsibility in receiving specimens
Specimen is lost
PLO ‐ Lost Business Specimen tracking
system not in place
of specimens occurs
PLO confidence
lost
os us essOpportunity:Reference lab account lost
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Root Cause Analysis
PROBLEM -SOLVING
Once the cause tree is completed and checked for logical flow, the team determines what changes to make to prevent the sequence of causes and consequences from occurring again.
Administration insists on providing
outreach lab service
Collection
No clear line of responsibility in receiving specimens
Specimen is lost
PLO ‐ Lost Business Specimen tracking
system not in place
of specimens occurs
PLO confidence
lost
os us essOpportunity:Reference lab account lost
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Root Cause Analysis
LEARNING ACTIVITY
Click on a possible cause(s) for the final failure
Test assay performed
QC drift on the QC drift in
False positive test result issued
Critical value
noted by the staff
Critical value
called to
Patient undergoes unnecessary
control charts
the assay not acted upon
called to the
physician
unnecessary procedure
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Root Cause Analysis
LEARNING ACTIVITY
How might this root cause be prevented in the future?
LEARNING ACTIVITY
prevented in the future?
<Click here to enter a response>
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Submit
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PROBLEM-SOLVINGIshikawa Diagram
This is a visualization and knowledge organization tool designed to collect ideas in a systematic way to facilitate the diagnosis of the problem.
Use brainstorming to determine 3 to 6 main categories that encompass all possible influences
Specification continues as long as the problem areas can be further subdividedfurther subdivided
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PROBLEM-SOLVINGIshikawa Diagram
This is a visualization and knowledge organization tool designed to collect ideas in a systematic way to facilitate the diagnosis of the problem.
The key is to have three to six main categories that encompass all possible influences
Brainstorming is done to add more possible causes to each category on the bone
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Use these steps to construct a Ishikawa Diagram
PROBLEM-SOLVINGIshikawa Diagram
Place the main problem or process under
investigation in a box on the right
Have the team generate potential variables that
are related to the problem or process
Use an affinity diagram to sort the process
variables into naturally related groups
1 2 3
Place positive or negative factors affecting
each variable on theCombine each bone until
process variable is ifi bl d
Determine actions to solve problem based on the likely
i bl d it
4 5 6
each variable on the appropriate bones of the
diagramspecific, measurable, and
controllablecause: variable and its
related factors
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LEARNING ACTIVITYIshikawa Diagram
Fill in the Blanks
LEARNING ACTIVITY
Physician orders sepsis panel and waits on results
Critical value delayed in reporting
<enter a response here>
<enter a response here>
Patient dies in ERHospital in the news: Sentinel
event Specimen sits while patient treatment is delayed
Turn around time is affected causing a reverberation in ER
No one is processing order
response here>
< t
here>
Submit
Shift Change:overtime not approved for laboratory night staff
Pending report of patient not read
<enter a response here>
<enter a response here>
Click inside each of the boxes to enter your response.
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LEARNING ACTIVITYIshikawa Diagram
Fill in the Blanks
LEARNING ACTIVITY
Physician orders sepsis panel and waits on results
P l Implement
Critical value delayed in reporting
Patient dies in ER.Hospital is in the news: Sentinel
event
Panels are assigned rather than individual tests
pimmediate testing at the Point of care
Specimen sits while patient treatment is delayed
Turn around time is affected causing a reverberation in ER
No one is processing order
Specify as a
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Shift Change:overtime not approved for laboratory night staff
Pending report of patient not read
Provide a minimum staff number for the amount of work. Give supervisor authority to approve overtime without prior approval.
Specify as a STAT test rather than routine test
k10
Brainstorming helps to develop as many creative solution options as possible and by pushing the ideas as far as possible.
PROBLEM-SOLVINGBrainstorming
Best PracticesBest Practices• Leader defines the problem and any criteria that must be met
• Participants should be knowledgeable about the problem, preferably from a wide range of disciplines and experience
• Participants identify any and all options focusing on creativity and number
• Capture all ideas in some way that is visible to all
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• NO criticism! Open up possibilities and break down preconceptions about the limits.
• Evaluate all ideas at the conclusion of session
Slide 53
k10 Need 2-4 sentences for feedback explaining a possible solution for each cause.karisam, 4/12/2013
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LEARNING ACTIVITYBrainstorming
Respond to the following multiple choice question
Why is it important to have participants from a wide range of disciplines and experience when holding a brainstorming session?
LEARNING ACTIVITY
o Participants will be more likely to eliminate potential solutions that will not work right away based on their experience
o The more varied the experience and knowledge of participants, the more likely you will find the right solution
o Participants will be more likely produce answers that a smaller group may not think of
o It is better to keep participants to a select gro p so that there are no distractionso It is better to keep participants to a select group so that there are no distractions from the focus of your discussion.
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LEARNING ACTIVITYSelf-assessment
Self-assessment
• Can help to determine where your strengths and weaknesses in management are
• Your weaknesses present an opportunity for you to improve
• Addressing these areas will ensure that you are more successful as a manager
Select this button to access the self-assessment required for completing this course Self‐assessment
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1‐ Vetter LP. A laboratory management primer. Lab Medicine. 2006; 37 (7): 397‐404.
Reference
You have successfully completed the online learning course:
The Laboratory Manager/Supervisor: Roles, Responsibilities and Expectations
CONCLUSIONCompletion Requirements
, p p
Credit 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 these best practices on the job? You can download LMU Educational Tools and Resources from your Learning Plan in LMU.
Please join the discussion in the Lab Management University online communities of practice. The more you participate and share, the more everyone can benefit including you and your team.
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